Depression is a common debilitating and under-recognised illness. Its emotional and economic impact is second only to that of cardiovascular disease in the number of productive days lost and the overall impact on society.
Depressed patients are not always readily recognised because they may present with different types of physical complains for which no medical cause can be found.
Depression is very common - one in five people become depressed at some point in their lives. Anyone can get low at times, but someone is said to be suffering from depression when these feelings donâ€™t go away quickly or become so bad they interfere with their everyday life.
Depression is associated with suicide. Approximately 60% of individuals suffering from a diagnosable mental health problem who commit suicide suffer from clinical depression.
Most people with depression will not have all the symptoms listed below, but most will have at least five or six.
feel unhappy most of the time (but may feel a little better in the evenings)
lose interest in life and can't enjoy anything
find it harder to make decisions
can't cope with things that you used to
feel utterly tired
feel restless and agitated
lose appetite and weight (some people find they do the reverse and put on weight)
take 1-2 hours to get off to sleep, and then wake up earlier than usual
lose interest in sex
lose your self-confidence
feel useless, inadequate and hopeless
avoid other people
feel worse at a particular time each day, usually in the morning
think of suicide.
You may not realise how depressed you are for a while, especially if it has come on gradually. You try to struggle on and may even start to blame yourself for being lazy or lacking willpower. It sometimes takes a friend or a partner to persuade you that there really is a problem which can be helped.
You may start to notice pains, constant headaches or sleeplessness. Physical symptoms like this can be the first sign of depression.
As with our everyday feelings of low mood, there will sometimes be an obvious reason for becoming depressed, sometimes not. It can be a disappointment, a frustration, or that you have lost something - or someone â€“ important to you. There is often more than one reason, and these will be different for different people. They include:
It is normal to feel depressed after a distressing event - bereavement, a divorce or losing a job. You may well spend a lot of timeÂ over the next few weeks or months thinking and talking about it. After a while you come to terms with what's happened. But you may get stuck in a depressed mood, which doesn't seem to lift.
If you are alone, have no friends around, are stressed, have other worries or are physically run down, you are more likely to become depressed.
Physical illnesses can affect the way the brain works and so cause depression. These include:
life-threatening illnesses like cancer and heart disease
long and/or painful illnesses, like arthritis
viral infections like 'flu' or glandular fever - particularly in younger people
hormonal problems, like an under-active thyroid.
Some of us seem to be more vulnerable to depression than others. This may be because of our genes, because of experiences early in our life, or both.
Regular heavy drinking makes you more likely to get depressed â€“ and, indeed, to kill yourself.
Women seem to get depressed more often than men.Â It may be that men are less likely to talk about their feelings and more likely to deal with them by drinking heavily or becoming aggressive. Women are more likely to have the double stress of having to work and look after children.
Depression can run in families. If you have one parent who has become severely depressed, you are about eight times more likely to become depressed yourself.
Once recognised, the depressive syndrome is eminently treatable with a number of effective medications and psychotherapies.