Feelings of hopelessness, sadness and a loss of interest in life, paired with a sense of lessened emotional well-being. Many people experience these feelings from time to time, often as a normal response to an distressing event; for example, it is expected to feel depressed when a close relative dies. When a person’s physical state and behaviour are also affected, however, this is a sign that the symptom is part of a depressive illness.
Depression that arises without any clear cause, persists and deepens can occur as part of a range of psychiatric conditions. Certain people who suffer from depression are eventually diagnosed as having bipolar disorder, a condition that is characterised by episodes of depression alternating with mania (periods of a very excitable mood and uncontrolled behaviour).
Symptoms can differ with the seriousness of the condition. With a person suffering from mild depression, the main symptoms are anxiety and a variable mood; the person could also experience fits of crying that seem to occur for no reason. More severe depression can cause difficulty in sleeping, loss of appetite, tiredness, no interest in social activities and impaired concentration; movement and thinking can also become a lot slower. On the other hand, the opposite can occur and the person can become excessively anxious. People who are severely depressed can experience thoughts of worthlessness and committing suicide. Delusions and hallucinations can occur in extreme cases.
Usually, there is no single clear cause, and a variety of factors can be involved. Depression can be triggered by physical illnesses (for example, viral infection), by hormonal changes that follow after childbirth or by hormonal disorders (such as hypothyroidism). Particular drugs, such as oral contraceptives can contribute to the condition. Inheritance can play a big part in bipolar disorder. Certain people become depressed in winter (seasonal affective disorder syndrome) possibly in response to the long hours of darkness.
Aside from these causes, there are psychological and social factors that can play a role. Depression can also be related to the number of events or disturbing changes in a person’s life.
There are three main forms of treatment for depression, depending on the severity and type of illness.
Treatment often includes a form of psychotherapy, administered in a group or individually. This type of treatment is most useful for those whose life experience and personality are the main cause of their illness. Types of therapy range from counselling to help deal with practical problems to more structure approaches such as psychoanalysis or cognitive-behavioural therapy.
Anti-depressant drugs can be extremely effective; with seven to ten affected persons responding well to the first drug they are offered. Antidepressants are not addictive. Most drugs, however, do not start to take effect until roughly two weeks into treatment and all types need to be continues after the symptoms of depression have gone.
ECT (electroconvulsive therapy) is not generally used in the U.K, but it is still considered to be a successful treatment for those suffering from extreme depression and for whom other treatments have not helped. ECT can be lifesaving but can also cause side effects such as, mild temporary memory impairment.
Depression frequently recurs; up to three quarters of people whom have needed hospital treatment for depression will experience another episode within ten years. Yet, psychological therapies and long-term antidepressant medication can significantly reduce the risk of recurrence.
However despite the effectiveness of drug treatment, suicide it still a serious risk for those suffering from depression; nearly half of all deaths in people with recurrent depression are caused by suicide. This risk can, however be considerably reduced by maintenance treatment with ant depressive drugs.