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An Overview of Depression

Everyone feels "blue" at certain times during his or her life. In fact, transitory feelings of sadness or discouragement are perfectly normal, especially during particularly difficult times. But a person who cannot "snap out of it" or get over these feelings within two weeks may be suffering from the illness called depression.

Depression is one of the most common and treatable of all mental illnesses. In any six-month period, 9.4 million Americans (340 million people in the world) suffer from this disease. One in four women and one in 10 men can expect to develop it during their lifetime. No one is immune from depression - it occurs in people of all social classes, all countries and all cultural settings. Eighty to 90 percent of those who suffer from depression can be effectively treated, and nearly all people who receive treatment derive some benefit.

Unfortunately, many fail to recognize the illness and get the treatment that would alleviate their suffering. They or their loved ones fail to notice a pattern and instead may attribute the physical symptoms to "the flu," the sleeping and eating problems to "stress," and the emotional problems to lack of sleep or improper eating.

But if people looked at all of these symptoms together and noticed that they occur over long periods of time, they might recognize them as signs of depression.

What Is Depression?

The term "depression" can be confusing since it's often used to describe normal emotional reactions. At the same time, the illness may be hard to recognize because its symptoms may be so easily attributed to other causes. People tend to deny the existence of depression by saying things like, "She has a right to be depressed! Look at what she's gone through." This attitude fails to recognize that people can go through tremendous hardships and stress without developing depression, and that those who suffer from depression can and should seek treatment.

Nearly everyone suffering from depression has pervasive feelings of sadness. In addition, depressed people may feel helpless, hopeless, and irritable. You should seek professional help if you or someone you know has had four or more of the following symptoms continually or most of the time for more than two weeks:

• Noticeable change of appetite, with either significant weight loss not attributable to dieting or weight gain.
• Noticeable change in sleeping patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much.
• Loss of interest and pleasure in activities formerly enjoyed.
• Loss of energy, fatigue.
• Feelings of worthlessness.
• Persistent feelings of hopelessness.
• Feelings of inappropriate guilt.
• Inability to concentrate or think, indecisiveness.
• Recurring thoughts of death or suicide, wishing to die, or attempting suicide. (Note: People suffering this symptom should receive treatment immediately!)
• Melancholia (defined as overwhelming feelings of sadness and grief), accompanied by waking at least two hours earlier than normal in the morning, feeling more depressed in the morning, and moving significantly more slowly.
• Disturbed thinking, a symptom developed by some severely depressed persons. For example, severely depressed people sometimes have beliefs not based in reality about physical disease, sinfulness, or poverty.
• Physical symptoms, such as headaches or stomachaches.

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For many victims of depression, these mental and physical feelings seem to follow them night and day, appear to have no end, and are not alleviated by happy events or good news. Some people are so disabled by feelings of despair that they cannot even build up the energy to call a doctor. If someone else calls for them, they may refuse to go because they are so hopeless that they think there's no point to it.

Family, friends, and co-workers offer advice, help, and comfort. But over time, they become frustrated with victims of depression because their efforts are to no avail. The person won't follow advice, refuses help, and denies the comfort. But persistence can pay off.

Many doctors think depression is the illness that underlies the majority of suicides in our country. Suicide is the eighth leading cause of death in America; it is the third leading cause of death among people aged 15 to 24. Every day 15 people aged 15 to 24 kill themselves. One of the best strategies for preventing suicide is the early recognition and treatment of the depression.

Depression can appear at any age. Current research suggests that treatable depression is very prevalent among children and adolescents, especially among offspring of adults with depression. Depression can also strike late in life, and its symptoms--including memory impairment, slowed speech, and slowed movement--may be mistaken for those of senility or stroke.

Scientists think that more than half of the people who have had one episode of major depression will have another at some point in their lives. Some victims have episodes separated by several years and others suffer several episodes of the disorder over a short period. Between episodes, they can function normally. However, 20 to 35 percent of the victims suffer chronic depression that prevents them from maintaining a normal routine.

Sadness at the loss of a loved one or over a divorce is normal, but these losses can also be the trigger for a depressive episode. In fact, most major environmental changes can trigger depression. Job promotions, moves to new areas, changes in living space--all can bring on depressive illness. New mothers sometimes suffer with post partum depression. Birth brings dramatic changes to both their environments and bodies--a combination that can trigger a downward swing in mood. Depression also afflicts many poor single working mothers of young children. These women live with loneliness, financial stress, and the unrelieved pressure of rearing children and maintaining a household without another's help.

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