Jennifer Wright, Clinical Psychologist

A major depressive episode is a very confusing and debilitating illness, which can leave previously high functioning people floundering on the couch, feeling totally inadequate and unable to complete simple tasks.

Depression has been described as the common cold of mental disorders, and most people will be affected by the illness directly or indirectly. Depression and its diagnosis is very confusing - what is depression exactly and what makes it different from feeling low for a few days?

Feeling stressed and overwhelmed is common in today‚ fast-paced society. People are working longer hours, for less pay. So it is natural to not feel 100 per cent some days, although not entirely satisfactory.

What differentiates feeling down for a few days from depression is the severity and duration of the symptoms. Typically, for most depressive disorders, you will have felt some of those symptoms for more than two weeks. The symptoms will have caused you distress, and interfered with your ability to live your normal lifestyle. Depression has many forms - unipolar depression, biological depression, manic depression, seasonal affective disorder, post-natal depression and dysthymia to name a few.

A situational or reactive depression is a reaction to a crisis, whereas an endogenous depression is more long-term, and possibly has a genetic component.

Symptoms of Depression

Depression is characterised by a number of symptoms, including a persistent sad, anxious, or empty mood, and feelings of hopelessness or pessimism. People who are depressed often have feelings of guilt, worthlessness, and helplessness. They no longer take interest or pleasure in hobbies and activities that they previously enjoyed. Insomnia, early-morning waking, and oversleeping are common. Loss of appetite and/or weight (or overeating and weight gain), decreased energy, fatigue, and a constant feeling of being slowed down are common symptoms. People with severe depression can have thoughts of death or suicide, no matter how high functioning they might seem. They can be restless and irritable, and have difficulty concentrating, remembering, and making decisions. Sometimes they imagine persistent physical symptoms that do not respond to traditional treatments - such as headaches, digestive disorders, and chronic pain.

Depression is a severe disorder that can often go undetected in some people lives because it can develop over time. Depression doesn't necessarily strike at once and can be a gradual and barely discernible withdrawal from a previously full, active life. Or it can follow a significant event, such as the breakup of a long-term relationship, a divorce or family problems. Finding the cause of depression isn't as important as getting appropriate and effective treatment for it.

Grief after the death or loss of a loved one is not considered depression in the usual sense. A teenager experiencing mood swings is probably not clinically depressed. Depression usually strikes adults, and twice as many women as men. It is thought that men express their negative feelings in external ways that don't get always get diagnosed as depression. Men may spend more time and energy on an activity to the exclusion of all other activities, or may have difficulty controlling outbursts of rage or anger.

Treatment for Depression

Many people battle on needlessly, feeling as if they are in an ocean without a life raft, and no island in sight. Anti-depressants can be helpful, providing the life raft while people recover and re-orient themselves.

Simple changes like increasing cardiovascular exercise, nutritional improvements, slowing down and saying no can help to create a rapid improvement in mood.

Learning to meditate and stay mindful in the present moment is a simple technique that can be difficult for high achievers.
Research shows that psychological support helps people to recover from depression, enabling them to recognise old patterns that may have been appropriate when they were younger, but are no longer necessary. People might realise that they grew up feeling they had to please and take care of others, without learning how to care for themselves.

Therapy can help people develop more appropriate strategies. People can change their beliefs about themselves, and make lifestyle changes, to beat depression.