What is depression?

Depression is a word which has found its way into everyday use as a way of expressing being down after a bad day or describing a reaction to bad news. However, this should not minimise the seriousness of clinical depressive illness. Depression is the predominant mental health problem worldwide and the second leading cause of disability globally. At any one time, over 3 in 100 people over the age of 16 in England are suffering with depression.

Symptoms of depression

Symptoms of a depressive episode must have been present for at least two weeks in order to make a diagnosis. The core features of depressive illness are low mood, tiredness and loss of ability to enjoy previously pleasurable things. There are some additional symptoms, such as poor sleep, poor appetite, poor concentration, loss of sexual interest and experiencing worse mood in the morning, which are also necessary to make the diagnosis. The severity of the illness depends on how many of these symptoms are present.

A depressive episode can occur as a single event, as part of a recurrent depressive illness or as part of bipolar disorder, when someone may previously have experienced an elated mood. It can also occur secondary to other conditions, for example, post-traumatic stress disorder.

Risk factors for depression

There are certain risk factors for depression, such as a similar illness in family members, early parental loss or childhood abuse, which are indicators of why someone might have developed a depressive illness but cannot be changed. It is common for an episode to be triggered by a significant life event. There are other risk factors, such as chemical abnormalities in the brain, persistent negative thinking and lack of social support, which maintain someone's depression if not tackled but which are capable of being changed and offer good targets for treatment.

Treatment for depression

Treatment will depend on the severity of the illness and an individual's circumstances. For mild depression, it is preferable to treat the symptoms with psychological therapy, such as cognitive-behavioural therapy, which aims to challenge the negative thoughts which can become the norm for people suffering with depression. For depressive illnesses which are more severe, other options include antidepressant medications, which are well established treatments and generally well tolerated by people who take them. It is recommended that these are taken for six to twelve months for the treatment of a depressive episode. It can also be helpful to look at other social factors which influence the development or maintenance of a depressive illness, such as employment or financial stresses.

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