What is depression?

How do I get help for depression?

Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles, or an injured self-esteem.

When feelings of intense sadness, including feeling helpless, hopeless, and worthless, last for days to weeks and keep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression, a treatable medical condition.

What is depression?

Depression is a condition that is characterised by depressed mood, and/or a loss of pleasure or interest in activities, and other symptoms that affect everyday life and functioning, for more than two weeks. Symptoms include:

• A depressed mood during most of the day, particularly in the morning
• Fatigue or loss of energy almost every day
• Feelings of worthlessness or guilt almost every day
• Impaired concentration, indecisiveness
• Insomnia or hypersomnia (excessive sleeping) almost every day
• Markedly diminished interest or pleasure in almost all activities nearly every day, a condition called anhedonia that can be indicated by a subjective account or by observations of significant others
• Recurring thoughts of death or suicide (not just fearing death)
• A sense of restlessness known as psychomotor agitation, or being slowed down, retardation
• Significant weight loss or gain (a change of more than 5% of body weight in a month)

How long do these signs have to be present before they are diagnosed as depression?

With major or clinical depression, one of the key signs is either depressed mood or loss of interest. For a diagnosis of depression, these signs should be present most of the day either daily or nearly daily for at least two weeks. In addition, the depressive symptoms need to cause clinically significant distress or impairment. They cannot be due to the direct effects of a substance, for example, a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism. 

What are some common feelings associated with depression?

People with depressive illnesses do not all experience the same symptoms. How severe they are, how frequent, and how long they last will vary. It depends on the individual and their particular illness. Here are common symptoms people with depression experience:

• Difficulty concentrating, remembering details, and making decisions
• Fatigue and decreased energy
• Feelings of guilt, worthlessness, and/or helplessness
• Feelings of hopelessness and/or pessimism
• Insomnia, early morning wakefulness or excessive sleeping
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable, including sex
• No pleasure left in life any more
• Overeating or appetite loss
• Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• Persistent sad, anxious, or "empty" feelings
• Thoughts of suicide, suicide attempts

While these are common symptoms of depression, they may also occur in patterns. For example, a person may experience depression with mania or hypomania, a condition sometimes called manic depression. Or the symptoms may be seasonal as in the case of seasonal affective disorder.

There are several types of manic depression. People with bipolar II disorder have at least one episode of major depression and at least one hypomanic (mild elation or high) episode. People with bipolar I disorder have a history of at least one manic (extreme elation or high) episode, with or without past major depressive episodes. A patient with unipolar depression has major depression only but does not have hypomania or mania.