Depression - Introduction

"Why don't you just pull yourself together?" It is really hard for non-sufferers to appreciate just what effect depression has on every aspect of a sufferer's life.

Twice as many women as men suffer from depression [Corbis].

A depressed state, including overwhelming feelings of sadness, worthlessness and pessimism, can last for weeks, months, even years. The feelings can lead to suicide, but even in mild cases of depression, sufferers lose their interest in food, socialising and other pleasures. They have trouble sleeping, and often become extremely hard to live with. So there is an impact on families, friends and workmates too.

Depression often runs in families and may be triggered by illness, stress or grief. More than one in five of us will have mild depression some time; women are twice as susceptible as men. Major depression, clinically known as unipolar disorder, hits 1 in 20 people at any one time in the UK, with an additional 1 in 50 people developing the mood swings of bipolar disorder (manic-depressive illness), which affects men and women equally.

All forms of depression tend to recur; indeed some psychiatrists describe depression as a chronic disease, like diabetes or asthma. Many people do not seek treatment but those who do have a range of treatment options from the selective serotonin reuptake inhibitors (SSRIs) through to electroconvulsive therapy. Psychotherapy, light therapy and relaxation techniques are other approaches that are being investigated as non-drug means of treating depression.

Types of depression

Vincent van Gogh suffered from bipolar disorder, which is often associated with creativity and genius.

Everyone feels a little down at times, but unipolar depression interferes with work, relaxation and enjoying oneself. Indicators include a persistent sad, anxious or empty mood, decreased energy, sleep disturbances and changes in eating patterns. The name unipolar depression indicates that the mood swing is towards a depressed state only. Dysthymia, a less severe form of unipolar depression, involves long-term feelings that do not necessarily disable sufferers but stop them feeling good about life. Other forms of unipolar depression include seasonal affective disorder and postnatal depression.

In bipolar disorder, patients experience cyclical mood swings. In the manic phase, they feel elated, and full of energy and grand schemes. In the depressive phase, they experience all the misery felt by patients with unipolar depression.

Depression can also be a secondary feature of other illnesses, such as heart disease or cancer. It can be serious enough to hinder recovery from the primary disorder.

Thanks are due to the following organisations and people: Dr Mark Tricklebank, Eli Lilly UK; Professor David Nutt, Director of the Psychopharmacology Unit, Faculty of Medicine and Dentistry, University of Bristol; Dr Clare Stanford, Reader in Experimental Psychopharmacology, University College London; the British Neuroscience Association.

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