The first step towards overcoming depression is understanding it. What it is, how it works, and what it does to us. Feeling down from time to time is a normal part of life. But when emptiness and despair take hold and won’t go away, it may be depression.

An important part of understanding depression is getting a sense of what it is where it comes from and how it affects people. To many people, depression is a confusing and intense mental illness that, until it is personally experienced, is somewhat of a mystery. Compounding the barriers to understanding depression are a variety of myths about what depression is, or isn’t. Another question raised is why some people seem more susceptible to depression and others struggle with it for many years.

Anyone, regardless of age, gender, race, or socioeconomic status, can suffer from depression. A disease that affects millions of Americans each year, believed to be caused by an imbalance of certain chemicals in the brain, called neurotransmitters.

When a brain is functioning properly, it controls many parts of your body, such as movement and emotions. The brain contains huge numbers of nerve cells known as neurons and these neurons transmit messages through brain chemicals known as neurotransmitters. Neurotransmitters are responsible for regulating many activities such as sleep, eating and mood. When neurotransmitters are not working properly, communication is essentially altered and depression can result.

More than just the temporary “blues,” the lows of depression make it tough to function and enjoy life like you once did. Hobbies and friends don’t interest you like they used to; you’re exhausted all the time; and just getting through the day can be overwhelming. If you’re depressed, the usual feelings of sadness that we all experience temporarily remain for weeks, months and years. They can be so intense that daily life is affected. You can’t work normally, you don’t want to be with your family and friends, and you stop enjoying the things you usually do.

When you’re depressed, things may feel hopeless, but with help and support you can get better. The good news is that with the right treatment and support, most depressed people make a full recovery. It’s important to seek help from your GP if you think you may be depressed.

What causes depression?

The causes of depression are not always clear. Depression is an extremely complex disease. It occurs for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason.

As depression can have many causes which include:

· Psychological – this is where a stressful or upsetting life event causes a persistent low mood, low self-esteem and feelings of hopelessness about the future.

· Physical or chemical – depression is caused by changes in levels of chemicals in the brain. For example, your mood can change as hormone levels go up and down. This is often seen in women as it is associated with the menstrual cycle, pregnancy, miscarriage, childbirth and the menopause.

· Social – doing fewer activities or having fewer interests can cause depression, or may happen because of depression.

· Genetics. A family history of depression may increase the risk. It’s thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known

· Past physical, sexual, or emotional abuse can cause depression later in life.]

· Certain medications. For example, some drugs used to treat high blood pressure, such as beta-blockers or reserpine, can increase your risk of depression. Propranolol can occasionally cause depression.

· Ageing brain, as we age, our brain’s capacity reduces, while certain neurotransmitters (which influence mood state) can become perturbed.

What Are the Symptoms of Depression?

For major depression, you may experience five or more of the following for at least a two-week period:

· Persistent sadness, pessimism

· Feelings of guilt, worthlessness, helplessness or hopelessness

· Loss of interest or pleasure in usual activities, including sex

· Difficulty concentrating and complaints of poor memory

· Worsening of co-existing chronic disease, such as rheumatoid arthritis or diabetes

· Insomnia or oversleeping

· Weight gain or loss

· Fatigue, lack of energy

· Anxiety, agitation, irritability

· Thoughts of suicide or death

· Slow speech; slow movements

· Headache, stomachache, and digestive problems

In children and adolescents, symptoms of depression may include:

· Insomnia, fatigue, headache, stomachache, dizziness

· Apathy, social withdrawal, weight loss

· Drug abuse or alcohol abuse, a drop in school performance, difficulty concentrating

· Isolation from family and friends are less intense and fewer in number, but long-lasting.

· For dysthymia (minor, but long-term depression), symptoms

Depression and suicide

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain.

Warning signs of suicide with depression include:

* A sudden switch from being very sad to being very calm or appearing to be happy

* Always talking or thinking about death

* Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse

* having a “death wish,” tempting fate by taking risks that could lead to death, like driving through red lights

* losing interest in things one used to care about

* making comments about being hopeless, helpless, or worthless

* putting affairs in order, tying up loose ends, changing a will

* saying things like “It would be better if I wasn’t here” or “I want out”

* talking about suicide (killing one’s self)

* Visiting or calling people one cares about