What is depression?

It is well documented that depression is now the most common illness in the world, the leading cause of disability worldwide and the major contributor to the global burden of disease.  Globally around 300 million people suffer from depression.

The Oxford English Dictionary defines depression as “a mental condition characterised by feelings of severe despondency and dejection, typically also with feelings of inadequacy and guilt, often accompanied by lack of energy and disturbance of appetite and sleep”. 

Clinical depression can result from a complex interrelationship between social, psychological and biological factors.  It is a medical condition with a recent Edinburgh University study of over 3,000 people suggesting the brain is altered, interrupting emotional processing and thinking skills.
 
There is no one factor, however, frequently depression occurs when an individual has suffered an adverse life event, which has caused chronic or traumatic stress. The most common being:

• High demands – for example raising children or extreme workloads

• Change of circumstances – for example moving home, getting married, changing jobs, losing a loved one.

• Loss of control – for example incarceration, being bullied, redundancy or severe injury

• Uncertainties – for example fear of the unknown

These will be different person to person, but one common factor is the disruption of normal coping mechanisms.
 
 Depending on the number and severity of symptoms, a depressive episode can be categorised as mild, moderate or severe.
 
Only those qualified can diagnose depression.  Counsellors for example, while trained to support individuals are not commonly diagnosticians.  A GP may take blood tests to rule out other medical conditions such as an under active thyroid, which can present with similar physical symptoms.  A GP will generally encourage seeking self-help in the first instance as frequently the symptoms of depression can be improved small lifestyle changes.
 
In more serious cases, a GP may recommend talking to a counsellor and in the most severe case may prescribe medication in the form of antidepressants.

There are numerous physical symptoms associated with depression, however it is important to note that the symptoms described below can be also seen in other medical conditions.
 
 Physical symptoms include:
 • Changes in appetite or weight
 • Constipation
 • Unexplained aches and pains
 • Lack of energy
 • Loss of libido
 • Disturbed sleep
 
Having only physical symptoms does not necessarily indicate depression, however when linked to the most common psychological symptoms, there is further evidence to suggest that depression could be diagnosed.
 
 Common psychological symptoms include:
 • Continuous low mood, sadness and feeling hopeless or helpless
 • Low self-esteem
 • Feeling tearful, guilt ridden and intolerant of others
 • Lack of motivation for everyday life
 • Difficulty making decisions
 • Not getting enjoyment out of life
 • Feeling anxious
 • Having suicidal thoughts or thoughts of self-harm
 
 An individual is unlikely to have all of the physical and psychological symptoms described and symptoms can vary between individuals and on a day to day basis.
 
The Beck Depression Inventory was created by Aaron T Beck, a leading American psychiatrist who is professor emeritus in the department of psychiatry at the University of Pennsylvania.  It is a multiple-choice questionnaire which seeks to determine the severity of depression in an individual.  It is widely used by health professionals.