5. Depression

Wednesday, 13 October, 1999, 17:16 GMT  BBC

Depression is a common mental illness which is estimated to affect up to one in five Britons at some point in their lifetime and to cost the UK about 8bn a year in medication, benefits and lost working days. It can strike at any age and the feelings of hopelessness and helplessness attached to it can make it difficult for people to carry out their normal activities. It can be more or less severe and symptoms are often varied, making it often hard to diagnose. It is thought that some individuals may be more prone to depression, whether because of life experiences, their body chemistry or genetically inherited conditions. Those who have suffered from depression include Sir Winston Churchill and Florence Nightingale.

What is depression?

Anyone can suffer from depression. The most common symptoms include:

         Feelings of helplessness and hopelessness

         Feeling useless, inadequate, bad

         A sense of self hatred, constant questioning of thoughts and actions and a constant need for reassurance

         Feeling vulnerable and being oversensitive to criticism

         Sense of guilt

         Loss of energy and the ability to concentrate and be motivated to do even the simplest tasks

         Harming oneself

         Sudden loss or gain in weight

         Sleep disruption or a need to sleep very long hours

         Agitation and restlessness

         Loss of libido

         Physical aches and pains


Most people only suffer two or three of these symptoms at any one time.

People with severe depression may also experience suicidal feelings, stop eating or drinking and suffer from delusions or hallucinations.

Many people who need treatment for depression suffer further bouts later in life.

Women are twice as likely to suffer from depression, but three times as many men commit suicide.

Experts say this could be because women are more likely to admit to depression because of the stigma attached to mental illness


Different types of depression

There are many different types of depression, including clinically diagnosed depression, manic depression and post-natal depression.

Manic depression is marked by extreme mood swings, between highs when a person experiences excessive energy and optimism and lows when they may feel total despair and lack of energy.

It is often treated with lithium or, in extreme cases, electro-convulsive therapy.

Post-natal depression can occur from about two weeks after the birth of a child to two years after and differs from the mood swings suffered by many in the first few days after the child is born.

Other forms of depression include Seasonal Affective Disorder which is thought to be associated with the approach of winter and may be linked to lack of sunlight.


Causes of depression

Depression can be caused by a combination of factors.

It often runs in families, suggesting a genetic component, but it may be triggered by stressful events.

Major depressive illness is usually linked to some form of chemical imbalance in the brain.

It is also thought that people with low self-esteem, a pessimistic outloook on life and difficulty coping with stress are more prone to depression.

Life events which may trigger depression include bereavement, chronic illness, relationship problems and financial difficulties.



In recent years, the market has been saturated by a range of new drugs called anti-depressants.

These include Prozac which is thought to correct chemical imbalances in the brain.

Other types of drugs may also be used to treat depression.

Many positive claims have been made for anti-depressants, but some patients experience bad side effects.

Other ways of treating depression include psychotherapy, which aims to uncover the reasons for depression and help the patient to find ways of overcoming them.

Self help groups may also offer people a forum for talking about their condition and sharing it with others so that they do not feel isolated and alone.

In extreme cases, a person with depression may need to be treated in hospital, for example, if they are threatening or have attempted to commit suicide.

If the person is deemed a risk to himself or others, he may have to be committed to hospital.

Besides psychotherapy and a course of anti-psychotic drugs, people in hospital may be offered or forced to undergo electro-convulsive therapy.

This involves applying electric currents to the brain. The treatment is controversial, but safety procedures have been improved in recent years.

Some psychiatrists are against its use, particularly without the patient's consent, but others believe it can be effective in dealing with life-threatening depression.


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