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Depression is much more than simple unhappiness. Clinical depression, sometimes called major depression, is a complex mood disorder caused by various factors, including genetic predisposition, personality, stress and brain chemistry. While it can suddenly go into remission, depression is not something that people can “get over” by their own effort.
Types of depression
Seasonal affective disorder: This type of depression is usually affected by the weather and time of the year.
Postpartum depression: This occurs in women, following the birth of a child. About 13 per cent of women will experience this type of depression.
Depression with psychosis: In some cases, depression may become so severe that a person loses touch with reality and experiences hallucinations (hearing voices or seeing people or objects that are not really there) or delusions (beliefs that have no basis in reality).
Dysthymia: This is a chronically low mood with moderate symptoms of depression.
The main symptom of depression is a sad, despairing mood that:
is present most days and lasts most of the day
lasts for more than two weeks
impairs the person’s performance at work, at school or in social relationships.
Other symptoms of depression include:
changes in appetite and weight
loss of interest in work, hobbies, people or sex
withdrawal from family members and friends
feeling useless, hopeless, excessively guilty, pessimistic or having low self-esteem
agitation or feeling slowed down
trouble concentrating, remembering and making decisions
crying easily, or feeling like crying but being not able to
thoughts of suicide (which should always be taken seriously)
a loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).
How does depression affect different populations?
Major depression can occur in 10 to 25 per cent of women—almost twice as many as men. Many hormonal factors may contribute to the increased rate of depression in women, particularly during times such as menstrual cycle changes, pregnancy and postpartum, miscarriage, pre-menopause and menopause.
Men with depression typically have a higher rate of feeling irritable, angry and discouraged. This can make it harder to recognize depression in men. The rate of completed suicide in men is four times that in women, although more women attempt suicide.
Some people have the mistaken idea that it is normal for older adults to feel depressed. Older adults often don't want to talk about feeling hopeless or sad or about losing interest in normally pleasurable activities or experiencing prolonged grief after a loss.
A child who is depressed may pretend to be sick, refuse to go to school, cling to a parent or worry that the parent may die. Older children may sulk, get into trouble at school, be negative or grouchy and feel misunderstood. Because normal behaviours vary from one childhood stage to another, it can be difficult to tell whether a child is going through a temporary “phase” or has depression.
Genetic or family history of depression, psychological or emotional vulnerability to depression, biological factors such as imbalances in brain chemistry and in the endocrine/immune systems, or a major stress in the person's life may play a part in the onset of depression.
Depressive symptoms may be:
the result of another illness that shares the same symptoms, such as lupus or hypothyroidism
a reaction to another illness, such as cancer or a heart attack
caused by an illness itself, such as a stroke, where neurological changes have occurred.
The most commonly used treatments are pharmacotherapy (medications), psychoeducation, psychotherapy and electroconvulsive therapy. These treatments may be used individually or in combination. Self-help organizations, run by clients of the mental health system and their families, can be an important part of treatment and recovery for people with depression and their families.
Clinical depression needs to be managed over a person's lifetime. Depression, like disorders such as diabetes, can be effectively managed and controlled by combining a healthy lifestyle and treatments. Watching for early warnings of relapse may also prevent a full depressive episode.
Adapted from Depressive Illness: An Information Guide © 1999, 2008 Centre for Addiction and Mental Health