What is depression?

Depression is different to occasionally feeling down. It is feeling down and low and hopeless for weeks at a time. It interferes with daily living and normal routine and affects the sufferer and those close to them. There are degrees of depression, going from mild to moderate to severe. Generally the earlier you can recognise the symptoms of depression and make positive changes to counter it, the less likely it is to worsen.

Depression can come about in many different ways. Generally, it is accepted that social circumstances, specific incidents and/or individual thought patterns can contribute to someone becoming depressed.

What causes depression?

There are various sources of depression. Some symptoms of depression may be associated with physical illness (it often co-exists with serious long-term physical conditions such as chronic pain, diabetes or HIV/AIDS), so it is best to speak to a specialist (GP or psychiatrist) if you feel that you might be depressed.

Different sections of society may also be more susceptible to depression:

the rate of depression in women in the USA is up to 3 times that of men
depression in low income groups is around twice that of high income groups
there is a link between getting older and depression, partly due to a deteriorating ability to perform routine tasks.

Change of circumstances might be a precursor to depression: if you have gone through a recent divorce or lost your job, you may experience depression. You might also feel quite down if you are recently bereaved. There are some circumstances of death that may be highly distressing (eg: accident, suicide or murder). People who are bereaved under these circumstances may wish to seek expert help. During a time of grieving for someone who has died, our mood is likely to dip and we are likely to display some signs of depression. What we would expect is for our mood to lift once the grieving process is complete.

Depression can also occur as a result of a traumatic event, such as a car crash. Someone who has experienced such an incident, particularly if it was life threatening, might feel quite low. They may also become irritable and experience anxiety. The depression experienced here may be associated with what is known as Post Traumatic Stress Disorder (PTSD) rather than depression and may require a different strategy to help the person recover.

Other factors that are known to put people at higher risk of depression include losing a parent in childhood, childhood sexual abuse and domestic violence.

Some people are more resilient to depression through having good social networks, supportive family and friends and better access to things to lift their mood. How people respond to, and make sense of, their difficulties can also help keep their mood level. People who perceive they have control over a situation - and confidence in their own (or others') ability to sort it out - can be less likely to experience a drop in mood.

Case study

Meet John. John felt a bit down. He had been having a hard time recently at work. He had just been turned down for promotion for the second time. He really needed the money. Debts were mounting up. He didn’t feel he’d been extravagant recently, just that life seemed to be getting more expensive. And, of course, his car had just had a new clutch fitted. That cost some. Sometimes it seemed to him that life dealt everyone else a good hand and left him with the dross. He wondered what the point in it all was sometimes. He seemed to be living to work rather than the other way around. He had little time for doing the things he enjoyed any more, given the amount of overtime he was putting in. And he couldn’t be bothered anyway. Same as meeting up with the lads once a week. What was the point? Same old thing. Same old dross. Most nights now he was staying home. Too tired to go out. He’d get a meal on the way home – a takeaway or ready meal – and sit in front of the TV with a couple of beers. He’d put on a bit of weight but where was he going to get the time to go down the gym? And that costs more money. Anyway, who cares what he looks like? Who really cares what happens to him?

John is very likely depressed. His depression appears to be the result of a combination of circumstances: living on his own, having difficulty with money and not being in a worthwhile job. It would seem that he has low self-esteem, though it is difficult to tell if this is a result of the depression or predated it. Some people would argue that it is not what happens to us but how we respond to it that determines whether or not our mood drops and we get depressed. John also responds to his situation by stopping doing the things he used to enjoy such as socialising and going down the gym. So, his style of behaving towards and thinking about his situation might actually be making it worse.