Most people feel depressed occasionally. There is no question of their being mentally ill, though, if they continue with a daily routine and gradually recover. The difference between "feeling depressed" and having the mental illness known as depression is that people who are actually ill cannot lift themselves out of their misery. Their depression persists, deepens, and eventually interferes with their ability to lead normal lives. If you or others in your family have occasional periods of low spirits that disappear after a few days or weeks, you have no cause for concern. The symptoms of true depressive illness are described below. There are two main types of depressive illness. One type is caused by an extreme reaction to a specific emotional blow such as the death of someone you loved, the end of a marriage or love affair, or a financial loss. Neurotic people sometimes overreact to such misfortunes, and the result may be a depressive illness. The other type of depression usually occurs without apparent cause. It may result from hormonal changes after childbirth or may be associated with schizophrenia .

There are periods of particular susceptibility to depressive illness in almost everyone's lifetime. Late adolescence, middle age, and the years after retirement are such periods. Many people find the transition from adolescence to diseases adulthood difficult, especially when there are intense family conflicts or educational or work pressures. Loss of fertility or virility in middle age may seem like loss of sexuality, a loss that would trigger depression in many people. A person in late middle age may brood over the realization that he or she can advance no further in a career.

Depressive illness among elderly people is extremely common. This may be related to many factors, including the death of friends, the physical limitations of old age, and the realization that death is now in the foreseeable future.

Every severe depression is probably accompanied by a chemical change that affects the way the brain functions.

What are The Symptoms?

Symptoms of depressive illness include not only overriding melancholy but also physical changes. It is common for the depressed person to become unconcerned or apathetic about the outside world. He or she may also lose interest in or have trouble with eating, sleeping and sex. Sometimes indigestion, constipation and headaches appear. Some depressed people have severe psychological symptoms. They may lose touch with reality, may feel guilty and worthless without cause, may believe that they are being persecuted or that their bodies are rotting away, and may have hallucinations. Sometimes acute anxiety accompanies the depression, and the resultant restlessness and agitation may mask the more expected symptoms.

Intensity of symptoms often varies with the time of day. Typically, a depressed person wakes up early in a sad mood that brightens as the day progresses. But some people have the worst symptoms at night. As the illness progresses, depression may deepen until it never lifts. The person then becomes totally withdrawn, and may spend most of the time huddled in bed.

What are The Risks?

About 15 per cent of the population is likely to experience at least one period of depression severe enough to require medical help, though the symptoms may not be specifically identified as a depressive illness. Some types of depression tend to run in families.

The gravest risk of depression is suicide, the last resort of someone who finds life unbearable . In rare cases the illness can unbalance a person's mind so much that they feel forced to kill others as well as themselves, to spare them the agony of being alive. Although they are too common in all age groups including the young, depression and suicide are particular problems of the elderly, and sometimes depression can resemble and be confused with senility . This confusion is particularly unfortunate since depression is often reversible. Thus a depressed elderly person may be thought to have senile dementia and get no treatment for his or her depression.

What Should be Done?

If you recognize the symptoms of increasing depressive illness (not just a passing sadness) in yourself, see a physician now. Do not be ashamed to tell him or her about your fears. If you recognize the symptoms in other people, try to persuade them to accept medical help.

What is The Treatment?

Self-help: If you think a mild form of depression is lasting too long or beginning to deepen, a vacation, active sports, or a hobby may help you pull out of it. It may not be possible to do this, however, if you have a depressive illness, so if these measures fail, see your physician. If a member of your family seems to be severely depressed, try gentle but firm persuasion to get him or her to a doctor. Threats of suicide should be considered an emergency.

Professional help: Treatment depends on the type and severity of symptoms. If you go to your family physician with symptoms of depression, he or she may refer you to a specialist for treatment. Treatment may consist of medications, psychotherapy, or a combination of both. Antidepressants, which are often used in treatment of depression, can usually begin to relieve a mild case within two to three weeks. In severe cases, especially when there is a risk of suicide, the physician may advise hospitalization, because in a hospital your symptoms can be monitored, you can be prevented from harming yourself, and drug treatment and psychotherapy can be closely supervised. In rare cases of persistent illness, electroshock therapy (EST) may be recommended.

If you are treated in a mental hospital, the goal of treatment is not only to cure your depression but also to prepare you for a return to normal life.

What are The Long-Term Prospects?

People who have a depressive illness almost always respond well to treatment. Unfortunately, some types of depression tend to recur. Yet many people who have repeated attacks of depressive illness manage to function by getting treatment in the early stages of each attack.