"Depression" is generally used to describe varying degrees of mood, from sometimes feeling fed up with low spirits to a debilitating problem the disrupts everyday life. It is the latter that causes so much torture, that we can't function in daily living and needs urgent treatment whether it be in the form of medication or counselling. But depression doesn't just cause feelings of sadness and hopelessness and symtoms such as insomnia and loss of appetite. It affects everything you do in your daily life - doctors call this 'social functioning'. This means how you cope with everyday activities - work, looking after the children, relationships with your family and friends, paying the bills, housework, shopping, travelling on public transport and so on.

There are a number of key symptoms, low mood, loss of interest and pleasure, feelings of worthlessness and guilt, tearfulness, poor concentration, reduced energy, reduced or increased appetite, sleep problems and anxiety. Others sometimes perceive you as being lazy or difficult, something that you will just snap out of, this is not the case and if untreated can become a severe problem interfering with your ability to function at all. Also no two people have the exact same symptoms. When you are depressed, you are often unable to do many of the things you normally take for granted. Some people feel completely lethargic - others feel agitated and the agitation and sleeplessness can leave them feeling exhausted. You may have so little energy that you can't shop or cook - even going upstairs feels like climbing a mountain. Contact with other people is important to make us feel good. Yet when you become depressed, you may start to withdraw from other people. This can be one of the earliest signs of depression. You start avoiding your friends and relatives and don't enjoy being with other people any more. You may lose interest in how you look. Organising yourself to pay the household bills, clean the house or take the car to be serviced may become difficult. Everyday tasks such as taking the kids to the park or helping them with their homework may suffer. You may feel as though there is no point to anything any more. You feel cut off from your partner and children, and isolated and rejected by everybody.

Anyone can get depressed, considering 1 in 4 people suffer from mental illness at any one time, about 1 in 20 will suffer from severe depression and another 1 in 20 are mildy affected and even more have some of the sypmtoms. Men and women suffer depression the same, but men are more reluctant to seek help with it dismissing it as maybe to do with work or they see it as a sign of weakness, which is why women see there doctors more than men. This is reflected in the high suicide rates of young men, depression left can become so severe that suicide is a real possibility. Many life circumstances make people unhappy, bereavement, problems with money, jobs, relationships and physical illness, but it can also come out of the blue, everything for you could be going well, then suddenely you feel so low, and this is difficult because you can't see where it came from and you feel you shouldn't be suffering this way.

SAD - Some people develop depression as a result of the days becoming darker, the night drawing in. People report that using a "light box" is helpful along with antidepressants.
PND - Post-natal depression is distressing and very disabling affecting about 1 in 4 mothers during the first year after their baby is born, feelings of guilt, inadequacy or fear about the baby, strong anxiety and an indifference towards your partner. When severe, feelings of hate towards your baby and thoughts of harming your baby or yourself, I saw one women on the ward that was like this and it was distressing to see.

There is no one answer to this one and professionals all have different opinions, personally it helped to write down my life history and reflect back, psychotherapy helped me enormously with this BUT I felt that medication was also of great help because it lifted me from thinking that my life was not worth living to being able to use psychotherapy productively and working on past issues. So a mixture of both, past life events and chemical imbalance in the brain. If medication works, which it does for about 80% of people, bearing in mind that the first choice of medication might not be the right one and that trying several different types will probably help, then there would'nt be such a big market for them.

Depression can happen to anyone, regardless of age. In children it is now becoming more recognised, and children themselves are more informed about depression. The way they express themselves is very different to adults, therefore parents need to understand what is going on with their children. Very young may become listless, clinging, lose their appetite and sleep badly. Children of school age my find they can't concentrate on work or play and my truant from school or steal. Withdrawing from friends and hobbies, changing eating habits, experimenting with drugs. Teenagers may become preoccupied with death and suicide and may attempt to harm themselves. Antidepressant drugs work just as well in children as the do in adults, but you must find out if there are any underlying issues that are making them unhappy, such as bullying, because the depression won't lift if these issues aren't resolved.

Depression in the elderely is very common, worries about retirement, physical illness, disability, bereavement, but bear in mind that a number of physical illnesses have "depression like" sypmtoms, for example loss of sleep or disturbed sleep may be associated with arthritis or heart disease. It can also work the other way round, doctors my focus on the physical ailments and not recognise the depression. Also remember that depression and dementia are very different and it is important they are correctly diagnosed.

Firstly be honest with yourself, look at your daily functioning and see if your unhappiness is interfering with your everyday life. The first step you should take is to see your doctor, 8 out of 10 people are treated my their doctor without the need for any further referrals. He/She my arrange for counselling and maybe medication my be of help. If you are so bad that you feel life is not worth living, the he/she will probably make an urgent appointment with a psychiatrist, who will again maybe prescribe medication and evaluate the need for psychotherapy. The last resort is to be in hospital, to keep you safe and stop you from harming yourself, again you will probably be prescribed medication, but be kept closely supervised on the ward, and only when your mood has lifted will other therapies be of use to you. One therapy that is becomine extremely popular is "cognitive behavioural therapy", which aims to modify the self-defeating thought patterns and overcome the lack of energy and motivation common in people with depression. Again this is only useful when your mood is better, because you will get more out of it. The good news is that these feelings won't last forever, though when you are depressed this may be hard to believe. Depression can be effectively treated, and when you have recovered you should regain your energy and start to enjoy life again.

There are things you can do to help yourself ease your depression

• Try to keep occupied, you might need to take some time off work, but this doesn't mean you have to get bored, as this will not help your depression, think of things you enjoy or used to enjoy, maybe ask your doctor to refer you to a day centre, this will give you the motivation to get up in the morning and go there to meet other people going through the same thing, and to learn new skills
• Exercise, keep fit, it will lift your mood and you'll sleep better at night. Relax, watch T.V or listen to the radio, if your concentration is not too bad read a good book, have a soak in the bath.
• Relaxation tapes can be useful, or join a class.
• Eat healthily, even if you're not hungry try and eat something you really enjoy.
• Don't drink too much alcohol, you may feel better for a few hours but the long term effects can make you feel much worse.
• Accept that you are not well, and that you are going through something that lots of people suffer from, and that you will get better. It just takes time, be patient.
• Try and find some self-help groups in your area, for those of you in the UK, Depression Alliance has groups all over the country run by people who have been through depression

If you do manage to carry on working, you can feel you are just 'going through the motions'. You may feel as though you can't think straight and have difficulty concentrating or making decisions, and your work performance could suffer. Many people are wary of letting their employers know they are suffering from depression and use some other term such as 'feeling under the weather'. You are the best judge of what is the right approach in your situation. If you are extremely lucky you may have the kind of job in which you can arrange a lighter workload for a while, perhaps arrange to do some work at home for a few days, or take some holiday at short notice. But if the worst comes to the worst and you simply can't face work at all, then accept the fact that you need time away from work, for the sake of your health.

When you are depressed, you are likely to find yourself becoming distant from the very people who love you most. Your family will be finding your problems difficult too, although you may not be thinking much about their feelings at the moment, because you can barely cope with your own. People who are depressed tend to be negative about any suggestions or attempts to help - which can leave their partner, parents or children feeling that whatever they do is wrong. Depressed people often lost interest in sex too, something else which makes their partner feel rejected. Children find it hard to understand why a parent seems cold and unresponsive, why he or she isn't interested in listening to them read or playing with them and won't take them to school or even cook a meal any more. There's no easy answer. Do what you can. If you can't face a trip to the park with your child, snuggling on the sofa while you watch a television programme together is better than nothing - it's something you can do together, and a cuddle could comfort both of you. At times when you are feeling slightly better you could try to reassure your partner that he or she is still loved and appreciated, and that it is your illness which is making you behave this way. Perhaps your partner could come with you on your next visit to your GP, so the doctor can offer some reasurrance and explain how depression affects people's behaviour.

Sometimes people with depression don't get better with the treatments I've mentioned and ECT if offered, this is a very controversial topic, and I was offered it in the hospital, but opted for a new antidepressant instead. Usually two treatments a week for 3 to 6 weeks is offered, some say it helped them very much whilst others report long lasting disabling effects like memory loss. This treatment needs to be discussed fully with your doctor, personally I would persevere with medications until you find the right one, if not then use it as a last resort.