Depression (also called a depressive disorder or clinical depression) manifests mainly as persistent feelings of unhappiness, sadness, disinterest and lack of energy. It causes mental, physical and social problems. It is a treatable illness. It has nothing to do with weakness or character flaws. Depression is due to involuntary changes in the brain, as well as events that influence a person’s life.

Depression is not always perceived as an illness. Occasional feelings of downheartedness are natural and usually disappear after a while. People tend to hide or suppress such feelings until they pass, but, in some cases, the negative feelings continue to grow, while the sufferer continues to hope that it will just go away by itself. It then gradually manifests as full-blown depression. The longer this goes on, the more it impacts on the sufferer’s life and the more difficult it is to heal.

Many outsiders do not, or can not, detect when someone has depression. They misinterpret the person’s negative behaviour and become angry or frustrated with them. Sometimes the sufferer does not tell others how they feel, because they do not want to be a burden, or because the depression, by its very nature, makes them unwilling to talk. The end result is that the sufferer receives no help and slips deeper into uncontrollable depression.

In many cases, the symptoms can be relieved with antidepressant medication. However, these medications have side effects. The problem is that the medication starts showing results only after several days or weeks of treatment, while the uncomfortable side effects exist from the beginning. Because of this, people sometimes stop taking their medication before it has a chance to work.

Another problem is that different antidepressant products affect different people in different ways, even though, on the surface, they seem identical. If the first brand that someone tries, has severe side effects, it is usually not replaced with another brand – instead of trying other products, the user simply discards the entire idea of using antidepressants.

Depression is often dampened by abusing alcohol, drugs or working overtime. These offer only short gasps of relief. After each session, the problem returns with an increased vengeance, plus the escape mechanisms burden you with extra ailments. (As a side note: Outsiders often blame things like alcohol abuse for the depression, but it is always highly debatable what came first).

In mild to moderate cases, it may help to confide in someone you trust and to attend social events, rather than isolating yourself. Sometimes just talking about it or being out and about will help. Exercise, a good diet and specialised relaxation techniques also help. Unfortunately, the intrinsic nature of depression makes many sufferers unwilling to indulge in these activities.

Depression makes no distinction. It can strike anybody, anywhere, at any time. People who have an episode of depression are at high risk of relapsing (getting it again) unless they receive specialist preventive treatment.

The most effective treatment for depression is a combination of medication and psychotherapy. Medication helps the symptoms. Psychotherapy accelerates recovery, restores all-round wellbeing and lays a good long-term foundation to prevent relapses. Early counselling is the best precaution against the progressive development of more severe depression.

Depression results from physical illness, lack of sleep, poor diet, drugs or alcohol, anxiety, stress, loneliness, insecurity, disappointment, isolation, melancholy, nostalgia, trauma and lack of social support. Other contributors are hormone imbalances, poor metabolism, genetic inheritance, under-exposure to sunlight and seasonal effects. In most cases, it happens in reaction to something, but it can be spontaneous (without apparent cause).

A big problem is that depression is underestimated. We all feel “down” at times and we are used to these temporary dips, but depression can sneakily grow while we wait for the dip to subside. Also, other people often misunderstand someone’s behaviour and fail to help them. Lastly, the word depression is often abused nowadays, so it has become an easily ignored item. As a result, only half of affected people go for timeous counselling. That is why so many suffer such serious consequences.

There are distinctions between different forms of depression. The main forms are subdivided into a number of specific types and there are also some special conditions. It requires professional analysis to define the exact type of depression that a person has, but here are some of the predominant expressions one hears:

Mild depression: The symptoms are troubling and you don’t feel like doing things, but you get through the day without noteworthy social or work problems. Usually occurs in reaction to events, circumstances or illness.

Moderate depression: You still function, but the symptoms cause big problems in both your social and working life. It takes a big effort to maintain yourself and to perform daily activities. Usually occurs in reaction to events, circumstances or illness, but can happen without apparent reason.

Major depression: Multiple, very severe symptoms. You can not function socially or at work. You stop performing daily chores and you neglect yourself. Usually occurs in reaction to events, circumstances or illness, but can be spontaneous (without apparent reason).

Endogenous Depression: Used to be a disorder of its’ own, but now classified under major depression. Has no apparent cause, reason or “trigger”. Is present even when the person’s general circumstances are pleasant. It simmers persistently over a very long period of time. The person fluctuates between mild, moderate and severe episodes of depression.

Dysthymia: A milder depression that lasts for a very long time (about two years), with the person feeling better for periods of time (usually less than two months). Some people may have periodic episodes of more severe depression on top of the prolonged depression (“dual depression”).

Postpartum depression: Affects some women shortly after childbirth, due to dramatic hormonal changes and other stressors. Symptoms are generally the same as for other depressions, except that the mother may also have trouble “connecting” with her baby.

Perinatal depression: Very much like postpartum depression, but affects women both before and after the birth of a baby.

Geriatric depression: Affects older adults. Mostly negative emotions about things that come with age, such as chronic pain, illness, loneliness and nostalgia. Of course, they can also be affected by all the things that trigger depression in other people.

Teenage depression: Young people are, in many respects, more vulnerable than older people and have more a pronounced tendency to run away or to commit self-harm.

Psychotic depression: This is when a depressed person experiences delusions or hallucinations or paranoia. This involves seeing and hearing things that do not exist or believing that people are blaming them, watching them or stalking them. They may sincerely believe they are evil and the cause of bad things happening in their environment.

Bipolar depression: This is when a person experiences depression, but it fluctuates with extreme good moods. The main condition is actually known as bipolar disorder (manic-depressive illness), because it contains two conflicting disorders (depression and an excessive feeling of wellbeing) afflicting the same person.

Seasonal Affective Disorder: Individuals experience symptoms characteristic of depression, however, these symptoms typically occur during winter months where biochemical imbalances in the brain are thought to be triggered by shorter daylight hours and less sunlight.

Symptoms depend on the type and stage of depression, but these are most common:

• Sadness, unhappiness, hopelessness
• Disinterest, isolation, self-neglect, feeling tired or listless
• Guilt, self-blame, anger, irritability, frustration
• Restlessness, worrying, appetite loss
• Sleep problems (too much or too little)
• Poor self-confidence, poor self-esteem
• Problems at work or school
• Drug or alcohol abuse
• Self-harm, thoughts of death or suicide

Depression can affect anybody at any time. It is not a character flaw but a chemical or emotional imbalance that needs the right guidance care. Underestimating it or applying self-diagnosis is risky and can delay the personal recovery process. If you think you struggling with depression symptoms, it is important to talk to a professional who can advise appropriate action. Seeking timeous advice, and early intervention if necessary, is the best solution.

There are various types of depression, as well as personalised mental health solutions. The precise diagnosis and treatment can be determined after we are able to best understand the issues in play – The important thing to know is that depression is treatable, it may take some time to establish what routines and care will work. Medication and personalised psychotherapy, bolstered by preventive treatment, accelerate healing, restores all-round wellbeing, and reduces the risk of relapse.

Feel free to call the number at the top of this page for advice or a personal appointment with an experienced, registered counsellor. Recovery Direct rehab Johannesburg is a specialist centre based in Johannesburg that helps with a broad range of mental health and behaviour related issues.