What is depression?
Depression is a medical illness of which there are several forms. Everyone feels down or low at point in life, but when the lows last for long periods and affect general functioning and behaviour, the person may be suffering from a Depressive Disorder.
Depression, which must be distinguished from sadness or “the blues”, is a fairly common and legitimate medical illness.
Everyone feels down or low at some stage, but when these lows last for long periods and affect general functioning and behaviour, the person may be suffering from a depressive disorder.
Although depression is defined as a disorder of mood, it affects more than just one’s mood and includes symptoms affecting the body (e.g. low energy, sexual dysfunction), thoughts (difficulty concentrating, indecisiveness) and feelings (depression, irritability).
Depression is a medical illness like high blood pressure, diabetes or heart problems and not a sign of personal weakness. Depression cannot be wished away and sufferers cannot simply pull themselves together.
However, with appropriate treatment (like psychotherapy and medication), 90% of sufferers will experience relief of symptoms, and up to 75% may recover fully.
Who is affected?
Depressive disorders are common and approximately 6-10% of the population will experience a depressive episode in any given year. More women than men are affected (2:1); with some estimating that as many as one in four women (25%) will experience an episode of depression during any given year. There is however, a possibility that depression in males is under-diagnosed because of the structuring of diagnostic criteria.
What we do know is that at least five times as many males commit suicide than women (although women attempt suicide more often). All races and socio-economic classes are affected equally, but it is possible that clinicians may under-diagnose depression and over-diagnose schizophrenia in patients from racial and cultural backgrounds different from their own.
The average age for a first diagnosed episode of major depression is about 40, while for bipolar disorder it is 30. Nearly 50% of patients have onset between the ages of 20-50. Depression can begin in childhood or in later life, but this is less common and tends to present differently in different age groups [e.g. childhood (2%)
presents with much apathy; adolescence (5%) have largely behavioural problems; and the elderly (25 - 50%) present mainly with physical complaints].
Depressive disorders are more likely in those individuals who are socially isolated and have no close interpersonal relationships, an uncertain work environment, are divorced or separated, or have experienced trauma or loss combined with these factors.
Reviewed by Zane Wilson, South African Depression and Anxiety Group (SADAG), March 2015.
(Previously reviewed by Dr Stefanie van Vuuren, Psychiatrist, MB ChB (Stell), M Med (Psig) (Stell), FC (Psych) SA, May 2011.