What is major depression?

Depression is a medical illness that affects the brain. It is a feeling of sadness or hopelessness, even when you have no reason to feel that way. It is the result of an imbalance of the neurotransmitter chemicals in your brain. The causes of depression are not clear: it can be inherited, related to emotional events, or even caused by medications.

To be diagnosed with major depression, you must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your own feelings or may be based on the observations of someone else. Some of these include: depressed mood most of the day, diminished interest or feeling no pleasure in all activities, significant weight loss, insomnia or increased desire to sleep nearly every day, restlessness or slowed behavior, fatigue or loss of energy, feelings of worthlessness, or excessive or inappropriate guilt, trouble making decisions, trouble concentrating, recurrent thoughts of death or suicide, or a suicide attempt.

Major depression is often precipitated by a loss, particularly one that engenders self-reproach or a diminution of self-esteem, depression is common following the death of a loved one, a miscarriage, the end of a relationship, or the termination of a job. People who have endured a major depressive episode describe the experience as a descent into the darkest recesses of one's consciousness, where the present is joyless, the past meaningless, and the future nonexistent. Nothing brings relief. Although they may recognize that they need help, they are often too enervated to seek it.