By 2020 depression will be the second most debilitating disease, yet in many parts of the world depression is stigmatized, with many people refusing treatment for fear of social backlash. Even so, tremendous strides are being made in the study and treatment of depression, including a better understanding of its causes and how best to treat it.
In psychiatry, a major depressive episode refers to a clinical syndrome consisting of lowering of mood-tone (feelings of painful dejection), and loss of interest or pleasure in all, or almost all, activities, most of the time for a period of at least two weeks. It is experienced as a paralyzing listlessness, dejection and self-deprecation, as well as an overwhelming sense of hopelessness. It is a pathological state of conscious psychic suffering and guilt, accompanied by a marked reduction in the sense of personal values, and a diminution of mental, psychomotor, and even organic activity, unrelated to actual deficiency. As used by the layman, the word depression refers to the mood element, which in psychiatry would more appropriately be labelled dejection, sadness, gloominess, despair or despondency. Dysthymia is the state just below the threshold for major depression.
Researchers reported in 2001 that they had identified an area on human chromosome 1 that is linked with vulnerability to alcoholism as well as to emotional disorders, primarily depression. Depending on circumstances, the gene or genes may manifest themselves in either form. The study also showed that in many cases, the incidence of depression in individuals was secondary to alcoholism.
Research by the US Mental Health Foundation shows that one in four adults suffers from significant depression. Students are particularly likely to have this trouble, with 46 percent of male and 64 percent of female students significantly disturbed by depression.
Depression is costly; it is the number one cause of disability in the world. Studies on depression have produced alarming figures. A depressed person, for example, is four times more likely to suffer a heart attack than a non-depressed person is. If a depressed person does have a heart attack, he or she is four times more likely to die. Elderly people who are depressed, even mildly depressed, have a 24 percent increased risk of dying than non-depressed people. In some countries the likelihood that people born after 1955 will suffer a major depression at some point in life is more than three times greater than for their grandparents' generation. In the USA, for example, of Americans born before 1905, only 1% had suffered a depression by age 75; of those born since 1955, 6% had become depressed by age 24. Those under 40 are three times more likely to become severely depressed than are older groups. In 2000, it was estimated from surveys that 10% of Americans suffer from clinical depression; millions more were believed to suffer depressed mood that was not severe enough to earn a diagnosis but still interferes with their lives. Of an estimated 50,000-70,000 suicides in the USA each year, up to 60% occur among persons suffering from depression. Approximately 125,000 people in the USA are hospitalized each year with depression, a further 200,000 are treated by psychiatrists, and 4 to 8 million more are in need of help but do not realize it. More women than men are treated for depression, and the largest occupational group is homemakers.
In Florence, Italy, those born between 1945 and 1955 were beginning to show an increase in the rates of depression compared with previous generations by the age of 15. By the time they reached 30, their rate of depression was about 18%. In Beirut, this rise in depression understandably seemed to track political events, sharply rising during the years of the civil war and instability. Of 175,000 admissions to mental illness hospitals and psychiatric units in the UK in 1969, 66,000 were suffering from depression.
2. Depressed people are more likely to develop heart disease and twice as likely to have a heart attack as non-depressed people. Their chance of suffering further heart attacks is also higher than for happy people.
2. While some forms of depression are clearly a result of genetic vulnerability and brain abnormality, others might have their roots in evolutionary history. Depression may have developed as a useful response to situation in which a desired goal is unattainable. Depression may help a person to disengage from what has proved a hopeless effort.
3. Depression represents a plea for help, a strategy for manipulating others into providing resources, a signal of submission or yielding in a conflict, or a way to conserve an organism's energy and resources in hard times.