Definition

All of us have gone through times in our lives when we were sad, and it is healthy to express our emotional responses to life events in this way. It becomes an illness when ‘feeling blue’, to use the popular expression, takes over our habitual mood and prevents us from leading a normal life. The symptoms are then persistent and intense and do not seem to improve over time. Depression is thus much more than occasionally feeling sad or simply ‘having the blues’.

Often, no precise event can explain the appearance and persistence of the symptoms.

Major depression

It is the constant, enduring sadness that we recognize first in a person who is depressed. He feels alone and desperate; no longer interested in family and friends, he feels isolated, tired, and cries easily.

Along with these external signs of depression comes guilt and low self-esteem. The depressed person may become very self-critical and accuse himself of every wrong; he feels quite guilty and consequently puts himself down and loses self-esteem. At times, he expresses thoughts of death and suicide. As well, sexual interest is often lowered or absent. There is a profound loss of interest in everything that interested him before. The depressed person no longer gets any pleasure from life.

A severely depressed person may experience an acute loss of appetite as well as substantial weight loss. He suffers from severe insomnia and from a general slowing down of all his activities. All daily activities required of him call for a superhuman effort – getting up, eating, even speaking seem to be beyond his capacities.

Secondary depression

Secondary depression, which is also characterized by a disproportionately depressed mood, generally occurs after a particularly painful experience.

Psychotic depression

This type of depression generally presents several characteristics of a major depression. It is differentiated by the intensity of certain symptoms and by the presence of psychotic characteristics.

Psychotic depression is recognized by false beliefs or by hearing voices. The person affected may be bombarded by thoughts that make him unjustifiably feel that he does not deserve to live; he feels guilty about being unworthy, or might feel persecuted. These feelings of unworthiness, guilt and persecution, while unfounded in reality, are so intense that suicide may seem the only solution.