Depression can be a feeling of hopelessness or despair. It may be accompanied by self-blame and low self-worth. Other symptoms may include feelings of pessimism, guilt, worthlessness and helplessness. Decreased energy, difficulty concentrating and loss of interest in pleasurable activities may be present. Symptoms may also include sleeping and weight issues – from insomnia to oversleeping, weight loss to weight gain. There may be restlessness, irritability and thoughts of death or suicide. Further, persistent physical symptoms may not respond to treatment, such as headaches, digestive disorders, and chronic pain.

Depressive symptoms can vary from barely perceptible to overwhelming; they can last for moments or a lifetime. Some people experience a few symptoms of depression, some many. Severity of symptoms also varies by individual and over time.

Different Types of Depression
In the United States, women are reported to experience depression about twice as often as men. Whether this reflects that women are actually more depressed or merely more likely to discuss their feelings than men, women experience depression differently. Many women face additional stressors, such as responsibilities at both work and home, single parenthood, and caring for children or aging parents. Hormonal factors may also contribute to depression in women – especially menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause.

Although men are less likely to admit to depression, and doctors less likely to suspect it, three to four million men in the United States report being affected by depression. Depression is typically expressed by men not as feelings of hopelessness and helplessness, but as irritability, anger, and discouragement. Men's depression can be masked by alcohol or drugs, or by more socially acceptable practices such as working excessively long hours. Encouragement and support from concerned family, friends, and co-workers can make a difference in understanding and accepting depression as a real problem that needs attention.

Depression is sometimes considered a normal part of aging when, in fact, more often older people feel satisfied with their lives. When an older individual does report depression, however, the symptoms described are usually physical. Although the elderly can be reluctant to discuss feelings of hopelessness, sadness, or prolonged grief, it is only by identifying and treating depression that health care professionals can help make the final years more enjoyable and fulfilling for the depressed elderly person, their family, and caretakers.

Symptoms for children and adolescents differ from adults and each other. A child, for example, may feign illness, refuse to go to school, cling to a parent, or worry excessively over a parent’s health and well being. Older children and adolescents may sulk, get into trouble at school, seem negative, grouchy, and angry, or express feeling misunderstood. It can be difficult to tell whether a child is just going through a temporary "phase" or suffering from depression. Open dialogue is a beginning. Even if the child or adolescent (or adult, for that matter) isn’t willing to say, ”I’m depressed and could really use some help,” feelings may be communicated very loudly through actions. Attentiveness can often mean more than hearing words.

Treatment
A good place to begin treatment is with a physical examination. Certain medications, as well as some medical conditions such as a viral infection, can cause the same symptoms as depression. A physician can rule out these possibilities through examination, interview, and lab tests.

If a physical cause for depression is ruled out, a psychologist or psychiatrist might perform a psychological evaluation. Quite possibly, antidepressants will be recommended. Medical treatment for depression should be carefully considered, however. While this means of treating depression has been helpful for some, it has been harmful for others. Side effects to antidepressants are commonly reported, and may include decreased libido, sexual dysfunction, sleep disturbances, and weight gain. Long-term effects are not clear, as the results of these drugs on our brain chemistry are not yet fully understood by the medical community, especially for children. As with any prescribed medication, it is important to do your own research. An Internet search can yield a wealth of valuable information to help with your decision. (If you or someone you know is taking antidepressants, note that sudden withdrawal can lead to dangerous physical reactions, including anxiety, depression, and suicidal feelings. It is best to withdraw from these drugs gradually and with the help on an experienced professional.)

Alternative herbal treatments are also available. St. John's Wort is an herb that has been used for centuries for medicinal purposes, including treatment of depression. SAMe and Ginkgo Biloba are also herbal treatments for depression. In addition, there are numerous homeopathic remedies. Consultation with a holistic practitioner or a physician open to alternative treatments may be very helpful.

It should be emphasized that depression is an emotional response. To be diagnosed, an individual must verbally acknowledge their symptoms to a professional. Depression is not diagnosed through blood tests or CAT scans. The notion of “chemical imbalances” is far from fact, and should be recognized as such. In cases where antidepressants are helpful, corresponding “talk” therapy will increase effectiveness of treatment.

Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help patients gain insight and resolve problems through verbal exchange with the therapist. Behavioral therapists help patients learn how to obtain more satisfaction and rewards through their own actions, and how to unlearn behavioral patterns that contribute to or result from a depression.

The most important thing anyone can do for the depressed person is to help him or her get appropriate help. This may involve encouragement to stay with treatment until symptoms begin to abate (several weeks). On occasion, it may require making an appointment and accompanying the person to a professional. It is also important to offer emotional support. This can involve understanding, patience, affection, and encouragement. Eventually, with treatment, most people do get better.