You might not know at all. In other words, some people are depressed without even knowing it. People show depression in different ways, depending on their biochemistry, age, upbringing, cultural background. With some people it is obvious, with others less so. Yet it is a serious problem. According to the World Health Organization (WHO), by 2020 depression will be the second cause of disability worldwide. It is currently ranked fourth.

What separates depression from feeling blue? If some unhappy circumstance comes our way, your boyfriend dumps you, you lose your job or miss out on a promotion, or you suffer the death of a loved one - we become unhappy. All of these are understandable sources of regret, sorrow, and lament. In some cases, they might trigger depression. But they are not depression. It is a natural part of life to go through bereavement. To have regrets. To feel sad. But when that sadness becomes a part of everything we do, and keeps us from enjoying life, it may, in fact, be depression.

Many of us associate depression with sadness or unhappiness. Less commonly known is that depression can, especially in children, show itself as irritability. Some express depression in a burst of activity, often followed by a devastating crash. In extreme cases this is called bipolar disorder, what used to be more descriptively known as manic depression. This is a form of major depression that can be crippling. Between the ecstatic highs and punishing lows is a very uncomfortable mix of the two. People in this energetic and depressed state are at a much higher risk for suicide. In a manic episode, a person may hear voices or see things. In the past, people in a manic state were often misdiagnosed as being schizophrenic.

Some people suffer through a kind of “living dead” depression. Everyone around this person knows something is terribly wrong. It is draining to be in a room with such a person. It is even more draining to be that person. These are what we call the vegetative symptoms of depression. It is what it sounds like, feeling like a vegetable. The person experiences a terrible lack of interest in things and people, difficulty getting out of bed in the morning, difficulty with sleep that can take a number of forms - sleeping round the clock, or having trouble getting to sleep, or waking up in the middle of the night.

How do I get treatment?

The good news is that depression is treatable. For some, psychotherapy is very effective in treating depression. For those with more serious depression, medication in conjunction with psychotherapy has been shown to be more effective than either treatment alone. Many different factors are considered in treating depression, your history of depression, family history of depression, severity and frequency of depressive episodes, as well as current life circumstances. But it is important to seek treatment. The current thinking is that untreated depression only worsens in severity, becomes entrenched, more difficult to treat. Treatment can mean the difference between suffering tremendously and getting on with one s life.

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