What is it?
There are a few pointers. First, doctors don't consider depression to be 'clinical' - meaning an illness in need of treatment - unless symptoms have lasted for more than two weeks.
This kind of depression is caused by changed brain and body chemistry, which doesn't happen overnight. In fact, depression often comes on so slowly that many men have difficulty noticing the change.
What happens?
Although depression is technically a mental illness, many of the symptoms of depression are actually physical. Depressed people find it difficult to get to sleep, or to feel rested when they wake. Waking through the night, or waking far too early in the morning, is quite a strong sign of depression.
Depressed people have little energy, and they often find it difficult to motivate themselves to do anything. Appetite and interest in food diminishes, and many people lose weight. Aches and pains and a general physical malaise are also very common.
Thinking is affected too. For example, it can be difficult to concentrate, so that it's impossible to follow a TV programme all the way through. Everything seems an effort.
Even short newspaper articles are a struggle, and few depressed people can manage to read novels, even if this is something they used to enjoy. Memory also suffers, so that it's hard (for example) to remember phone numbers, and easy to forget important things at work.
Other, subtler, changes in thinking can be harder to spot. For example, people find that minor setbacks - things they would usually shrug off - seem devastating. Problems in one area generalise, so that they seem to affect every aspect of life.
Severe symptoms
In severe depression, people can feel that they're useless; that their lives are a waste of time; or that they must have been guilty of something terrible. A few people hear voices that aren't really there (hallucinations).
It's very common to feel you can't face the day, to wish you didn't have to wake up in the morning, or even to feel like ending it all. Suicidal thoughts like this are a frightening symptom. Fortunately, most people don't act on them.
Treatment
But there is some good news in all this despondency. Paradoxically, the worse depressive symptoms are, the more likely the sufferer is to get better with treatment. GPs are able to prescribe antidepressants, which aren't addictive, aren't usually sedating, and which begin to work in two to four weeks.
Psychological treatments such as counselling or cognitive behavioural therapy can be very effective, not only in healing depression, but also in preventing the illness from coming back. These 'talking treatments' work well alongside medicine.
Coping with suicidal thoughts
Thinking about suicide is one of the common symptoms of depression. These thoughts are 'the illness speaking': they aren't logical or sensible, and not how you'd usually think.
Thoughts of harming yourself can be hard to get rid of if you're on your own. Try to be with people (even if you're feeling rotten and not saying very much).
Confiding in someone about suicidal thoughts doesn't make it more likely that you'll act on them. If possible, try to let someone know how you feel. "I'm going through a rough patch" can be enough - you don't necessarily need to say more.
Try to distract yourself if the thoughts become too much: go for a walk, listen to music, or watch TV.
Make sure you avoid alcohol or drugs - although they can ease some of the tension, they also make it much more likely that you'll act impulsively, or will not be aware of what you're doing.
Depression News:
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