Illness or Medical Conditions: Serious diseases e.g. cancer, heart disease can lead to development of depression. A serious medical condition takes its toll physically, causing stress and weakness, as well as mentally. Depression can also be a side-effect of a medication used to treat another disorder.

Ø       Other Psychological Conditions: Eating disorders, schizophrenia, anxiety disorders, and substance abuse can all contribute to the development of depression.

Depression, age and gender

Women undergo many hormonal changes in their life and so are twice more likely to develop depression than men.  Puberty, menstruation, menopause, pregnancy and childbirth can all contribute to developing depression.

Although men are at a lesser risk of developing depression they are less likely to seek treatment when they do.  Men are also more likely to hide symptoms of depression with anger, violence, and substance abuse and, are four times more likely to kill themselves than women when they are depressed.

As one gets older and less physically active the risk of depression increases depression.  This is even more likely where people are living alone and having to deal with physical illness on their own.  In these cases, many seniors may be reluctant to seek help for depression as they fear their mental capacity will come into question, or some people may attribute the symptoms of depression to the normal aging process.

Mild depression and treatments

Mild depression means you may have some symptoms but you are still able to reasonably cope with normal activities.  For example still being able to do your normal job with some difficulty. A Doctor may suggest one or more of the following treatments:

Talking treatments (psychological treatments)

For some people talking through their feelings may be all that is needed. In some cases talking with a close relative or friend may be helpful.  Your Doctor may also talk things through with you or refer you to a counsellor. A brief course of cognitive behaviour therapy may also help.

Specific counselling

In some cases there is a particular problem that triggered the depression or making it is worse e.g. marital problems, bereavement etc.  It may be then helpful to have counselling that is directed at a specific area.  This may be done by a local agency or self-help group which deals with specific problems.  For example RELATE for marital problems or, a bereavement counsellor for those suffering bereavement.

Exercise programmes

In some cases, research has shown that exercise can ease symptoms of depression. A typical exercise programme would be three ‘formal’ sessions a week of moderate duration (45-60 minutes) for 10 to 12 weeks.  Aerobic exercises are considered best e.g. brisk walking, jogging, swimming, playing a vigorous team sport e.g. football or netball etc.  Ideally one should try to get into a habit of doing some sort of exercise on most days when not attending ‘formal’ sessions e.g. going for a walk each day.

Self-help programmes

There are a variety of information leaflets, books, and audio tapes that can help you to understand and deal with depression.  The best information is based on the principles of cognitive behaviour therapy. Guided self-help programmes require alot of motivation and effort and, some evidence suggest guided programmes are therefore better.  This is where; a doctor or nurse provides the materials and monitors your progress.

More recently, computer and internet-based cognitive behaviour therapy programmes have become available.

Antidepressant medicines

Antidepressants are not routinely recommended for mild depression unless in the following circumstances:

Ø       Other treatments have been tried but mild depression persists

Ø       A combination of mild depression and a physical illness

Ø       An episode of moderate or severe depression in the past

Moderate or severe depression and treatments

With moderate depression a person has many symptoms and finds it very difficult coping with their normal activities.  The case is even worse with severe depression. A doctor may in either situation suggest one or more of the following:

Antidepressants as first line treatment

These do not change ones circumstances but can often ease symptoms such as low mood, poor sleep, poor concentration etc which may help in the ability to function normally and enable a person to better deal with any problems or difficult situations.

It is common for some people to stop taking their medication after a week or so if they have seen no effect on their depression.  The effect of the antidepressants is not usually not seen for between 2-4 weeks so it is important not to stop taking the medication. Similarly, if the medication is working finish the course as prescribed.  It is normal to continue antidepressants for 6 months or more after symptoms have eased. Stopping treatment too early can lead to a return of depression.

There are several types of antidepressants each with varying benefits and side effects. If one does not suit you then a doctor can recommend another.  It is therefore important to tell your doctor if you are having any problems with an antidepressant.

About 5-7 in 10 people improve with moderate or severe depression improves within a few weeks of taking antidepressant treatment.