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What is it?
What does being 'depressed' really mean? When is being down is a sign of illness, rather than normal sadness, frustration, anger or stress? There are a few pointers. Firstly, 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 people have difficulty noticing the change.

What happens?
No two people experience depression in the same way. Symptoms may vary in severity and intensity. If you have five or more of the following symptoms for at least two weeks, you may be depressed.

- Depressed or irritable mood most of the day
- Loss of interest or pleasure in all or almost all usual activities
- Change in appetite or significant change in weight
- Change in sleep pattern (including sleeping too much or not being able to sleep)
- Unusual agitation, restlessness, or slowing down of motor skills
- Loss of energy; fatigue
- Feelings of worthlessness, hopelessness, or guilt
- Slowed thinking, indecisiveness, or impaired concentration
- Recurrent thoughts of death or suicide; wishing to die or attempting suicide

Severe symptoms
In severe depression, people can feel that they are 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.

Can I stop it?
For mild-to-moderate depression, non-drug therapies may be sufficient, but many people also need antidepressant medications. The two often work best together.

Have More Fun: In mild depression, this often helps. "Happiness requires action," says psychologist Jennifer James, Ph.D., author of Women and the Blues. Try not to mope. Visit a friend. Have a massage. Get a pet. Redecorate. Take a class. Take a vacation. If nothing feels fun, do things you used to enjoy.

Exercise: A tremendous amount of research shows that exercise--particularly strenuous aerobic exercise--elevates mood, relieves anxiety, improves appetite, sleep, sexual interest and functioning, and self-esteem. Studies show that it also helps normalize the chemical imbalances in the brain linked to depression

Treatment
There is some good news in all this despondency. Paradoxically, the worse depressive symptoms are, the more likely they are to get better with treatment. GP’s are able to prescribe antidepressants, that are not addictive, are not usually sedating, and which begin to work in 2-4 weeks.

Psychological treatments like counse lling 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 are not logical or sensible, and not how you'd usually think.

Thoughts of harming yourself can be hard to get rid of if you are 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, or listen to music, or watch TV. "Will I or won't I" situations quickly become unbearable.

Make sure you avoid alcohol or drugs - although they can ease some of the tension, they also make it much more likely you act impulsively, or are not aware of what you are doing.

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