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Depression, also known as major depressive disorder, is a common mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and a range of physical and cognitive symptoms. This wiki page provides an overview of depression, including its symptoms, causes, diagnosis, treatment, and impact on individuals and society.
	'''Depression''' is a mental health condition involving persistent low mood, loss of interest or pleasure, and changes in thinking, sleep, appetite, energy, and daily functioning. It is more than ordinary sadness, although it can follow grief, stress, trauma, illness, isolation, or major life changes.

	Depression can be mild, moderate, or severe. It may happen as a single episode, return in episodes, or become long-lasting. It can affect work, study, relationships, self-care, physical health, and safety.

== Symptoms ==	== Symptoms ==
The symptoms of depression can vary from person to person, but commonly include:
	Common symptoms include:

* Persistent feelings of sadness, emptiness, or hopelessness
* Loss of interest or pleasure in activities once enjoyed
* Changes in appetite and weight
* Sleep disturbances, such as insomnia or excessive sleeping
* Fatigue or loss of energy
* Feelings of worthlessness or excessive guilt
* Difficulty concentrating or making decisions
* Recurrent thoughts of death or suicide
	* Low mood, sadness, emptiness, or hopelessness.
	* Loss of interest or pleasure.
	* Tiredness or low energy.
	* Sleep problems, including insomnia or sleeping more than usual.
	* Appetite or weight changes.
	* Poor concentration or difficulty making decisions.
	* Feelings of guilt, worthlessness, or failure.
	* Slowed movement or agitation.
	* Loss of sex drive.
	* Thoughts of death, self-harm, or suicide.

	Physical symptoms can also occur, including aches, digestive problems, headaches, and changes in movement or speech. Symptoms vary, and some people mainly show irritability, withdrawal, anxiety, or reduced functioning rather than obvious sadness.

== Causes and Risk Factors ==	== Causes and Risk Factors ==
Depression is a complex condition with multiple factors contributing to its development. Some factors that may increase the risk of depression include:
	Depression usually has more than one cause. Risk can be affected by:

* Biological Factors: Imbalances in brain chemicals (neurotransmitters) such as serotonin, norepinephrine, and dopamine may play a role in the development of depression. Additionally, a family history of depression or other mental health disorders can increase the risk.
* Environmental Factors: Stressful life events, such as loss of a loved one, relationship problems, financial difficulties, or trauma, can trigger or contribute to depression. Chronic stress, social isolation, and a lack of social support can also increase the risk.
* Genetic Factors: Certain genetic variations may predispose individuals to depression, although specific genes and their interactions are still being researched.
	* Family history and genetics.
	* Previous depression or other mental health conditions.
	* Trauma, abuse, bereavement, bullying, or severe stress.
	* Loneliness or lack of support.
	* Long-term physical illness or pain.
	* Alcohol or drug misuse.
	* Some medicines or hormonal changes.
	* Financial pressure, work problems, housing insecurity, or relationship conflict.

== Diagnosis and Treatment ==
Diagnosing depression involves a comprehensive evaluation of the individual's symptoms, medical history, and psychological assessment. There is no specific test to diagnose depression, so healthcare professionals rely on clinical judgment based on established diagnostic criteria.
	Depression is not a simple chemical imbalance. Brain chemistry, psychology, body health, environment, and life history can all matter.

Treatment for depression often involves a combination of therapy, medication, and lifestyle changes. Psychotherapy, such as cognitive-behavioural therapy (CBT), is commonly used to help individuals identify and change negative thoughts and behaviours contributing to their depression. Antidepressant medications may be prescribed to balance brain chemistry and alleviate symptoms. In severe cases or when other treatments haven't been effective, electroconvulsive therapy (ECT) may be considered.
	== Diagnosis ==
	Diagnosis is based on symptoms, duration, impact on life, risk assessment, and clinical judgement. There is no single blood test for depression, although tests may be used to look for other causes of symptoms, such as thyroid disease, anaemia, vitamin deficiency, or medication effects.

== Impact on Individuals and Society ==
Depression can have a profound impact on individuals, affecting their overall well-being, relationships, work, and daily functioning. It may lead to reduced productivity, impaired social interactions, and increased healthcare utilization. Depression is also a significant risk factor for suicide, highlighting the importance of early detection and appropriate treatment.
	Clinicians may use questionnaires such as PHQ-9 to measure symptom severity, but questionnaires are tools rather than the whole diagnosis.

In society, depression poses a substantial burden. It is a leading cause of disability worldwide and affects people of all ages, genders, and socioeconomic backgrounds. Public awareness campaigns, improved access to mental healthcare, and efforts to reduce stigma are crucial for supporting individuals with depression and promoting mental health.
	== Treatment ==
	Treatment depends on severity, preference, previous response, risk, and access to care. Options can include:

	* Guided self-help and supported online programmes.
	* Talking therapies, including cognitive behavioural therapy.
	* Behavioural activation and structured activity planning.
	* Antidepressant medicines.
	* Combined therapy and medicine for more severe depression.
	* Support for sleep, alcohol use, social isolation, work, debt, or physical health problems.
	* Specialist mental health care for severe, psychotic, chronic, or treatment-resistant depression.

	NICE guidance separates less severe and more severe depression and recommends matching treatment to the person's needs and preferences. WHO notes that psychological treatments are first treatments for depression and that antidepressants can be combined with them in moderate and severe depression.

	== Risk and Crisis ==
	Depression can increase suicide risk. Thoughts of self-harm or suicide need to be taken seriously, especially where there is a plan, intent, previous attempts, severe agitation, intoxication, psychosis, or lack of support.

	In the UK, urgent help may involve NHS 111, a GP urgent appointment, a local crisis line, A&E, or 999 where there is immediate danger.

	== See Also ==
	* [[Common_Medical_Terms]]
	* [[Vitamin_B12]]
	* [[Osteoporosis]]

	== References ==
	* [https://www.nhs.uk/mental-health/conditions/depression-in-adults/overview/ NHS: Depression in adults]
	* [https://www.nhs.uk/mental-health/conditions/depression-in-adults/treatment/ NHS: Depression treatment]
	* [https://www.nice.org.uk/guidance/ng222 NICE: Depression in adults, treatment and management]
	* [https://www.who.int/news-room/fact-sheets/detail/depression WHO: Depressive disorder]
	* [https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/ NHS England: Talking therapies for anxiety and depression]
	* [https://111.wales.nhs.uk/depression/ NHS 111 Wales: Depression]

	[[Category:Medicine]]
	[[Category:Mental Health]]