Depression is a mood disorder including many symptoms such as : depressed mood, loss of interest or pleasure in daily activities, a decrease or increase in appetite or weight, sleeping problems, diminished ability to think or concentrate, fatigue or loss of energy, irritability, feelings of worthlessness or guilt, thoughts of death or suicidal ideation...
A certain number of these symptoms must be present ( not necessarily all of them ) to make the diagnosis of depression, and these symptoms must have been present during a same 2-week period, and therefore not just be a transient state of " feeling down ".

What are the causes of depression ?

Depression is not due to a single cause. The causative factors can be divided into biological factors, genetic factors and psychosocial factors with every factor affecting the others.
Biological factors are most important ; the concentration of certain neurotransmitters present in the human brain ( serotonin, noradrenalin and dopamine particularly ) are diminished and this is mainly responsible for the depressive symptoms ( sadness, fatigue..)
Genetic data indicate that a significant factor in the development of a mood disorder
is genetics, thus depression is more frequent in persons who already have relatives suffering from depression, but this is not a general and strict rule.
Psychosocial factors ( life events, environmental stress...), can be triggers and can sometimes precipitate recurrences, but depression might be present without any major psychosocial stressor.

Is depression related to organic diseases ?

Many illnesses, affecting various parts of the human body ( brain, digestive system, endocrinian system...), can cause depression. It is therefore necessary to search for organic diseases such as thyroid problems, tumors or others, when diagnosing a depression, because the treatment of these diseases can cure the depressive symptoms.
Depression can be associated to many physical symptoms such as pain, vertigo, nausea, that are not related to any organic disease, but are related to depression.

Are there many forms of depression ?

A depressive episode presents with the symptoms mentioned above, but this depressive episode can be integrated in different classifications ( bipolar disorder, dysthymia...) according to certain criteria. A depressive episode can also be present with other psychiatric disorders ( phobia, schizophrenia, drug abuse, alcoholism...).

Are there persons that have predisposition to depression ?

Certain persons might have a predisposition to depression, due maybe to genetic factors or to certain traits of personality. But every person can develop a depression during its life and it is not possible to predict if one person is going to fall or not into depression.

Does depression starts at a particular age ?

Some types of depression can begin more frequently at about thirty, but depression can be seen at all age ( children, adolescents, old people ).
In young people, depression can sometimes appear as delinquency or as an aggressive behaviour, and in the elderly, depression might be hidden behind many physical complaints. That's why one must be aware of these symptoms that are not really "typical" of depression but can be the main presentation of a depressive episode.

How can we treat depression ?

Depression is treated mainly by two ways : medications and psychotherapy.
Usually, association of both ways gives the best results in the short and in the long term.

What are the effects of medications ?

Medications are often necessary and effective. Even when a major problem leads to depression, medications are helpful for regularizing the biological disorders that result, which can relieve the depressive symptoms. Medications are part of the anti-depressant family, need a lapse of time before they start being effective which is about three weeks and must be given at the adequat doses.Medications must be taken for a minimum of six to twelve months to prevent the return of symptoms, that can be possible if the medications are stopped prematurely.
The new anti-depessants have little side-effects and are well tolerated.Furthermore, there is no harmful consequences for the human organism if these anti-depressants are taken for a long period. Anti-depressants don't lead to dependence and then there's no risk of "getting used " to an anti-depressant.
Sometimes, anti-depressants need to be associated to other medications depending on symptoms and on certain criteria of classification.

What is the role of psychotherapy ?

Different kinds of psychotherapies can be useful in treating a depressive episode
( cognitive therapy, psychoanalysis, interpersonal therapy...).
Cognitive therapy is widely used and effective in the treatment of depression.
The goal of cognitive therapy is to alleviate depressive episodes and to prevent their recurrences by helping persons identify and test their negative cognitions or ideas and develop alternative, flexible and positive ways of thinking. Cognitive therapy is relatively of short duration; it takes about twenty sessions at the rate of one session per week.

Is hospitalization necessary ?

Clear indications for hospitalization are the risk of suicide, the need for diagnostic procedures or when withdrawal from the environment seems necessary.
Hospitalization helps to start the treatment, to follow the course of the depression and eventually to settle conflictual situations.