As many as 30 per cent of people will suffer from at least one episode of depression during their lives. The World Health Organisation estimates that by the year 2020, depression will be the second largest cause of death and disability in the world.

It is a complicated, ‘multi-factorial’ illness caused by a combination of genes and environment. It can affect anyone from any walk of life (although some studies show that some people can be genetically predisposed towards depression) and while it can be triggered by traumatic and stressful events, often there is no obvious cause.

Two things are certain: Depression is an illness, and is not something you can just snap out of, nor is it anything to be ashamed of. The sooner a sufferer recognises this, the sooner he or she can begin to take treatment. (and in the vast majority of cases, it can be effectively treated).

Depression affects your whole body; mood, sleeping patterns, eating habits and outlook. It doesn’t just pass and without treatment can linger for years and have serious impact on your whole way of life; from relationships to work and everyday events.

Also, there are different types and levels of depression. Not all are complex. By getting advice you make major steps in defining how serious the problem really is.

Typical symptoms

Symptoms include feeling sad or miserable, low self-esteem, persistent tearfulness, tiredness and fatigue, sleep disturbance (either wanting to stay in bed or sleeplessness), feelings of hopelessness, appetite disturbance (either increased or decreased) and suicidal thoughts and ideas.

What can help?

Recognise when you are suffering from depression, for many it is the need to admit that they are depressed. Get medical help. Try to spend time with friends and discuss problems.

Depression can be difficult to prevent, but it can be combated by strengthening emotional well being through taking regular exercise, getting plenty of rest and undergoing relaxing therapies like yoga and massage. Avoiding alcohol, tobacco and narcotics also helps, too, as does a healthy and, balanced diet.

Sometimes St John’s wort is recommended as a natural and often effective alternative medicine, but it is always a good idea to check with your GP if symptoms last more than a couple of weeks.

Doctors often prescribe drugs for even minor cases of depression. The new generation of anti-depressants developed in the 1980s work on blocking the reuptake of different neurotransmitters (brain chemicals) and generally have fewer side effects than other anti-depressants. However, long-term use of antidepressants is far from the being the answer. There is a high chance that people who have suffered from depression will succumb to it again, so it is important to learn the cognitive skills to tackle it.

Try to recognise patterns of negative thinking, and replace them with more constructive thoughts or activity. Look for things to do that occupy your mind.

Counselling can be of great benefit, especially to relieve mild depression and it is often combined with anti-depressant medication. There is likely to be a self-help group in your area that can help lead you towards a happier state of mind through the sharing of experiences with of depression.

In extreme cases, when other treatments fail, electro-convulsive therapy may be considered for battling depression. At best it can prove highly effective – at worst it can cause severe side effects such as loss of permanent memory and mental skills.

Friends and family

It is very difficult for people who are depressed to admit they have a problem and ask for help. If you are worried about someone, offer him or her plenty of appropriate opportunities to talk to you. Try getting them to open up by asking them if they have anything on their mind or if something is bothering them.

If your friend or relative has feelings of isolation, invite them to social gatherings and keep inviting them even if they refuse, which they may well do. Depressives often don't feel like socialising, or feel their contribution won't be of value.

If you want to help, it is important that you are as understanding as possible. Learn about the condition and try to accept what the depressed person has to say. Be as supportive as you can and don't expect them to return to their old selves overnight.

A surprising number of suicides – especially among young men – come as a complete bolt from the blue to families who had little idea their loved one was depressed. Don't be afraid to talk about suicide, or ask your friend or relative if they ever have thoughts about killing themselves. Contrary to popular myth, focussing on suicide is not likely to encourage someone to go through with it.

Encourage a depressed person to seek professional help. Keep reassuring them that their illness can be treated.

• Depression Alliance is a leading UK charity for sufferers and their web site contains information about symptoms, treatments, campaigns and local groups. www.depressionalliance.org
  
  
• SANE is a charity dealing specifically will depression and other mental illnesses, and helps ensure that sufferers and their families no longer need to feel so neglected and isolated. www.sane.org.uk/About_Mental_Illness/Depression.htm It also has a phoneline: 0845 767 8000
  
  
• The mental health charity Mind (www.mind.org.uk) can suggest a number of helpful organisations, as well a great deal of information on depression and how to fight it. It too has an information line: 0845 766 0163.