No one escapes depression. A great many people get depressed, however briefly, at some time in their lives. You may never get depressed, but some of the people close to you will. One person in five will suffer clinical depression requiring medical or other intervention.

The experience of depression can be the very worst experience you have ever had. It can also be the source of acquiring wisdom. Nowadays people often talk about “getting depressed” when what they are talking about is not depression but unhappiness or disappointment or anger or guilt. Anyone who has been depressed will know that it is totally different from unhappiness. When you’re unhappy, people around you can comfort, sustain and warm you with their love and sympathy. When you are depressed, you can observe the people around you being sympathetic and supportive but somehow their sympathy and love never gets through the barrier that surrounds you, and you are powerless to fix it.

Those who say “pull yourself together” are as thick as a rhino and just as damaging. When you’re unhappy, even if no one else will comfort you can comfort yourself, give yourself little treats and cheer yourself up but when you’re depressed, not only will you not be able to comfort yourself but you will even make things worse. You become your own worst enemy and feel the world is against you. The colour has drained out of life and an invisible, impenetrable barrier isolates you from the rest of the word.

The experience of being depressed is being utterly alone. I have been there.
Quite often depression passes after about six months but may require medical intervention in the way of anti-depressants. Statistics show that patients treated with anti-depressants may relapse after a time and need further treatment but those who receive psychiatric care or counseling (or both) rarely succumbs again. The old adage “strongest in the broken places” holds good.

Those who can make use of even the most unpleasant experiences and use them to their advantage are the most likely to lead a full and happy life. You can discover that your life story and the world as you see it are not fixed in stone but something you have constructed and, since you constructed them, you can change them – with a bit of help from someone who understands.

Some people associate depression primarily with psychological symptoms such as low mood and lack of pleasure whereas, in reality, it can also cause a variety of physical symptoms such as poor sleep quality, general aches and pains, sexual dysfunction and appetite or weight change. Aches and pains are commonplace.

A recent survey showed that physical symptoms were considered to be a key factor in in opinion of 99% of the participants in the survey (Depression Alliance 2005b). These included fatigue (85%), insomnia/hypersomnia (78%), general aches and pains (49%) and sexual dysfunction (48%).

Despite this, many people with physical symptoms fail to discuss them with their doctor, partly due to the fact that patients do not associate depression with physical malaises.
Having said that, a high proportion of doctors apparently do not tell their patients of the connection. Quite a lot of doctors prescribe placebos (something prescribed for psychological effect which has no physiological effect). Patients are often satisfied and not only do they show a remarkable improvement but a relapse is almost immediate if the treatment is interrupted.

When doctors prescribe anti-depressants for mild depression that can be really harmful. Tests have shown that while severe depression responds well to anti-depressants, mild depression responds no better than to a placebo because the drugs can have unpleasant side-effects. Doctors continue to prescribe placebos because the ritual of prescription is such an integral part of the medical consultation.

A new drug for depression holds out hope. Ketamine was developed as an anaesthetic but became better known as a club drug due to its ability to produce feelings of detachment from reality. It seems somehow to jolt people out of depression. Used under medical supervision, though, it appears to reboot the brain without harmful side effects. Tests continue.
I know something about depression from the sharp end. Many years ago now I was fearful of redundancy and the effects it would have on my young family, and at an age when I was virtually unemployable if I lost my reasonably well-paid job. So to make myself indispensable (no one is indispensable) I gradually increased my load, working 12 -14 hours a day, 6 or 7 days a week.

The first sign was when I found my memory was going and I had to write down all that was said before I forgot it. Then other incidents: I could not remember the way back to the office after going for a short walk at lunch-time, something I had been doing for years. Numerous other things happened such as getting up from my desk, saying goodnight and finding out there were no trains home as it was only 3 pm. I felt quite sure in my own mind that I was OK but the rest of the world was being bloody-minded. My caring family had a hell of a time though, at the time, I could not see it.

This was, of course, a mental breakdown following a long period of untreated depression,
Finally, I decided to go to the top of our office building and jump off as I could see no point whatsoever in continuing. Fortunately a member of the executive was watching, aware that I was cracking up and escorted me home and to my GP. I burst into tears in front of the GP and the silly man said ‘I expect you will feel better now’ which unleashed a torrent of abuse for the humiliation I felt - which he took very well, better than I could have done.

One of my prescribed drugs was Halcyon, much later withdrawn because of several deaths linked to it. A few years later I had a series of heart attacks - although the consultant said I was not a typical cardiac patient, being lean and physically fit. I often wonder about that.

Depression is an illness more common than appendicitis. There is no more reason to be ashamed of it than of any other illness.

I have had acute depression and reached the point of being completely unable to function normally. It used to be called a nervous breakdown. Having completely recovered from it, I am glad to have had the experience as it has added to my store of accumulated experiences and knowledge which I use to my advantage. Like a healed bone fracture, the bit that was broken is stronger than before.