Depression Alliance: Providing Information, Support and Understanding to People Affected by Depression

epression is a serious medical condition. In contrast to the normal emotional experiences of sadness, loss or passing mood states, clinical depression is persistent and can interfere significantly with an individual’s ability to function. There are three main types of depressive disorder: major depressive disorder, dysthymic disorder, and bipolar disorder (manic-depressive illness). Depression can devastate family relationships, friendships and the ability to function well on a daily basis and, too often, is associated with suicide. Sadly, many people still believe that the emotional symptoms caused by depression are ‘not real’, and that a person should be able to ‘pull themselves together’ and shake off their ‘troubles’. Because of these inaccurate beliefs, people with depression either may not recognise that they have a treatable disorder, or may be discouraged from seeking or staying on treatment due to feelings of shame and stigma. In fact, brain imaging research is revealing that in depression neural circuits responsible for moods, thinking, sleep, appetite and behaviour fail to function properly, and that the regulation of critical neurotransmitters is impaired (Soares & Mann, 1997). Genetics research, including studies of twins, indicates that genes play a role in depression. Vulnerability to depression appears to result from the influence of multiple genes acting in tandem with environmental factors, while other research has shown that stressful life events, particularly loss or bereavement, may trigger major depression in susceptible individuals (Mazure et al, 2000). The hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that regulates the body’s response to stress, is overactive in many people with depression. Research findings suggest that persistent overactivation of this system may well lay the groundwork for depression (Arborelius et al, 2001). However, while D studies of brain chemistry, mechanisms of action of antidepressant medications, and the cognitive distortions and disturbed interpersonal relationships commonly associated with depression continue to inform the development of new and better treatments, the support and understanding of others are also critical factors on the journey towards remitted depression. Major depression is the world’s number one mental disorder (WHO, 2001). By 2020, it will be the second greatest cause of disability in the developed world. Significantly, nearly twice as many women (12%) as men (7%) are affected by a depressive disorder each year. Within the UK, the extent of the challenge posed by mental illness, and by depression in particular, has at last started to receive the attention, if not quite the resourcing, that the problem requires. We are now aware that one in four of us will at some point suffer from a mental illness. Mental health is a stated Department of Health priority and enhanced training has enabled GPs and psychiatrists to become significantly better able to detect, prescribe for and manage patients with this disabling, painful and sometimes fatal condition. Furthermore, it is now recognised that effective caring for people with depression goes wider than the clinical forum: social, economic and environmental circumstances all have a major impact upon the ‘mental wealth’ of every individual. Because many of the triggers for depression relate to life-shattering events such as unemployment, bereavement or separation, the sufferer can become withdrawn and isolated and thus out of sight becomes, literally, out of mind. Depression Alliance (www.depressionalliance.org) works for the benefit of people suffering from depressive disorders, their families and their carers. It is a member-led organisation with offices in England, Scotland and Wales. Many of those working for Depression Alliance have themselves suffered from depression or have experience as carers and are very