Depression is a psychiatric disorder characterized by a profound and long-lasting sadness or despair. It affects approximately 18 million people in the United States every year and not all of them are old enough to vote. Everyone experiences some unhappiness, often as a result of a change, either in the form of a setback or a loss. The painful feelings that accompany these events are usually appropriate, necessary, and transitory and can even present an opportunity for personal

growth. However, when depression persists and impairs daily life, it may be an indication of a depressive disorder. Severity, duration, and the presence of other symptoms are the factors that distinguish normal sadness from a depressive disorder. Depression has been alluded to by a variety of names in both medical and popular literature for thousands of years. Early English texts refer to "melancholia," which was for centuries the generic term for all emotional disorders. Depression

is now referred to as a mood disorder, and the primary subtypes are major depression, chronic and usually milder depression (dysthymia), and atypical depression. Other important forms of depression are premenstrual dysphoric disorder (PDD) and seasonal affective disorder (SAD). ƒË Major Depression

In major, or acute, depression, at least five of the symptoms listed below must occur for a period of at least two weeks, and they must represent a change from previous behavior or mood. Depressed mood

or loss of interest must be present.

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„Y Depressed mood on most days for most of each day. (Irritability may be prominent in children and adolescents.) „Y Total or very noticeable loss of pleasure most of the time. „Y Significant increase or decrease in appetite, weight, or both. „Y Sleep disorders -- either insomnia or excessive sleepiness -- nearly every day. „Y Feelings of agitation or a sense of intense slowness. „Y Loss of

energy and a daily sense of tiredness. „Y Sense of guilt and worthlessness nearly all the time. „Y Inability to concentrate occurring nearly every day. „Y Recurrent thoughts of death or suicide.

In addition, other criteria must be met: the symptoms listed above should not follow or accompany manic episodes (such as in bipolar or other disorders) ;they should impair important normal functions (such as work or personal relationships) ;they are not caused by drugs, alcohol, or other

substances ;and they are not caused by normal grief (see below). One long-term study found that episodes of major depression usually last about twenty weeks. ƒË Chronic Depression (Dysthymia)

Chronic, but mild depression, or dysthymia, is characterized by many of the same symptoms that occur in major depression but they are less intense and last much longer -- at least two years. The symptoms have been described as a "veil of sadness" that covers most activities. Typically, there

are no disturbances in appetite or sexual drive ;mania, severe agitation, and sedentary behavior are not present. Suicidal thoughts are not usually present. Possibly because of the duration of the symptoms, patients who suffer from chronic depression do not exhibit marked changes in mood or in daily functioning, although they have low energy, a general negativity, and a sense of dissatisfaction and hopelessness. J.J.Daino IV Page3

They may suffer from episodes of major depression ;in such cases,

the condition is known as double depression. The family life of such patients is often impaired because of their decreased level of emotional, psychic, and physical energies. ƒË Atypical Depression and Seasonal Affective Disorder

People with atypical depression generally overeat, oversleep, have a general sense of heaviness, and have strong feelings of rejection. Seasonal affective disorder (SAD) is characterized by annual episodes of depression during fall or winter, which remit in the spring or summer, and which may

be replaced by a manic phase. Other symptoms include fatigue, a tendency to overeat -- particularly carbohydrates -- and to oversleep in winter. (A minority of individuals with SAD has the more common depressive symptoms of under-eating and being sleepless). SAD tends to last about five months in those who live in the northern part of America. ƒË Premenstrual Dysphoric Disorder

The syndrome of severe depression, irritability, and tension before menstruation is known as premenstrual dysphoric disorder

(PDD) (also called late-luteal dysphoric disorder). It affects an estimated 3% to 8% of women in their reproductive years. A diagnosis of PDD depends on having five symptoms of depression (see above) that occur during most menstrual cycles, with symptoms worsening a week or so before the menstrual period and resolving afterward.

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Depression is an illness that can afflict anyone, regardless of age, race, class, or gender. About 17 million Americans are estimated to develop

depression each year. In one large survey, 8.6% of adults over the age of 18 reported