Depression does not play favorites. It affects men and women of all races, ages and backgrounds equally. It even strikes highly successful people — the people you’d say have nothing to be depressed about — from chief executives and world leaders, such as Abraham Lincoln and Winston Churchill, to celebrities and sports heroes including Sting and Hall of Fame quarterback Terry Bradshaw. Even the father of psychiatry, Sigmund Freud, suffered from depression.

The fact that we know about so many prominent people suffering from depression is a good thing, because it is therapeutic for individuals to talk to others about the condition and their struggles with it.

Depression affects thoughts, moods, feelings, behavior and even physical health. Although people may describe it as “feeling blue” or “down in the dumps,” true clinical depression is a medical disorder with a biological and chemical basis. It may occur just once in a lifetime, periodically throughout one’s life or as a chronic condition. Symptoms usually include trouble sleeping or excessive sleeping, a dramatic change in appetite, weight loss or weight gain, lack of energy or exhaustion. Other symptoms include feelings of guilt, low self-esteem, difficulty concentrating, agitation, restlessness or irritability. Reoccurring thoughts of suicide or death can also be a symptom.

Two symptoms that are essential in establishing a diagnosis of depression are loss of interest in normal activities and a dejected mood in which the individual feels sad, helpless and hopeless for a prolonged period — usually two weeks or more.

There is no single cause of depression. Genetics probably play a part, since depression often runs in families. Environmental factors, such as stress or physical illness — particularly chronic illness or chronic pain — can also contribute to depression by triggering an imbalance in brain chemicals or neurotransmitters.

Additional causes of depression include the loss of a loved one such as child, spouse or friend; alcohol, nicotine and/or drug abuse; change in life patterns; or financial problems. Childhood events such as abuse or neglect also can be a basis for depression.

Chemical triggers for depression may include sedatives and medications for high blood pressure and birth control. Nutritional deficiencies, such as lack of omega-3 fatty acids or the B vitamin folate also can contribute to depression.

To assess the type and severity of your depression, your physician will take a complete history, perform a physical examination and complete a psychiatric interview. He or she will also check for underlying causes such as alcohol abuse or an underactive thyroid.

Treatment will vary according to the cause and severity of the depressive symptoms as well as your preference. Medications, such as antidepressants and mood-stabilizing drugs, can relieve symptoms, however such prescription medications must be taken specifically as recommended and need to be closely monitored by your doctor for possible side effects.

Other effective treatments include counseling and psychotherapy in individual sessions or as part of a group. Even exercise and nutrition can play a part in relieving depression. Adding more omega-3 fatty acids to your diet from cold-water fish such as salmon, tuna and mackerel, and folate from dark green vegetables such as spinach, asparagus and broccoli, can help your body’s natural chemical balance.

Most importantly, if you’re suffering from a “down in the dumps” feeling that you just can’t seem to shake, and that feeling is getting in the way of your everyday life — taking the joy out of things you normally like to do — talk to someone about it. Visit your physician and discuss your feelings. Believe it or not, there’s good news about depression: It can be treated. And talking about it is the first step toward feeling better.

Help a Friend

Untreated, depression can lead to disability, dependency and suicide. If someone you know seems chronically unhappy, watch for warning signs that may indicate serious depression and potential for harm. Take any threat of suicide seriously even if the person is already being treated for depression. If the person has been depressed for two weeks or more, suggest that they contact a physician. If they discuss suicide or intent to harm themselves or others, call 911 or a suicide hotline, or get them safely to the nearest emergency room for care and observation.