What is depression?

Most people sometimes feel unhappy, sad, miserable or just down. Depression is different from that, in the sense that a person feels down for a longer period of time and the feeling involves the person’s total being. It means we are emotionally unhealthy.  Depression is a normal response to abnormal life experiences. The symptoms are a messenger of a deeper problem.

“We have been systematically misinformed about what depression and anxiety are. What if depression is, in fact, a form of grief—for our own lives not being as they should? What if it is a form of grief for the connections we have lost, yet still need?”
 – Johann Hari, Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions

Depression doesn’t mean a person is ”crazy.”

”The more I investigated depression and anxiety, the more I found that, far from being caused by a spontaneously malfunctioning brain, depression and anxiety are mostly being caused by events in our lives. If you find your work meaningless and you feel you have no control over it, you are far more likely to become depressed. If you are lonely and feel that you can’t rely on the people around you to support you, you are far more likely to become depressed. If you think life is all about buying things and climbing up the ladder, you are far more likely to become depressed. If you think your future will be insecure, you are far more likely to become depressed. I started to find a whole blast of scientific evidence that depression and anxiety are not caused in our skulls, but by the way many of us are being made to live. There are real biological factors, like your genes, that can make you significantly more sensitive to these causes, but they are not the primary drivers.”
— Johann Hari, The Real Causes Of Depression Have Been Discovered, And They’re Not What You Think

What is ”feeling depressed” trying to tell you?

Much the same as a patient with a stomach flu who suffers from nausea, stomach ache and vomiting, Johann Hari says: “You need your nausea. You need your pain. It is a message that something in your life is wrong, and we must listen to the message. All these depressed and anxious people, all over the world—they are giving us a message. They are telling us something has gone wrong with the way we live. We need to stop trying to muffle or silence or pathologize that pain. Instead, we need to listen to it, and honor it. It is only when we listen to our pain that we can follow it back to its source—and only there, when we can see its true causes, can we begin to overcome it.”

Johann Hari, Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions

Most people who get help for depression, feel better and go on to live happy, fulfilled lives.


Signs and symptoms of depression include:

  • Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  • Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
  • Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems. Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Different types of depression:

  • Minor depression: is having symptoms of depression for longer than 2 weeks, but not being totally disabled in your daily functioning as yet. Untreated minor depression can become a major debilitating depression.
  • Major depression: is disabling and prevents a person from functioning normally; symptoms are constant, ranging from moderate to severe and lasts untreated up to 6 months.
  • Dysthymia: is a mild recurring “low-grade” depression that lasts longer than 2 years and may cause a person to feel unwell and prevent normal functioning.
  • Bipolar depression: is also known as manic-depressive illness is characterized by cycling mood changes from extreme highs (hyperactive, rapid speech, little sleep) to extreme lows (severe depression symptoms).
  • Post-partum depression: is a longer lasting and more serious depression triggered, in part, by hormonal changes associated with having a baby and develops any time from the birth to six months afterwards.
  • Seasonal affective disorder: is characterized by the onset of depression during the winter months, when there is less natural sunlight and it lifts again in spring and summer time.
  • Psychotic depression: is a severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).

Why do people get depressed?

Causes and risk factors for depression

  • Lack of social support
  • Recent stressful life experiences
  • Family history of depression
  • Marital or relationship problems
  • Financial strain
  • Early childhood trauma or abuse
  • Alcohol or drug abuse
  • Unemployment or underemployment
  • Health problems or chronic pain
  • Loneliness

The different faces of depression

Depression often looks different in men and women, and in young people and older adults. An awareness of these differences helps ensure that the problem is recognized and treated.

Depression in men

Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign of weakness and excessive emotion. This is especially true with men. Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse. Even though depression rates for women are twice as high as those in men, men are a higher suicide risk, especially older men.

Depression in women

Rates of depression in women are twice as high as they are in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression.

As for signs and symptoms, women are more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. Women are also more likely to suffer from seasonal affective disorder.

Depression in Teens

While some depressed teens appear sad, others do not. In fact, irritability—rather than depression—is frequently the predominant symptom in depressed adolescents and teens. A depressed teenager may be hostile, grumpy, or easily lose his or her temper. Unexplained aches and pains are also common symptoms of depression in young people.
Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing—even irreversible tragedy such as homicidal violence or suicide. But with help, teenage depression is highly treatable.

Depression in older adults

The difficult changes that many older adults face—such as bereavement, loss of independence, and health problems—can lead to depression, especially in those without a strong support system. However, depression is not a normal part of aging. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized. Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important.

Post-partum Depression

Many new mothers suffer from some fleeting form of the “baby blues.” Postpartum depression, in contrast, is a longer lasting and more serious depression triggered, in part, by hormonal changes associated with having a baby. Postpartum depression usually develops soon after delivery, but any depression that occurs within six months of childbirth may be postpartum depression.

Depression is a major risk factor for suicide.

”My best friend has been acting so strange lately. Now she’s really scaring me because yesterday she said the world would be better off without her.”

The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and learn to recognize the warning signs.

Click on Suicide for information

Get help

Self Help

Tips for reaching out and staying connected

  • Make face-to-face contact a priority.
  • Talk to one person about your feelings
  • Find ways to support others. Help someone else by volunteering
  • Have lunch or coffee with a friend
  • Ask a loved one to check in with you regularly
  • Accompany someone to the movies, a concert, or a small get-together
  • Call or email an old friend
  • Try to keep up with social activities even if you don’t feel like it.
  • Go for a walk with a workout buddy
  • Schedule a weekly dinner date
  • Meet new people by taking a class or joining a club
  • Confide in a clergy member, teacher, or sports coach
  • Get a pet and care for it.

Do things that make you feel good: a hobby, something that you create, take a trip, a treatment.

Look after your health – eat well, get enough rest, get some sunlight on your skin. Go for a walk. Swim. Cut down on carbs and sugar. Avoid alcohol.

Challenge negative thinking patterns. A man is as he thinks. Are you hard on yourself? A black and white person? Do you overthink and over assume?

When should you get help?


As a general rule of thumb, if your feelings of depression persist for most of every day for two weeks or longer, and interfere with your ability to manage at home or outside the home, then you would benefit from assessment by a skilled professional.



Depression medications are a common part of treatment. Some people use these medications for a short time, while others use them long term. Your doctor will take multiple factors into consideration before prescribing any medication, including:

  • possible side effects
  • current health concerns
  • possible drug interactions
  • cost
  • your specific symptoms

Medications that are commonly used to treat depression include:

  • Selective serotonin re-uptake inhibitors, or SSRI’s. These typically have less side effects than other types of antidepressants. Fluoxetine (Prozac ®), sertraline (Zoloft®), and escitalopram (Lexapro®) all fit into this category.
  • Serotonin-norepinephrine re-uptake inhibitors, or SNRI’s. These include duloxetine (Cymbalta®) and desvenlafaxine (Pristiq®).
  • Tri-cyclic antidepressants. These antidepressants can be very effective, but cause more severe side effects. They’re often used if you haven’t responded to other medications. These include imipramine (Tofranil®) and nortriptyline (Pamelor®).
  • Mood stabilizers or anxiety medications are sometimes combined with antidepressant medication. If you’re seeing a counselor or a therapist who can’t prescribe medications, they can contact your primary care doctor and request the prescription for you.

Please note:

Finding the right treatment is often a trial-and-error process. If one doesn’t work, you may discuss it with your health practitioner and try another antidepressant. If two or more months have gone by and you’ve stuck to a treatment but don’t feel any relief from the depression, it’s likely not working for you. You should experience relief from depression within three months of starting a medication. Relief is not lasting and many patients become depressed again with 1-2 years.

In his book Lost Connections Johann Hari writes about drug manufacturing companies that produces anti-depressants, and they are also responsible for the clinical trials and findings on their own drugs. Unfortunately they publish selective research on their products more often than not. At least 40% of the research are never released to the public. They want you to buy their product, even if it works on less than 10 of patients that uses it. 65 – 80% of patients on anti-depressants continue to feel depressed.

Talk to your doctor immediately if you’re:

  • depression doesn’t improve after several month of treatment
  • symptoms have improved, but you still don’t feel like yourself
  • symptoms get worse

These are signs that your treatment plan isn’t working for you. Depression is not only a problem with a brain going wrong, it is caused by life going wrong. Therefor treating depression requires more than just taking tablets which treats symptoms. Johann Hari says symptoms are messengers of a deeper problem and it requires to find the deeper problem and start working from there. Everyone of the social and psychological causes of depression and anxiety have something in common – they are all forms of disconnection. According to his book Lost Connections you can disconnect for example from meaningful work, other people, meaning values, childhood trauma, the natural world, status and respect and a hopeful future. To heal from depression, lost connections must be identified and restored. This may need therapy sessions, changes in your way of life and new commitments.

Alternative treatments for depression

There are a variety of alternative and natural treatments that are often used to treat depression. These treatments shouldn’t be used without consulting your doctor first, especially if you’re taking prescription antidepressants or other medications.

Some alternative remedies for depression include:

  • St. John’s Wart
  • omega 3 fatty acids
  • acupuncture
  • massage therapy
  • relaxation techniques
  • meditation



You can do a self-test quiz to learn more about signs and symptoms of depression or suicide.

Depression Quiz

Suicide Quiz

MOBIEG Helpline


If you have symptoms of depression and feel unsure what to do about it – please chat to a facilitator on the LIVE CHAT about it and get help. It is an anonymous helpline. We are online Sundays: 18h00 – 20h00 / Mondays – Thursdays from 19h00-21h00.


What to do if you feel suicidal

  • Tell someone right away.
  • Make sure you are not alone.
  • Don’t use alcohol or drugs.
  • Ask your family to lock away knives, ropes, pills and guns.
  • Keep pictures of your favourite people with you.
  • Spend time with family and friends. Even if you would rather be alone – it is not a good idea.

Warning: What happens when you stop taking anti-depressants abruptly?

Some people stop taking their medication because they feel better, others because they feel it isn’t working. Quitting “cold turkey” may cause major withdrawal symptoms. A sudden drop of your medicine may also worsen your depression, send your symptoms on a downward spiral, or set your treatment back several weeks or months.

Just found out you’re pregnant? That’s no excuse to stop taking your antidepressants. According to the Mayo Clinic, women who stop taking antidepressants while pregnant are more likely to suffer a relapse during pregnancy than women who continue taking their prescribed medication. Let your doctor know about your change in circumstances. They may decide to take you off your medication or lower the dosage. You can also take a different antidepressant, one that’s safer for pregnant women.

The best way to stop taking your antidepressant is to slowly taper yourself from the medication under a doctor’s supervision. This involves slowly lowering the daily dose of medication until you are completely off the drug.

Book a Counselling Session

You can book individual counselling sessions with the following therapists:


Please read:

Johann Hari, Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions


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