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Depression is the most common mental health disorder today. The seriousness of depression can range from mild "blues" with bad weather or with winter, to severe and life threatening suicidality. Understanding the symptoms can lead to early diagnosis and treatment, and prevention of disability.

While many of us have down days now and again, there are specific symptoms that characterize the clinical disorder of depression. When a person stops enjoying their usual activities; when they feel that routine chores are impossible to tackle; when they feel sad all the time, then depression as a diagnosis should be considered. Depressed people may have changes in their appetites and sleep cycles, may have increases in restlessness and anxiety, or feel like they want to stay in bed all day. They may feel guilty or worthless and think of suicide. They may have trouble concentrating and feel forgetful.

When these symptoms persist for more than two weeks, especially when a person's ability to function in their usual activities is impaired, they should seek medical attention. A primary care physician can assess medical problems that might cause similar symptoms, such as low thyroid, diabetes, anemia, and others. If those problems are ruled out and a diagnosis of depression is verified, then the patient has a choice of treatment options. If symptoms are mild, then psychotherapy alone is often the best first step. Exercise, bright light, and healthy eating, as well as eliminating the use of alcohol and illicit drugs, also can help lessen the symptoms of depression.

However, if the depression is more severe, especially with disordered eating and sleeping and trouble with self-care, medications, prescribed by a primary care physician or psychiatrist, should also be considered. Medications usually include antidepressants, such as SSRI's fluoxetine, paroxetine, sertraline, or citalapram, for instance or SNRI's venlafexine, for instance. Many of these medications are generic and quite affordable, even for those without insurance. Sometimes medications to help improve sleep, such as trazodone, are also prescribed. Studies show that lack of sleep itself can induce depression.

When a patient is actively suicidal, immediate evaluation at an emergency room or emergency mental health services is necessary. In the hospital, the suicidal patient can be kept safe, and medications can be given to more rapidly lessen the suicidal thoughts. Once out of the hospital, close follow up with a mental

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