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Depression is so misunderstood that some people don't even realize it is a disease. That's understandable. Doctors don't know exactly what goes wrong in depression, and the symptoms are not always obvious. People with depression often hide their illness instead of looking for help.

Yet for people who are diagnosed with depression and given help, the results can be very good. Many people have big improvements in their mood.¹

• Depression can be treated; you don't have to suffer.
• Depression is common. It affects about 1 in 7 people at some time.
• If you think you might be depressed, it's important to talk to a doctor who can tell you whether you are depressed and give you treatment.
• Antidepressants and talking treatments, such as cognitive therapy, can help treat depression.
• It can take as long as six weeks for antidepressants to make you feel better, so it is important not to stop taking them too soon.

Everyone feels down sometimes, but depression is more than feeling unhappy.

If you have depression you might be irritable, unable to sleep, unable to eat, low on energy and unable to make decisions. You might also feel dissatisfied, guilty, hopeless, helpless and you might want to cry all the time. And as much as you try, you can't make yourself feel better.

Although everyone can have these feelings from time to time, if you have depression, they accumulate and don't go away. They can last for weeks or months. They can affect your sleep, relationships, job or school work, hobbies, sex drive and appetite. To learn more, see What are the symptoms of depression?

Some people with depression have symptoms that are not typical. If you're a man or a child, you might be anxious or irritable. If you're an older adult, you might suddenly lose memory or concentration.^{1 2}

You can have depression at the same time as other illnesses, such as diabetes, cancer, a heart attack or a stroke. Depression could also happen after a traumatic event, such as the death of someone close to you. Some people can become depressed after they've been drinking alcohol or using illegal drugs.²

Many people with depression don't ask for help. About half of all depression is not properly treated.^{1 3}

Depression is not just a state of mind. It's not something you can just "will" away. With depression, the most important thing is to recognize that you might have it and to see someone qualified to give you the right diagnosis and treatment.¹

It's also good to remember that the hopelessness you may feel is a symptom of your depression, and it doesn't mean that there really is no hope. It might help to confide in someone you trust, and to keep busy and meet up with people rather than stay at home on your own.¹

Men, in particular, are at risk of not being treated. They might not recognize their anger or feelings of hopelessness as depression. They are also less likely than women to tell someone how they feel. Also, doctors are less likely to suspect depression in men than in women. Men's depression is often covered up by drinking or drug-taking, or lots of overtime at work.¹

No one knows for certain what causes depression.

Doctors and researchers think that personal experience can often play a role in the development of depression. For example, it can be triggered by the death of a loved one, the break-up of a relationship, financial trouble or a stressful change in your life. A difficult childhood also can mean that you may be more at risk of getting depression.¹

Depression is also linked to changes in how the brain works. This makes sense, given that our emotions, thoughts, sleep, appetite and behavior are regulated by our brain.¹

The brain sends signals from nerve to nerve using special chemicals called neurotransmitters. But the levels of certain neurotransmitters in your brain called noradrenaline and serotonin are abnormal if you have depression, and they don't work properly.^{1 4}

Family history also appears to play a part in depression. In some cases, depression seems to run in families, suggesting that it can be caused by genes. In other cases, however, it can occur in people with no family history of depression.¹

What's more, hormones can contribute to depression, especially in women, who are more likely than men to be depressed. Depression in women is sometimes linked to changes in their menstrual cycle, pregnancy, miscarriage, just having had a baby (postpartum depression) and menopause.¹

The word depression is used to describe a range of emotions. We often say we're depressed when we're down in the dumps or feel a bit sad. Depression is also used to describe feelings of utter hopelessness and withdrawal that stop you from doing things you used to enjoy or getting on with life. Doctors often use other words to describe different types of depression.

In what's called major depression, you feel depressed or uninterested in doing anything nearly every day for at least two weeks. You also have several other symptoms, including changes in sleep, appetite and concentration. Major depression is also called clinical depression or unipolar depression.⁵

Dysthymia is a less severe illness that lasts at least two years. Some people with dysthymia have episodes of major depression as well as low-grade depression. This is sometimes called double depression.^{1 3}

Another kind of depression is bipolar disorder, in which a person swings between high and low moods. This is also called manic-depressive illness.

If you get big mood swings in different seasons of the year, it is known as seasonal affective disorder (SAD). People with SAD usually get more depressed in the winter. If you have SAD, you might also have unusually high moods (mania) in the spring.

Some women have postpartum depression soon after childbirth. This may be because having a baby leads to changes in a woman's hormones, as well as her lifestyle and responsibilities.^{1 3}

The exact causes of depression are often complicated. However, there are some things that increase your chance of becoming depressed. Doctors call these risk factors.

A stressful situation, such as losing someone close or being in a difficult relationship, can trigger depression. Some people are prone to depression and find other people in their family have had it too. This suggests that the genes we inherit from our parents might have something to do with whether we get depressed or not.

To learn more, see Risk factors for depression.