What is depression ?. Depression is a syndrome which can have co morbid features. Those comorbid features themselves can be syndromes. Examples of comorbid features to depression include psychosis, anxiety, and mania. If a simultaneous occurence of depression and mania occurs, there is the expectation that some of the features of both syndromes will not be present.
The most common feature of depression is the sense that one has a loss of enjoyment. But to be depression, this must be accompanied by no other explaining circumstances.
For instance, if one has an anxiety (either common anxiety, or anxiety present as an illness), then that anxiety, in and of itself, can prevent enjoyment.
Alternatively, other physical symptoms can prevent enjoyment (a classic example, is being on vacation in the tropics, and being subdued by the humidity).
The hallmark of depression is loss of enjoyment for no evident reason. Of course, all of the other typical symptoms seem be directly linked to this. For instance, a patient may be told they are depressed due to others noticing no expression of happiness (no expression of enjoyment). In addition, as sleep, sexual fullfillment, and eating are all typical human pleasures, the loss of the enjoyment of those (and thus their temporal disruption) are also hallmarks of depression. Sleep disturbances are often hallmarks of depression.
Also, with loss of enjoyment, comes the loss of energy to pursue tasks, and often fatigue. because loss of energy and fatigue are so commonly seen in an onset of a cryptic illness (such as ovasrian cancer or pancreatic cancer, or stomach cancer), the general expectation is that a competent physican will ensure that the onset of depression does not have a cryptic or undiscovered cause. The same can be said for the somatic (felt) sensation of muscle fatugue, often described by patients as "my head feels heavy" or "My legs feel heavy", etc.
In other words, the patient may observe their own symptoms, or describe their learned sense of emotional content, or evidence of depression may be observed by others.
Once all other causes are excluded, the form of the depression needs to be determined. And the course of the depression needs to be identified.
Because so much of depression with non - genetic causes can simply be attributed to environmental factors that the patient does not recognize as causal, a history becomes important.
For instance, a patient may not recall until the question is asked, a history of head injury, or of a disturbed diet, or of an unhealthy work shcedule or an unhealthy type of work.
Once these have been ruled out, and all other causes have been ruled out (so we no longer say depression due to"xxx" but rather depression, we are almost always facing a genetic cause.
What will produce depression in one zone of life, will not produce depression in another zone of life, so it may even be possible to treat genetically caused depressions by moving to a lower lattitude - or to a diffferent type of wind and humidity and rainfall pattern.
This fact has been known by physicans for two thousand years, but due to the recent deterioration in medical education, few physicans are now aware of this, much less capable of diagnosing it.
Depression, in the form of a persistent depression, or recurrent depression, with no known cause at the moment of examianation, is almost always genetic. The genetic disturbance itself, in our society, is almost always due to environmntal toxiccity and its impact on human genetics. The treatment of any depression for which the underlying cuases cannot be modified, is the treatment array that modern humans are so commonly now familiar with -- social / talk therapies, medicines, and holistic remedies (such as accupuncture, diet, movement therapies, and light therapies).
What we have not explained, thus far, is why there is, despite the damaging nature of the illness, such a prevalence, so that the cryptic toxic injuries a low concentrations can have such a prevalence.