Major Depression: What is it?

Written by Clinical Research Associates Staff

Depression is an illness that affects the way people think and feel. It is not a weakness or state of mind that someone can "snap out of." It is also not the choice of any depressed person to feel that way. It can be a crushing, debilitating disease that prevents people from:

  • doing normal daily activities
  • having any sense of joy
  • sometimes even getting out of bed.

The National Institute of Health reports that it is the leading cause of disability in the United States. However, about 40 percent of depressed individuals do not seek treatment. Why? For many people, lack of access to proper healthcare or fear of being labeled can prevent them from getting proper treatment for depression.

How it Feels

Depression affects people differently depending on culture, gender, age and even social background. There are some common symptoms (see box at right). In some people, symptoms of depression can be severe and obvious, while other people may feel generally miserably or cry without really knowing why. It's best to have a trained health professional diagnose clinical depression. The professional will be able to identify if the symptoms are explained by something else, or part of another psychiatric problem.


Untreated depression can cause emotional and behavioral health problems. These can wreak havoc on one's personal and professional life. Social isolation and irritability take a toll on personal relationships, and fatigue and difficulty concentrating make work and school hard to manage. Depression can also lead to alcohol and substance abuse, which can begin a vicious cycle. A common coping mechanism for these uncomfortable troubles is avoidance. This can cause even more anxiety. Without treatment, depression can make life feel unmanageable fairly quickly.

Treatment Options

Typical treatments for depression include medication and psychological counseling. Primary care doctors and psychiatrists usually prescribe medication first and then refer patients to counseling. Psychiatrists are trained to manage medications for depression and other mental illnesses. They are also knowledgeable of how certain types of drugs work for different individuals.

Drugs for depression are classified by the way they act on brain chemistry. The most well known class is the Selective Serotonin Reuptake Inhibitors (SSRIs), which includes Prozac and Paxil. Some classes of antidepressants have been around longer than SSRIs, but they are depression drugs in development that represent entirely new classes of drugs. This is an exciting development in an industry that has a common goal of potentially producing more effective medicines for those in the future that have fewer side effects than previous drugs.