I feel like I'm floating under an endless gray sky in an endless gray sea of tepid water. There is no horizon. There is nothing to break the monotony. I feel nothing. I see nothing. I hear nothing. I can't bring myself to move. My world is nothing.

21-year-old woman suffering from major depression

No one can understand this - this sense of aloneness and pointlessness. I know I should care about my family, my job, and my friends. But it's like I'm under layers on layers of padding. They can't get to me. I don't have whatever it is to want to reach for them.

42-year-old man suffering from major depression

Why is life such a struggle? It just feels too hard to keep on living. I don't really want to die. I want this pain to end. Nothing is worth this pain.

35-year-old woman suffering from major depression

"Depression" is a term loosely tossed about in American culture. When people say, "I'm depressed," they usually mean that they are merely garden-variety sad or down about something. They know (and you know) that in a few minutes, hours, or after a good night’s sleep, they will feel better and be their usual selves.

Not so with major depression. A major depressive episode is not fleeting or insignificant. Major depression isn't about being "down in the dumps," "blue," or in a “bad mood.” Sufferers can't just "snap out of it" or distract themselves into a better mood. Rather, major depression dominates a person's life for anywhere from two weeks to many years.

It's not unusual for a person with major depression to question whether life itself is worth living. Fifteen percent of those who suffer from depression die from suicide. If you or someone you love is severely depressed, it's important that it be taken very seriously.

AT THIS MOMENT, AS YOU READ THIS TEXT, IF YOU ARE SERIOUSLY CONSIDERING SUICIDE, PLEASE LOG OFF YOUR COMPUTER AND TELEPHONE THE POLICE OR EMERGENCY MEDICAL SERVICES.

Symptoms of Major Depression

Five or more of the following nine symptoms must last for two weeks or more for a person to be diagnosed as suffering from major depressive disorder:

• Depressed mood for most of the day, nearly every day (adolescents and children tend to show depression as irritability and anger rather than the sadness and withdrawal of adults);
  
  
• Loss of interest or pleasure in most activities the person once found enjoyable;
  
  
• Insomnia (too little sleep) or hypersomnia (too much sleep);
  
  
• Suicidal feelings or frequent thoughts of death;
  
  
• Feelings of either being slowed down or restless for most of the day;
  
  
• Feelings of worthlessness or guilt;
  
  
• Pervasive fatigue or loss of energy;
  
  
• Significant but unintentional weight loss or weight gain or decrease or increase of appetite; and
  
  
• Inability to concentrate or make decisions.

It Isn't Always Depression

Medical conditions can cause symptoms that look like depression. These include diabetes, hypo- or hyper-thyroidism, multiple sclerosis, Parkinson's disease, head trauma, hepatitis, AIDS, or other infectious diseases. Use of steroids or withdrawal from cocaine, alcohol, or amphetamines can also produce depressive symptoms. Finally, normal bereavement after the loss of a loved one can look very much like depression. A careful assessment includes screening for medical problems and questions regarding what else may be going on in a person's life that might produce symptoms that look like depression.

What To Do if You Are Depressed

• Don't isolate. Get help! Fight the impulse to withdraw under the covers and shut out the world. Use whatever energy you have to find treatment.