Depression is a disorder of mood, varying from a mild normal reaction to life's vicissitudes, requiring a sympathetic ear, through moderate depression which may respond best to brief psychotherapy, to severe, clinical depression with a strong risk of suicide. The latter requires a determined management plan, including an effective antidepressant drug and regular psychotherapy. Te symptoms must have been present for at least a month and should preferably include at least four of the following, elicited by a careful mental state examination, before a diagnosis is made and treatment is considered:

low mood, loss of happiness or equanimity, loss of hope

mood not improved by pleasant events or relationships

loss of enjoyment of everyday life

loss of interest in things and people

sleep disturbance, varying from insomnia to spending most of the day in bed

difficulty in concentrating and making decisions

withdrawal from personal relationships

slowing of thought processes and physical activity.