I am ignorant and impotent and yet, somehow or other, here I am, unhappy, no doubt, profoundly dissatisfied... In spite of everything I survive.

Aldous Huxley (1894-1963)

Depressive illness, which is probably the greatest masquerade of general practice, is one of the commonest illnesses in medicine and is often confused with other illnesses. It is a very real illness that affects the entire mind and body. Unfortunately, there is a social stigma associated with depression and many patients tend to deny that they are depressed.

It is a useful working rule to consider depression as an illness that seriously dampens the five basic activities of humans:

• energy for activity

• ability to cope with life

Many episodes of depression are transient and should be regarded as normal but 10% of the population have significant depressive illness. The lifetime risk of being treated for depression is approximately 12% for men and 25% for women. 1

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