Depression can strike without much warning. It has a very high prevalence with the DSM-5 (American Psychiatric Association, 2013) estimating the occurrence of major depressive disorder in the USA as around 7%, with females showing an incidence one and a half to three times higher than males. The World Health Organisation (2012) estimated that 350 million people worldwide suffer from depression.

Often people report that they try to ride out the symptoms at first. This can sometimes work, but when it doesn’t, the effects build up and can leave the person feeling debilitated, hopeless and low. The person often feels isolated and doesn’t know where to turn. They often feel somehow to blame for what is happening.

However when carefully treated depression often has a very good outcome (we should remember here, that there are several different types of depression, and many possible causes). Depression has been very extensively studied and this has revealed many factors which can be important. Tried and tested techniques individually tailored to the person act in combination with encouragement and support, and medicines where these are indicated.

Treatment for depression sometimes has to start slowly as the person may be low in energy. As their energy builds up they can learn the strategies and techniques which help them to be more resilient, and to self-manage better by spotting early warning signals which respond very well to prompt actions. Treatment for depression should progress in different phases: the first incorporates a thorough formulation of causes coupled with symptom relief. If necessary, environmental causes might need to be dealt with. The second establishes methods for increasing the strength of the person and providing them with techniques for improved symptom management. The final phase is about stabilisation and long-term prevention as depression can be a highly relapsing condition if these are not attended to.