Beating the blues; Depression is more than just low spirits. It can

As a minister for the Church of Scotland, Mary Henderson knows how important it is to think positively. Eight years ago though, she struggled to believe in herself, never mind keep the faith. Every day she would wake up feeling useless and incompetent, believing that life was not worth living. "It felt as if I was seeing myself and the world clearly and it was just absolutely bleak," she remembers.

The dark cloud had hovered twice before, when she was a student and again after her father died, but no one picked up on the symptoms. When she moved to another parish, her new GP diagnosed depression. "It was actually such a relief for someone to put a name on it - it wasn't that I was going mad, but it was a recognised condition," explains Henderson.

This week, mental health organisations around Britain will stage awareness-raising events to help sufferers of this treatable illness recognise the symptoms of depression. It is believed that as many as one in five people experience the illness at some point in their lives, but a large number are never detected due to the stigma and lack of information surrounding it. People feel guilty and embarrassed about their inability to cope with life, while friends and family may be irritated by the sufferer's inability to "snap out of it".

Part of the problem is the word itself, which has been confused with feeling down or in a negative mood - conditions which affect everyone. "People can experience different degrees of low spirits, but serious depression hampers ordinary living and affects a lot of the bodily functions, as well as psychological functions," explains psychiatrist Ann Rathie Guldberg.

Depressives tend to feel constantly down for several weeks or months, may be lethargic and lacking in energy, often sleep too much or too little and can find it difficult to concentrate or make decisions. Often they will lose interest in food or may eat excessively and some will experience psychosomatic symptoms, frequently manifested in the bowels. Manic depressives have "high" periods where they feel hyper and elated and extreme lows, when they may be unable to do even the simplest of tasks.

Depression can affect all age groups and appears to run in families, although this may be partly due to the negative influence of being brought up in the environment of a depressive person. It is often triggered by external factors such as bereavement, the loss of a relationship or a job, and for sufferers of Seasonal Affective Disorder, it is brought on during the winter months. In addition, up to 20 per cent of mothers experience post-natal depression.

The good news is that depression can be effectively managed. Increasingly psychiatrists are focusing on the importance of "talking treatments", often in conjunction with drugs, to manage the condition. Cognitive behavioural therapy can help reverse depressive thought patterns by trying to correct automatic reactions and assumptions that the patient may have adopted. Another method is psychotherapy, which delves into the person's background and childhood to help resolve past failures, trauma and insecurities.

In addition, anti-depressants are successful in around 70 per cent of cases, although the patient may need to try several drugs before they feel any benefit. For example, Mary Henderson has now stabilised the illness using anti-depressants, while counselling sessions have helped unravel some of the reasons for her mood swings.

The problem is that such drugs must be taken long-term to avoid a relapse of the condition. When Henderson tried to stop her medication, the negative thought patterns swung back.

Herbal medicine is a milder alternative. St John's Wort can be effective, but a professional herbalist should be consulted before using it, especially as it can react with other drugs. For many depressives, it is the realisation that they are not alone which is the biggest step on the road to recovery.

"A lot of people suffer in silence and think that they are the only one and it's their personality, so it's quite a relief to people when they realise [the depression] is something that is happening to them rather than their own personal character," says Wyn Merrells, groups coordinator for Depression Alliance Scotland, an organisation which provides information and support to depressives and their carers.

Although it was a struggle to continue her public role as a minister during her illness, Henderson took the courage to be open about her depression and found the parish surprisingly supportive. "It was amazing how many of them had gone through something similar themselves or knew other people who had," she says. "It actually brought me a lot closer to them."

Depression Alliance Scotland: 0131 467 3050

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