Around 10 % of men and 20 % of women will suffer depression during their lifetime. Depression can be clinical, severe and debilitating, or low level and chronic, sapping joy and pleasure from life so that the sufferer feels constantly listless, exhausted, jaded. It can come in short bouts or be a life-long problem.

Depression sucks all meaning from life so that the sufferer comes to feel that nothing matters, they want nothing, care about nothing, and yet the pain they experience is excruciating to the point that sometimes suicide seems the only escape. Depressed people have a low quality of life and are unable to focus on the positive, or to experience real joy or hope. One of the worst symptoms of depression is a sense of worthlessness or even self-loathing.

Stress, particularly prolonged stress, is often a trigger for depression. Feeling trapped, feeling as though we have no control over our lives, trying to do the impossible, trying to live up to others’ standards, or meet unachievable expectations can also contribute.

There is a strong link between depression and troubled intimate relationships. Fifty per cent of depressed patients report serious marital problems and if a person is in a problematical relationship they are ten times more likely to become depressed (Kaslow F (ed) Handbook of Relational Diagnosis and Dysfunctional Family Patterns, John Wiley & Sons, NY, 1996).

Mental health professionals have even come up with a label—Partner Relational Affective Disorder—for clinical depression triggered by relationship stresses (Kaslow, 1996). Yet even though the importance of destructive relationships in depression is well recognized in psychological circles many medical practitioners and patients themselves distance themselves from such ‘personal’ issues.

‘Kath’ for example, suffered abuse from her alcoholic husband for years. Debilitating depression blighted her life but the doctors could only treat the symptoms not the cause. Depression is a normal response to <a target="_blank" href="/abuse/index.html" title="Abuse"