People suffering from depression experience a lasting and continuously depressed mood that interferes with the ability to function, feel pleasure, and even maintain interest in life. The occasional feeling of being "blue" does not usually cause a downward spiral into depression. People suffering from major depressive episodes may feel so fatigued that they cannot go to work, school, or even do the simple things we take for granted. They may sleep day and night, have problems concentrating, and feel so deeply sad and guilty. This could lead to infinite thoughts of suicide. Thus showing that depression has an effect on a person's mind and personal life.

When depression ends, most people return to a "normal" emotional level. In some cases, however, people rebound to the opposite state, also known as, "mania." The spectrum of manic symptoms can be quite severe, ranging from cyclothymia to severe delusional mania. Cyclothymia, which usually starts in the adolescent years or early adulthood, is also known as fluctuations of mood between mild elation and depression (Daly 1997). The most common form of manic depression is the bipolar disorder.

Bipolar disorder is characterized by clinically marked mood swings between mania and depression (Daly 1997). These forms of manic depression are obtained in many ways. They can be passed on generation to generation within a family. It can also be obtained through the use of drugs as well as alcohol. Yet, one of the major causes for mania is neurological lesions or other states affecting the brain (Daly 1997). When a person is diagnosed with manic depression, he or she will have certain outbreaks and episodes that range in severity and outcome.

Clinical description and diagnosis of a manic depressant may begin abruptly, over the space of a few hours or days, or gradually over some weeks. The subjective experience of mania in its minor form usually includes heightened feelings of well being with increased alertness and drive, inflated self-esteem, and expansive sociability (Daly 1997). In addition to the increased sense, irritability may easily be evoked, and other mood states such as anxiety or sadness, brief but intensely expressed, may become apparent (Daly 1997). As mania deepens, over-activity and excessive talkativeness become more obvious. These are the signs of a true manic episode. The patient will then begin to have grandiose ideas and plans.

These delusions occur more commonly than hallucinations, but ideas of reference or even experiences of possession or control, may also be seen (Daly 1997). These delusions can be a source of great distress to the family and the recovering patient. In my own personal experiences, these delusions are true occurrences when dealing with manic depression. My uncle suffers from manic depression and has had several episodes. While in a city park, he thought that a park attendant was attacking him.

He then pulled a knife on the attendant and was arrested. This incident was posted throughout the local newspapers. He felt ashamed for what he put his family as well as the rest of the family through. This had a traumatic affect on his recovery and the rest of his treatment. Now with the help of his medication, he manages to keep his depression under control.

The primary drug used when dealing with depression is Lithium. "Lithium is generally used only as an augmenting agent in patients who have not had a response to antidepressant drugs alone (Price 1994). Most patients receiving lithium have side effects, reflecting the drug's narrow therapeutic index. Many symptoms and signs of toxicity are closely correlated with plasma lithium concentrations (Price 1994).

The Food and Drug Association (FDA) banned lithium in response to the deaths of several patients in 1949 (Price 1994). There are several more side effects when dealing with lithium and the patients who use it. The most common is hand tremors, which occur in 25 to 50 percent of patients and diminishes with time and the reduction of dosage. There is also some minor memory impairment and lethargy may occur. Difficulty finding words, decreased creativity, and constriction of normal affects are also common (Price 1994).

Depressive illness is one of the most common disorders seen in primary care and is associated with high rates of chronic disability and other functional impairment (Croghan 1998). Depressed patients frequently suffer from other mental and or general medical disorders. Depression is quite difficult to recognize in the general medical setting, in fact, only half of all patients with depression are correctly diagnosed (Croghan 1998). What does treatment for depression really cost? In Croghan's report, treating an uncomplicated episode of depressive illness in this primary care population averaged a bit more than two thousand dollars.

However, depressed patients consume a disproportionate amount of medical resources; an overall average of nearly eight thousand dollars during the year following the index prescription for an antidepressant (Croghan 1998). Treatment is quite expensive and time consuming. It controls a person's life with such things as doctor visits, medical bills, required medication, and family dilemmas. Severe depression can lead to suicidal thoughts on the patient's behalf.

A patient usually becomes suicidal due to the feeling of hopelessness and helplessness. A patient can even be diagnosed with suicidal depression. The patient might start to turn to other objects for help. This is when a person becomes addicted to alcohol or some sort of drug for no other reason, but suppression. Still a person who is determined to kill him or herself will probably prevail despite the best efforts of family members and health care professionals (Hirschfeld 1997).

However, the overwhelming majority of people who desire the kill themselves at one time or another will feel quite different after improvement in their depression or after receiving aid with other problems (Hirschfeld 1997). Suicide is a serious thing and a surreal incident that I have been involved in. As said before, my uncle does get severely depressed and has discussed the idea of suicide. Everyone jokes here and there about killing him or herself; however, it isn't a joke when they lock themselves in a room with a loaded gun. He yelled threats of suicide and had been drinking excessively. My father and aunt were able to calm him down and he began to cry.

This could have all been avoided if my uncle was taking his regular dosage of lithium. Yet, what if we weren't there? Manic depression is a disease that can change a person's life. Depression can start at anytime within your life. "By the age of 3, they are able to conceal disappointment spontaneously, but will believe the examiner knows how they truly feel. By the age of 6, children will know that facial expressions can be misleading, and by the age of 7 up until 11, they will be able to feign emotions for self-protection or out of consideration for others (Gonzalez-Heydrich 1996)." As we grow older our minds expand. Depression can set in at an early point in your life or late into it.

Traumatic episodes and even thoughts can play a role in the dilemma of depression. This disease can be controlled, yet think about those who cannot afford the treatment. Who do they turn to? They are going to live the rest of their lives in an altered state of depression forever. Works CitedCroghan, W. Thomas, Oben chain, L. Robert, and Crown E.

William. July 1998. What does Treatment of Depression really Cost? Health Affairs. Daly, Ian. Mania. Lancet 1997: 349 (9059): 1157-1160.

Gonzalez-Heydrich, Joseph. The Depresses Child and Adolescent: Development and Clinical Perspectives. N Engl J Med; 334: 1410-1411. Hirschfeld, M. A. Robert, & Russell M.

, James. 1997. Current Concepts: Assessment and Treatment of Suicidal Patients. N Engl J Med; 337: 910-915. Parton en, Timo, & Lonnqvist, Jocko.

1998. Seasonal Affective Disorder. Lancet 1998; 352 (9137): 1369-1374. Price, H. Lawrence, & Henninger, R. George.

1994. Drug Therapy: Lithium in the Treatment of Mood Disorders. N Engl J Med 1994; 331: 591-598.