Depression is a very common experience.  Everyone feels fed up, miserable or sad sometimes.  Usually the reasons seem obvious such as a disappointment or frustration, losing someone or something important, but not always.  Sometimes we are feeling low, sad, moody and the reasons are not so obvious.
In some people depression can be so severe that it dominates their lives, Coping may seem  difficult or impossible preventing them from leading the life they really want. Well meaning relatives or friends may suggest "pulling yourself together", they may even make accusations about " being lazy", "giving in", "self pity" .  These kind of responses are not helpful and also untrue, and only make things worse in most cases. Depression of this degree is an illness, and needs treatment.
As in the more ordinary, everyday depression, there is sometimes an apparent cause, and sometimes not.  It may be a reaction to physical illness, bereavement, stress, overwork, unemployment, problems with relationships, money, housing worries for example, but the reaction is much more intense and lasting. However, quite severe, devastating depression can also come right out of the blue.

Symptoms
Certain characteristic symptoms can give you, your family or your doctor a clue that you need professional help:

A loss of interest and enjoyment in life
A lack of drive and motivation that makes even simple tasks and decisions seem difficult or impossible
Utter fatigue
Agitation and restlessness
Loss or gain in appetite, with loss or gain in weight
Sleeplessness or excessive sleeping
Loss of outward affection, going off sex
Loss of self confidence, avoiding meeting people
Irritability
Feeling useless, inadequate, bad, helpless and hopeless
Feeling worse at a particular time of day
Thoughts of suicide; these are very common in depression and are a certain sign that help is needed

Causes
It is quite normal to feel depressed after a distressing event, but normally, after time we 'work through' our feelings about what has happened and come to terms with them. But sometimes such events lead to more serious and persistent depression from which we find it harder to emerge.
Circumstances at the time we are stressed play a part.  If we are alone, friendless, have many other worries or are physically debilitated, then we may get seriously depressed where in happier times we would cope.

One in ten women suffers persistent depression after childbirth.  Depression is also a common accompaniment to physical illness, especially those which threaten life, like cancer and heart disease, or are long and painful, like arthritis. bronchitis or stroke.  Some depression may follow infections, like influenza.
Personality may also play a part in depression.  Although anyone can become depressed under certain circumstances, some of us seem to be more vulnerable than others, because of our individual make up (including our body chemistry) or because of certain earlier experiences.

It seems that women get depressed more than men.  This may be because men are less likely to admit their feelings, bottle them up, or express them through aggression or through drinking heavily, or because women may be under more stress, say from having to work and also look after a child or children.
About one in ten people who suffer from serous depression will also have periods when they are elated and overactive.  This form of depression, known as manic depression affects equal numbers of men and women and tends to run in families.

Seeking Help
When depression is more severe than we might expect, or goes on, it is time to seek help.  We also need help if the depression seems to affect our work, interests and feelings towards family and friends, or if there are thoughts or feelings that people might be better off without us.

Sometimes just talking things over with a relative or friend, in whom we can confide, and who can support and reassure us, may be enough to see us through the bad patch. If however the depression seems to have taken a stronger hold, then a visit to the General Practitioner or suitably qualified therapist is usually the most sensible course.

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Further Reading
Rowe, D. (2003) Depression:The way out of your prison. Sussex.  Brunner Routledge.
Brampton, S. (2009) Shoot The Damn Dog: A memoir of depression. London. Bloomsbury.
Cantopher, T. (2006) Depressive Illness:Curse of the strong. London. Sheldon Press.