Depression is a state of low vitality and discontent with life in which the individual withdraws from normal life activities even to the point of considering death as an attractive alternative.

Although everyone experiences "the blues" or periods of low spirits when nothing in life seems to go well, when everything seems to be an effort, and when efforts lead to frustration, these periods are usually brief and are likely to occur when the person is tired, hungry, lonely, or sick. Rest, good food, talking with friends, some fun, and/or an end to the sickness are usually enough to cure the blues. But when the low spirits persist, or when there are large swings in mood from elation to desolation, when nothing seems to catch the interest of the person, when relatives or friends cannot cheer the person and he or she continues to withdraw, then the person is depressed.

Even such depressions are normal under certain circumstances. Anyone who is faced with a serious and painful illness or the loss of a limb, is exhausted by repeated narrow escapes from death (such as occurs in wartime), has been exposed to a dehumanizing environment (such as occurred with the Jews in Nazi Germany), has had an overwhelming series of stressful setbacks, or has experienced the death of several family members within a short time is expected to be depressed.

However, there are many depressed people who seem to the casual observer to have no reason to be depressed. Depression under these circumstances stems from severe behavior disturbance in which the person sees himself or herself as worthless. Such an image is usually the result of the psychosocial conditioning of a childhood deprived of a parental role model of security, love, care, and attention essential for the development of trusting relationships. The depressed person needs to build a new image of himself or herself as a useful and needed person. Psychotherapy is often helpful in restoring natural inner confidence and capacity for meaningful and trusting relationships.

The depressed person can find little beauty or fun in life. His or her talk is filled with gloomy negatives. Doom and anxiety fill his or her mind. Depression is often cyclical, and when the anxiety does lift the person may demonstrate an opposite extreme of carefree irresponsibility.

Although it often takes years of psychotherapy for the individual to work through the underlying suspicion and anger of his or her problems, acceptance by another will get through to even the most deeply depressed person if the other is sincere. An attitude of matter-of-fact hopefulness on the part of those around the depressed person can reassure him or her of eventual recovery.

The disturbed thoughts of the depressed person cannot be forgotten until they are replaced by other thoughts. Yet, in depression, the person does not see that he or she has choices about what thoughts occupy his or her mind. The person needs to explore alternatives for thoughts and actions and learn to care for himself or herself enough to modify his or her own behavior.