In factors (Bradley, 2016). These abnormal factors tend

today’s society, depression is one of the principal causes of disability
worldwide, affecting more than 400 million individuals’ length and quality of
life. According to the 2013 Global Burden of Disease Studies, it is considered
the worlds most prevalent and widespread mental health disorder (Vos, et al.,
2013). It has been said that roughly 1 in 6 individuals in the UK reports
experiencing depression each year (McManus, et al., 2016). If left untreated at
its worst state, it can lead to suicide (WHO, 2017).  With the rise of depression amongst
individuals, it poses a threat to public health and population, resulting in
the demand for its treatment to increase drastically.

medical definition of depression according to the Oxford dictionary is a mental
condition characterised by feelings of severe hopelessness and dejection, in
addition to the feelings of inadequacy and guilt, which is also accompanied by
the lack of energy and changes in appetite and sleep” (Oxford English
Dictionary, 2010). This condition can also be called Clinical Depression where
the symptoms in individuals can often be present on their own or coexist with
each other.

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is no specific reason as to why certain individuals experience depression, but
it is said that it can be caused by abnormalities in factors such as genetic,
environmental, psychological and social factors (Bradley, 2016). These abnormal
factors tend to trigger the onset of the disorder; an interaction between them
can also worsen the depression itself (WHO, 2017). These ideas are further
explored in Chapters 2, 3 and 4. It is important to consider these factors as
they tend to affect the severity of depression and the individual’s response to
the antidepressant treatment.

diagnosis of depression is currently done using any of the two major
classification systems available. This is either the World Health
Organisation’s – International Classification of Disease -10 (ICD-10) system or
the Diagnostic and Statistical Manual (DSM-IV) system (Bebbington, 2004). Both these
systems screens the affected individual, and, determines the severity of the
condition by establishing the number and severity of the symptoms present, in
addition to determining the degree of functional impairment (NICE, 2009). The
criteria of diagnosing depression using ICD-10 is that patient must have at
least 4 depressive symptoms out of the 10 available, whilst on the other hand,
DSM-IV requires at least 5 depressive symptoms out of the 9 available (See
Table 1 for symptoms). However, both systems require the presence of key
symptoms (*) and for the symptoms to have been present for 2 weeks or more to
provide a diagnosis (Nice Clinical Guidelines, 2010). Through this, healthcare
professionals are able to categorise the individual into one of these
categories – mild, moderate or severe depression and provide appropriate