Depression is a mental disorder characterized by gross mood disturbances which is of extreme sadness. In addition to the mood changes there are other bodily and emotional disturbances.

One should be able to distinguish "true" depression from states of unhappy "malaise" that troubles people with abnormal personalities, those with drug abuse or people with chronic painful illness. They are not depressive (dysphoria).

Depression comes with three types which includes; Neurotic, Endogenous and Involutional depression.

Under the causes of depression, it includes the following external factors; Bereavement, loss of property, disappointment, failure to achieve set goals, loss of jobs, feeling of isolation and insecurity due to broken homes, drugs such as subhonamides. All these external factors are the main causes of neurotic type of depression.

 The actual cause of the psychotic type is unknown. It is a type of functional psychotic, therefore the onset is due to the interplay between predisposing and precipitating factors. These include; Genetic, Biochemical hypothesis, Age, Sex, head injury, drugs, constitution (body type, pyknic personality) and psychodynamic factors such as loss of love one or object.

The general signs and symptoms of depression include the following (psychological); irritability, hopelessness, withdrawn, anxiety and tension, depersonalization, loss of self esteem, lack of concentration, apathy, crying spells, and feeling burdened. The physical symptoms includes; Insomia, Blurred vision, amenorrhoea, dryness of mouth, indigestion, palpitation, refusal of food and constipation.

The prognosis of depressive patients are generally good than other forms of psychiatric disorder. The average stay in hospital should not exceed 6 weeks.

The management and medical treatment of depression in most cases should include; admission, especially when there are suicidal tendencies, in the approach there should be good interpersonal relationship between the supportive relative and patient, rest must be ensured (both physical and mental), patient vital signs must be observed.

Medical drugs such as Tricyclic antidepressants include; Imipramine (75-200 mg), amitriptyline (17 – 200 mg) and Trimipramine (75- 200 mg) daily.

Other therapies such as Electro – Convulsive therapy (ECT) is good for endogenous depression but should not be used for reactive depression. Psychotherapy such as individual or group, behavior modification therapy should be used. Social therapy, occupation therapy, recreational therapy and rehabilitation, these are necessary to raise the patient self esteem and make him feel acceptable. The most important nursing management here however, is the observation and prevention of suicide and suicidal tendencies and this is achieved by maintaining good nurse-patient relationship.

The complications of depression include the following; suicide and attempted suicide, malnutrition, dehydration, constipation, retention of urine, abuse of drugs and deterioration of co-existing physical disease.