One of my patients, for example, was a brilliant and hardworking successful City man. Arguably he was the leader of his particular City discipline; undeniably he had achieved eminence in the financial world. He wouldn't admit consciously to himself that his troubles were psychological rather than physical. What he didn't realize was that depression may well be cyclical. Each time he became depressed, he complained of symptoms that might well have occurred if he had some actual physical ill. When his depression lifted, all was well for a few years before he came back to see me with a new batch of symptoms.
It is important to recognize that the signs of depression are legion. They may often be an indication that stress from one aspect of life or another has become important - but this is rarely the whole story if a patient has the classic signs of an affective illness: one that affects mood. These people need treatment at the earliest opportunity.
Any one of the many symptoms of depression shown in the following questions is important, and each has to be evaluated on an individual basis. These symptoms may not only be precipitated by stress, but they may also be worsened by it. The symptoms are also analyzed so that the depth of a patient's depression may be assessed. Doctors especially take note of any suicidal thoughts, feelings of hopelessness, diurnal variation (that is to say, a lighter, more cheerful, positive mood in the morning than in the afternoon), loss of appetite, loss of weight, or any symptoms that might be indicative of psychotic change.