According to NIH findings, one in20 American adults experiencemajor depression in a given year.1 The Depression and Bipolar Sup-

people suffer from depression annual-ly, with twice as many women afflicted as men. They estimate that as many as 25 % of women suffer from depression serious enough to require treatment at least once in their lifetime.2 The Na-tional Alliance on Mental Illness indi-cates that “major depression is the leading cause of disability in the United States and many other developed countries, and affects 15 million American adults or about 5 to 8 % of the adult population in a given year.”3 Many other comorbid disabilities—such as cardiovascular events—can accompany depression. Depression may also result in chronically elevated levels of stress hormones, such as corti-sol and epinephrine, and thus represents a condition that di-verts metabolism away from tissue repair when needed for heal-ing. Feelings of helplessness or of being out of control of one’s life also impair the immune system, increasing susceptibility to a wide spectrum of pathologies from infections to cancer. The fact that women are twice as likely as men to develop depression is also in accord with the finding that, in U.S. society, it is more likely for women to feel out of control of their lives.4 Aside from the general population, chronic pain patients al-most invariable suffer depression as a direct result of their pain and accompanying disability. Almost any chronic illness, espe-cially ones with no clearly effective treatment, have a high inci-dence of comorbid depression. Based on these descriptions of the physical manifestations of depression, it is clear that it can have a devastating effect in the pain patient and others with chronic diseases. While depression is a common term for describing how one feels, the technical psychiatric definition goes beyond just a feel-ing of sadness. For such a commonly-used term, it behooves us to scrutinize some technical definitions and terms. Depression is a “mental state characterized by feelings of sadness, loneli-ness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation or, at times, agitation, withdrawal from interpersonal contact, and vegetative symptoms such as insomnia and anorexia. The term refers to either a mood that is so characterized or a mood disorder.”