ABSTRACT
Chapter 2 describes features of the course of depressive disorders, such as age of onset, duration and severity, chronicity and recurrence. For some people depressive experiences may be minor but for others depression is literally a life and death experience. Some individuals may experience depression that meets diagnostic criteria for only a single episode with full recovery, but for many its course is recurrent or persistent. The most typical age of onset is adolescence or early adulthood, and commonly, earlier onset may portend more impaired functioning and more depression. Depression can also occur in older age, but first onset in later ages may be especially related to neurobiological disorders. Depression may be detected in childhood, sometimes marking an especially impairing and adverse course of depression, but childhood depression can also be an early marker of nondepressive disorders. Depression sometimes has been misunderstood as a state to be overcome with stronger character, willpower or just ‘snap out’ of, but society has recently begun to understand the enormous costs of depression in terms of its debilitating effects not only on the sufferer but on spouses, children and families, the workplace and health.
