Depression manifests itself in four ways: state of mind or mental state; thinking or cognitive patterns; somatic functioning; and behavioral patterns. Patients with depression almost always experience a state of mind that is sad, gray, worried like an abyss, depressed, and depressed. If the state of mind does not manifest as depression, the patient may show a loss of interest in most activities of daily living. Sometimes the state of mind can be lifted by encouragement and praise from good news, sometimes it cannot. Many times doctors use the term affect instead of state of mind, which refers to the same thing in depression. Depression is classified as a state of mind disorder or what is called an affective disorder. The depressed person’s thought patterns are often characterized by negative evaluations of themselves, the present, and the future. Repressed ruminative meditation is often characterized by recurrent pessimistic thoughts. Depressed people often complain about their inability to concentrate, memory loss, and difficulty making decisions. Anxiety is also frequent, manifesting as a non-specific feeling of uncertainty about what is going to happen, or as an excessive fear of particular situations. When depression is most severe, delusions and hallucinations may also occur. This type of severe depression is considered “psychotic depression”. People who have hallucinations, delusions and loss of judgment have lost the ability to empathize with reality. The effects of depression also involve the vegetative functions of the body. Patients have disturbances in appetite, which may manifest as loss of appetite and weight loss and, in a few cases, hyperphagia and weight gain. Sleep disturbances, usually difficulty falling asleep, insubstantial sleep, early morning awakening with difficulty falling back to sleep, and in a few cases excessive deep sleep or increased sleep; fatigue; low energy; decreased interest in daily activities including sex; gastrointestinal symptoms such as dry mouth, nausea, constipation, diarrhea; unexplained wandering pain that improves with depression. Behavioral changes in depression are closely related to changes in state of mind, thinking, and somatic changes. Behavior can range from less severe incomprehensible to more severe and obvious problems such as easy crying, sadness, stiff posture, swaying gait, fidgeting, rubbing both hands together, etc. Some patients are able to perform daily tasks, but may feel somewhat fearful and depressed. Others are unable to perform daily operations such as dressing, eating, washing and working. Sometimes depressed people smile to hide their depression, called “forced smiling depression”. The most unusual example of depression is suicide.