Depression is probably the most familiar disease in our field. Since I’ve been in this industry, the most consulted by my friends around me is: I’m in a bad mood, I can’t be happy, do I have depression? Next I will talk to you about depression, so that you can see if you are depressed or not. Clinical manifestations Depressive episodes are clinically characterized by depressed mood, slowed thinking, reduced volitional activity and somatic symptoms. 1, depressed mood . Mainly manifested as significant and persistent depressed mood, depression and pessimism; patients spend their days worried, depressed, sad, long and short sighs. Patients who are more advanced feel sullen and unhappy, lack interest in everything, and feel bored in activities they usually enjoy, such as playing cards and watching soccer matches, and feel uninterested in anything, feeling “psychologically depressed” and “unmotivated”. Patients often complain that “there is no point in living” and “it’s hard to feel psychologically”. Some patients may be accompanied by anxiety and agitation symptoms. Typically, the mood depression is more severe in the morning and decreases in the evening. Under the influence of depressed mood, patients have low self-esteem, feel inferior to everything, blame all the faults on themselves, often produce a sense of uselessness, hopelessness, helplessness and worthlessness. They feel that they are incapable and incompetent, and feel that they have dragged down their families and society; when they look back on the past, they have achieved nothing, and feel guilty for their unimportant and dishonest behavior in the past; when they think of the future, they feel that their future is bleak, and meet that their jobs will fail, their finances will collapse, their families will have misfortunes, and their health will definitely deteriorate. On the basis of pessimism and disappointment, there is a feeling of isolation, accompanied by self-blame and self-guilt, and even delusions of guilt (the patient is convinced without any basis that he/she has made a serious mistake, an unforgivable sin, and should be severely punished, so he/she believes that he/she is so guilty that he/she has to die or refuses food to commit suicide; the patient asks for labor reform to atone for his/her sin); there is also a suspicion of illness on the basis of somatic discomfort. The patient may also have delusions of relationship (the patient believes that things in the environment that are not related to him are related to him), delusions of victimization (the patient is convinced that he is being followed, monitored, slandered, isolated, etc. The patient may refuse food, press charges, run away, or act in self-defense, self-injury, or hurt others under the control of delusions), and so on. Some patients may also experience hallucinations. 2. Delayed thinking. Patients have slow thinking, slow reaction, closed thinking, and feel that “the brain is like a rusted machine” or “the brain is not opening like a layer of paste”. The clinical manifestation is the reduction of active speech, the speed of speech is obviously slowed down, the voice is low, the patient feels that the brain can not be used, it is difficult to think about problems, and the ability to learn and work is reduced. 3. Decreased volitional activity. Clinical behavior is slow, life is passive, lazy, do not want to do anything, do not want to contact with people around, often sit alone, bedridden, do not want to go to work, do not want to go out, do not want to disability usually like activities and hobbies, often closed door to live alone, alienated friends and relatives, avoid social. In severe cases, even food and drink and their personal hygiene are not taken into account, and even develop into non-verbal, non-moving, non-food, and can reach the state of rigor mortis. Patients with anxiety may have symptoms such as fidgeting, finger grasping, hand rubbing or pacing around. Patients with severe depressive episodes are often accompanied by negative suicidal ideation and behavior. Negative pessimistic thoughts and self-blame can lead to desperate thoughts that “ending one’s life is a relief” and “one is redundant in the world”, and can promote planning for suicide and develop into suicidal behavior. The idea of suicide usually arises gradually, the lighter the person only feels that life is meaningless and not worth staying, and gradually the idea of sudden death arises, with the aggravation of depression, the idea of suicide becomes stronger and stronger, and tries to end oneself by all means. 4.Somatic symptoms. Mainly sleep disorders (mainly manifested as early awakening, usually 2 to 3 hours earlier than usual, unable to fall asleep after waking up, which is characteristic for the diagnosis of depressive episodes, but also can be manifested as difficulty in falling asleep and not sleeping deeply; a few manifested as excessive sleep), loss of appetite, weight loss, loss of libido, constipation, pain in any part of the body, impotence, amenorrhea, weakness, etc. Somatic discomfort can involve all organs. Autonomic dysfunction is also more common. 5. Other. Depersonalization, dissociation of reality and its obsessive-compulsive symptoms may occur. In addition to depression, most patients with geriatric depression have prominent anxiety and irritability, which can sometimes be manifested as irritability and hostility. Psychomotor retardation and somatic complaints are more pronounced than in younger patients. The symptoms of cognitive impairment, similar to dementia, may be more pronounced due to significant delays in thinking and memory loss, such as decreased ability to calculate, remember, understand and judge. Somatic complaints include gastrointestinal symptoms, such as loss of appetite, bloating, constipation, etc., and often dwell on a single physical complaint, and tend to develop suspicion, which can lead to hypochondria, vagueness and delusions of guilt. The above are only the common clinical manifestations of the disease, and whether it is the disease or not, it needs to be analyzed by a specialist according to the specific situation of each patient. What I want to say to the patients and their families about the disease is: (1) I understand the patients’ pain, the patients’ negative experiences are real, not something they want to think about, not something that will disappear if they don’t want to. impotence, amenorrhea, weakness and other somatic symptoms, forming a new virtuous cycle and improving the patient’s quality of life; (3) the support and understanding of the patient’s family is important to reduce the patient’s anxiety and depression and improve the patient’s confidence in treatment, while, as the patient’s family needs to be alert to the patient’s negative behavior such as suicide.