Please note, this is not a authoritative medical/clinical statement, but one of personal opinion and anecdotal observation.

Clincial depression is, and must be treated as, a genuine physical illness - of which the sufferer has little or no control. It is a physical illness of the brain chemistry (lymbic system) which results in irrational thought processes, feelings of utter doom, despair, worthlessness, inability to cope and often an inability to control which thoughts are in your head (often typified by "ruminating" - having the same thoughts of despair or overwhelmingness over and over again uncontrollably).

This is a devasating condition for the sufferer, who more  than anyone in the world wants to get better and recover, but is powerless to do so of their own accord. They are as powerless to do so as someone with a broken arm is to make their arm heal faster. Someone with a broken arm can create the best conditions to allow nature and medical intervention to take its course, but nature will take her own time to heal. The same is true with clinical depression. I sometimes talk of clinical depression as "limbic dsyfunction", because that way people tend to think of it and treat it as a "proper" illness.

Telling someone who has clinical depression how they could get better or what they ought to do to recover is futile and often counter-productive, because if it was possible, the sufferer (who is in such misery) would have certainly done it already. The person making such remarks comes across as not understanding the illness, and so this further isolates the sufferer. Most sufferers talk of clinical depression as feeling in a deep (perhaps infinitely deep) black well, with no way out, no ladder, and no light at the top. It seems pointless even trying to climb out, because it seems such an impossibility and there is nothing at the top to look forward to. Metaphorically, anti-depressant medication begins to offer the sufferer a ladder - but the road to recovery is often long and prone to many slips and falls.

Clinical depression is therefore not the same as what most people call "depression" - a "dose of the blues", or low mood or a period of being unable to cope very well during difficult periods. Some of the symptoms manifest in the same way - loss of sleep, loss of appetite, low mood, feelings of not being able to cope - but ultimately someone who is "a bit down (depressed)" can often recover fairly quickly, can continue to think rationally about how to solve their problems and experiences a "depressed" mood for a relatively short period and can recover without medical intervention.

This is simply not the case with clinical depression, which can incapacitate and totally debilitate the sufferer. Sometimes the sufferer can see no way of recovery or recall any feelings of happiness or worthiness, and this may lead to "suicide ideation" - i.e. coming to the conclusion that the only way to end the misery is to end their life. Sadly, some sufferers then carry this out.

Anyone who says (or thinks) "pull yourself together" as the best means for a sufferer to recovery is grossly ignorant of the condition, its physiology and it effects. Many people think "we never had depression in my generation, we just got on with life". In fact, older generations probably did have depressive illness, but perhaps never really spoke of it or diagnosed it - very often mental illness was treated in inhumane ways in times gone by.

But it may also be the case that depressive illness is more prevalent in today's society (certainly if you believe the statistics). After all, we are much more fragmented and mobile and live at a much faster (and arguably more stressful) pace. Families live together less and thus support networks can be non-existent. Single parent families are more the norm than the exception, placing parents and families in stressful and perhaps dysfunctional situations of upbringing. Our expectations are driven and conditioned by a media-led money-hungry world and information overload is the norm. I personally think these factors contribute significantly to extent that depressive illness touches so many lives

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