context: Untreated clinical depression is a serious problem. Untreated depression increases the chance of risky behaviors such as drug or alcohol addiction. It also can ruin relationships, cause problems at work, and make it difficult to overcome serious illnesses. Clinical depression, also known as major depression, is an illness that involves the body, mood, and thoughts. Clinical depression affects the way you eat and sleep. It affects the way you feel about yourself and those around you. It even affects your thoughts. People who are depressed cannot simply âpull themselves togetherâ and be cured. Without proper treatment, including antidepressants and/or psychotherapy, untreated clinical depression can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression. There is mounting evidence that clinical depression takes a serious toll on physical health. The most recent studies exploring health and major depression have looked at patients with stroke or coronary artery disease. Results have shown that people with major depression who are recovering from strokes or heart attacks have a more difficult time making health care choices. They also find it more difficult to follow their doctor's instructions and to cope with the challenges their illness presents. Another study found that patients with major depression have a higher risk of death in the first few months after a heart attack. One of the most telling symptoms of clinical depression is a change in sleep patterns. Though the most common problem is insomnia (difficulty getting adequate sleep), people sometimes feel an increased need for sleep and experience excessive energy loss. Lack of sleep can cause some of the same symptoms as depression -- extreme tiredness, loss of energy, and difficulty concentrating or making decisions. In addition, untreated depression may result in weight gain or loss, feelings of hopelessness and helplessness, and irritability. Treating the depression helps the person get control over all of these depression symptoms. Common signs of insomnia include: Daytime fatigue Irritability and difficulty concentrating Sleep that never feels like "enough" Trouble falling asleep Trouble going back to sleep after waking up during the night Waking up at all hours of the night Waking up before the alarm clock goes off Alcohol and drug abuse are common among people with clinical depression. They're especially common among teens and among young and middle-age males. It is very important to encourage these people to get help, because they are more likely to attempt suicide. Signs of drug and alcohol abuse include: Inability to maintain personal relationships Secretive alcohol use Self-pity Tremors Unexplained memory loss Unwillingness to talk about drugs or alcohol Those who suffer depression and abuse drugs or alcohol may need very specialized treatment. Men who have untreated clinical depression may exhibit more anger, frustration, and violent behavior than women. In addition, men with untreated depression may take dangerous risks such as reckless driving and having unsafe sex. Men are not aware that physical symptoms, such as headaches, digestive disorders and chronic pain, can be symptoms of depression. Depression can render people disabled in their work life, family life, and social life. Left untreated, clinical depression is as costly as heart disease or AIDS to the U. S. economy. Untreated depression is responsible for more than 200 million days lost from work each year. The annual cost of untreated depression is more than $43.7 billion in absenteeism from work, lost productivity, and direct treatment costs. Living with a depressed person is very difficult and stressful for family members and friends. It's often helpful to have a family member involved in the evaluation and treatment of a depressed relative. Sometimes marital or even family therapy is indicated. Depression carries a high risk of suicide. This is the worst but very real outcome of untreated or under-treated depression. Anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call your local suicide hotline immediately. Call 800- SUICIDE (800-784-2433) or 800-273- TALK (800-273-8255) -- or the deaf hotline at 800-799-4889. Most people who suffer from clinical depression do not attempt suicide. But according to the National Institute of Mental Health, more than 90% of people who die from suicide have depression and other mental disorders, or a substance abuse disorder. Men commit almost 75% of suicides, even though twice as many women attempt it. The elderly experience more depression and suicide than you might think. Forty percent of all suicide victims are adults over the age of 60. Older adults suffer more frequently from depression because of the frequent loss of loved ones and friends as they age. They also experience more chronic illnesses, more major life changes like retirement, and the transition into assisted living or nursing care. Warning signs of suicide include: Talking, writing, or thinking about killing or hurting oneself or threatening to do so Depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse Having a "death wish;" tempting fate by taking risks that could lead to death -- for example, driving through red lights Losing interest in things one used to care about Making comments about being hopeless, helpless, or worthless Putting affairs in order, tying up loose ends, or changing a will Saying things like "it would be better if I wasn't here" or " I want out" A sudden switch from being very sad to being very calm or appearing to be happy Suddenly visiting or calling people one cares about Talking about suicide Increase in drinking alcohol or using drugs Writing a suicidal note Watching well publicized murder and/or suicide reports in the media Conducting on-line searches on ways to commit suicide Seeking methods to kill oneself, such as getting a gun or pills For in depth information, see Web MD's Depression and Suicide. More than 80% of people with clinical depression can be successfully treated with early recognition, intervention, and support. Depression affects almost 19 million people each year, including a large portion of the working population. People with untreated depression can usually get to work. But once there, they may be irritable, fatigued, and have difficulty concentrating. Untreated depression makes it difficult for employees to work well. Most people do best with depression treatment using psychotherapy, medications, or a combination of both. For treatment-resistant depression, one that does not respond to medication, there are alternative treatments. One example is electroconvulsive therapy or ECT.