However, given several such persistent problems, a professional review is needed. Important indicators are lack of energy, becoming socially withdrawn, feeling inadequate, less efficient, inability to concentrate and being indecisive. Some people develop physical complaints that do not respond to medical care. Hopelessness is often associated with severe depression and may pose the risk of suicide. Some depressions are chronic and persistent whereas others may last for months and then improve for no apparent reason.
Patients differ in their ability to be cheered up.
Some simply have no response to usually pleasing situations, whereas others have their spirits raised but then slump again. A loss of ability to care for themselves or preoccupation with thoughts of death and suicide is a psychiatric emergency that requires prompt care. Confusingly, one depressive illness, often called Manic-Depressive or Bipolar, is characterized by phases where people seem the exact opposite of depressed. They are overly energetic, risk taking, impulsive, over-talkative, require little sleep, and have an elated mood. These manic periods are particularly dangerous because they prompt dangerous activities that may destroy reputation, relationships, and life's work.