
THE LIFETIME RISK FOR major depression (severe depression) has varied from 10% to 25% for women and from 5% to 12% for men. The prevalence of major depression in adults has varied from 5% to 9% for women and from 2% to 3% for men. Unable to cope with the pressures of life, some students may breakdown and have a severe depressive episode or even commit suicide. Major psychosocial factors in university students who are experiencingdepression consist of academic problems, problems with friends, economic problems, family problems, and identity problems.
Major depressive disorder (severe depression) may be diagnosed when five (or more) of the following nine symptoms have been present during a 2-week period; depressed mood, loss of interest or pleasure, significant weight loss or weight gain (a change of more then 5% of body weight) or, insomnia or hypersomnia (extreme sleepiness), psychomotor agitation, or retardation fatigue, or loss of energy, feelings of worthlessness, or excessive guiltiness, diminished ability to think or concentrate or indecisiveness, recurrent thoughts of death.

The combination of pharmacy therapy & cognitive therapy may be the most effective treatment for depression. Aaron Beck postulated a cognitive triad of depression that consists of (1) views about the self - a negative self-precept, (2) about the environment - a tendency to experience the world as hostile and demanding and (3) about the future - the expectation of suffering and failure. Therapy consists of modifying these distorted views. Cognitive therapy is a technique in which patients are taught new ways of thinking to replace faulty negative attitudes about themselves, the world, and their future. Norepinephrine and serotonin in the central nervous system are the two neurotransmitters most implicated in the pathphysiology of depression. So, selective serotonin reuptake inhibitors such as fluoxetine, sertraline, paroxetine, citalopram are of used for patients who are experiencing severe forms of depression. Similarly, bupropion, venlafaxine, or Mirtazapine may also be effective treatments for patients with depression.