Psychological medicine. Stress and distress.

A patient's anxiety or depression can be the natural consequence of change in his life's circumstances, whether the death or departure of a loved one, overcrowding in the home, loss of job owing to retirement or redundancy, financial crisis, or simply loneliness and despondency. It is easy to recognize an anxiety state when it accompanies a reason for intense strain. But feelings of sadness can follow, perhaps after a delay, when it can be more difficult to connect their cause. Indeed stress can precipitate florid depressive illness, when guilt and suicidal feelings determine the clinical picture.