Although depression is often thought of a being an extreme state of sadness, there is a vast difference between clinical depression and sadness. Sadness is a part of being human -- a natural reaction to painful circumstances. All of us will experience sadness at some point in our lives. Depression, however, is a physical illness with many more symptoms than an unhappy mood.
The person with clinical depression finds that there is not always a logical reason for his dark feelings. Exhortations from well-meaning friends and family for him to "snap out of it" provide only frustration, for he can no more "snap out of it" than a diabetic can will his pancreas to produce more insulin.
Sadness is a transient feeling that passes as a person comes to term with his troubles. Depression can linger for weeks, months or even years. The sad person feels bad, but continues to cope with living. A person with clinical depression may feel overwhelmed and hopeless.
To clarify the differences between normal sadness and depression, there are specific, defined criteria for the diagnosis of major depression:
A person who suffers from a major depressive disorder must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a two-week period. This mood must represent a change from the person's normal mood and impair his functioning in his daily life.
A depressed mood caused by substances such as drugs, alcohol, or medications is not considered a major depressive disorder, nor is one that is caused by a general medical condition.
In cases of bereavement, major depressive disorder may be at play if the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
Major depressive disorder cannot be diagnosed if a person has a history of bipolar disorder (ie. manic, hypomanic or mixed episodes) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia.
This disorder is characterized by the presence of 5 or more of the following symptoms:
•Depressed mood most of the day, nearly every day. An individual may express feeling sad or empty, or others may observe it (ex: appears tearful). Children and adolescents may exhibit irritability
•Markedly diminished interest or pleasure in all, or most, daily activities most of the day, nearly every day
•Significant weight changes (ex: a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day
•Insomnia or hypersomnia (sleeping too much) nearly every day
•Psychomotor agitation or retardation nearly every day
•Fatigue or loss of energy nearly every day
•Feelings of worthlessness or excessive or inappropriate guilt nearly every day
•Indecisiveness or diminished ability to think or concentrate nearly every day
•Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
If you are still uncertain as to whether you (or a loved one) may be suffering from depression, screening tests exist that can help you determine whether seeking a professional evaluation is advised. There is a test provided on this site that is simple to use and completely confidential.
Common Causes of Depression
In a general sense, depression is caused by an imbalance in chemical messengers in the brain called neurotransmitters; however, a variety of factors - including your genetic makeup, your environment, your physical condition and your psychological coping resources - interact together to determine whether you will develop depression.
Types of Depression
Depressive disorders may be classified as major depressive, dysthymic, or not otherwise specified -- a catch-all for conditions that do not fit the other categories. Specifiers, such as atypical, postpartum, or seasonal, may be added to a diagnosis to describe the nature of the most recent episode of depression or the course of the illness over time. Depression may also be part of bipolar disorder, in which a patient experiences alternating periods of depression and mania. It may seem like depression is depression, but there are many shades of grey that set one type apart from another.
Signs and Symptoms
Symptoms of depression can seem both subtle or pronounced. Knowing what to be on the lookout for can help you determine when it's time to see a doctor.
Getting an Formal Diagnosis
In order to make a diagnosis of depression, your doctor uses a set of diagnostic criteria found in a book called the Diagnostic and Statistical Manual of Mental Disorders. During his interview with you he will look for any signs of depression that you may be exhibiting and ask you about your symptoms. He will also ask about your and your family's medical history. In certain cases, he will also order laboratory tests to rule out any other conditions that may be causing your symptoms.
Concerned for a Loved One?
It is very important for those who love a depressed person--as well as the depression person themselves--to understand that a depressed person suffers from a very real illness. A depressed person cannot just "snap out of it" or "cheer up". They are not weak, lazy, defective, or seeking attention. They are ill and need your help.
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