It's usual to feel low, blue or unhappy at various times in our lives, but clinical depression is more than this in its severity and/or frequency. When the feelings have got to a point of being disruptive to a person's social functioning and daily life, and last for more than two weeks, that may be a sign that clinical depression has set in.
Prevalence (or How Common Is It?)Edit
Depression (and other associated affective disorders such as bipolar) are one of the most common psychiatric categories of disorders (with schizophrenia and anxiety related disorders) that affects about 20% of the population at least once in their lives. The average age of the first bout (called onset) is around the late 20s. About twice as many women as men are treated for depression, although this may be because women are more likely to seek help than men. More recently, this difference has reduced and it doesn't seem to apply to men and women over the age of 50 - 55. Some people claim that women are more likely to suffer from depression due to their brain structures, hormones and society influence, which puts much more pressure on women than on men when it comes to some particular aspects, though this hasn't been proved yet.
Signs and symptoms with DSM Edit
Although it's not the perfect guide to diagnosis, it's sometimes useful to look at the critera in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the clinician's dictionary of mental disorders.
In the section about the criteria for diagnosing a major depressive disorder it says that depression includes one of:
- Depressed mood, or
- Loss of interest or pleasure (anhedonia).
As well as either of those symptoms, depression also includes at least four of a list of other symptoms. These include:
- Feelings of overwhelming sadness or fear, or the seeming inability to feel emotion.
- A decrease in the amount of pleasure derived from what were previously pleasurable activities.
- Changing appetite and marked weight gain or weight loss.
- Disturbed sleep patterns, such as insomnia, loss of REM sleep, or excessive sleep.
- Changes in activity levels, such as restlessness or a slowing of movement.
- Fatigue, either/both mental and physical.
- Feelings of guilt, helplessness, hopelessness, anxiety, and/or fear.
- A decrease in self-esteem.
- Trouble concentrating or making decisions, or a generalized slowing and obtunding of cognition.
- Self-harm or ruminating on self-harm.
- Ruminating on death and/or suicide.
- Reduced memory.
- Loss of appetite.
- Sleep problems, such as recurrent nightmares.
- Learning or memory problems were nonexistent prior to the onset of depression.
- Significant behavioural changes; such as withdrawal, social isolation and aggression.
Other forms of clinical depression besides Major Depression exist such as Dysthymia (a lower severity/grade depression). You can ask a doctor about it.
Alcohol and Other DrugsEdit
People suffering from depression are also more likely to use drugs or alcohol - possibly in an attempt to self-medicate. Depressed teenagers are at particular risk of further destructive behaviours, such as eating disorders and self-harm.
Depression Severity InstrumentsEdit
One of the most widely clinically used instruments for measuring depression severity is the Beck Depression Inventory, a 21 question multiple choice survey.
A general rule of thumb for self assessment is if you have low energy, have lost interest in things you once enjoyed, are thinking of harming self or others, and/or are largely unable to care for yourself, professional and/or appropriate alternative help is probably needed.
More humorously, if you can't get out of bed for days, forgot how to shower, eat, etc and start thinking your life would be better if it were over, then you might have depression. [parallels to an American comedian named Foxworthy saying "if you have a couch and three cars in the yard, you might be a redneck" ;-) ]...Loss of a sense of humor may also be an indication of a depressive state.
Depression, Treatment, Barriers and OthersEdit
It is hard for people who have not experienced clinical depression, either personally or by regular exposure to people suffering it, to understand its emotional impact and severity, interpreting it instead as being similar to "having the blues" or "feeling down". Many people will also suggest that a sufferer "snap out of it", "get over it" or "pull themselves up by their bootstraps" and sometimes withdraw from the person all together in frustration and/or anger. As the list of symptoms above indicates, clinical depression is a serious, potentially lethal, disorder that affects many parts of a suffers body, mind, spirit and social systems.
Many others will also avoid seeking treatment for a potentially life threatening illness, sometimes with dire consequences. While depression itself is not considered contagious, others are likely to be affected by an individual's depression and may want to seek support for family and friends of depressed people. This can involve hospitalization for suicidality (or "vegetative symptoms " like sleeping too much, lack of hygiene, etc) or seeing a doctor or other professional. While general practictioners are usually licensed to dispense medication for depression, it is generally considered wise to see the specialized help of a psychiatrist if medications are indicated.Many times an individual when depressed will not have the energy to seek help, but should be cautioned at a sudden change in energy with someone recently appearing depressed, as it may be an indication of activating a suicidal plan.
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