What is Depression?

Depression is used colloquially, and many times used when clinical depression is not actually the factor. We throw that term around easily. “That movie was depressing.” “I was depressed just looking at myself in that outfit.” However, there are very specific criteria that classify something as true depression.

Clinical depression is marked by at least two weeks duration of a mood disturbance, or a difference from baseline mood. At least one of the symptoms has to include either a depressed mood, or a loss of interest or pleasure in previously enjoyable activities. Other symptoms may be feeling sad and hopeless, significant weight loss or weight gain (or significant change in appetite), significant changes in sleep (too much sleep, or insomnia), feeling either sluggish, or restless, feelings of loss of energy, feeling worthless or guilty inappropriately, difficulties with concentration, and thoughts of death or suicide. One does not need to have ALL of these symptoms to meet criteria, but having at least 5, plus an impairment in functioning and lasting at least two weeks, indicates that there is a mood disturbance, and that clinical depression is a part of that.

In some populations, particularly children, irritability and anger is also a symptom of depression. Clinical depression can occur in isolation, or as a part of another disorder, such as bipolar disorder or dysthymia, which is a persistent lingering depression, lasting at least two years. It also can be related to other factors including substance use or abuse, certain medications, as well as part of a premenstrual cycle.

It is important to treat clinical depression, primarily because of the risk to life that can occur if depression is untreated. Research has suggested that the most effective treatment of mild to moderate depression is a combination of talk therapy and medication. Therapy should include the technique of behavioral activation, or making small behavioral changes that can help increase mood. Additional research has suggested that with mild depression, therapy can be an important step prior to starting medications – this is particularly helpful for populations that may experience more side effects, or who have contraindications with medication. However, for severe depression, it is critical that intervention happen quickly – severe depression includes unmanageable symptoms and very significant distress. Often for severe depression, medication is the best first step, and then adding in talk therapy once the symptoms are reduced.

For more information on how depression impacts a person, their family members, and how to get help, contact us.  We can help!

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