Feeling depressed vs “Depression”

Being a soon to be doctor, depression is something we come across in the clinical setting a lot. Not only in that setting, but also in our everydays life we meet people telling us that they have an Depression or feel depressed.

Definition of Depression

Depression is a major cause of morbidity worldwide. Lifetime prevalence varies widely, from 3% in Japan to 17% in the US. In most countries the number of people who would suffer from depression during their lives falls within an 8–12% range. (Wiki)

Depression cannot be diagnosed with any blood test or physical examination. The handbook DSM-5 is used to diagnose Depression, as well as all other phsychiatrical disorder. In order to diagnose depression, also called an unipolar disorder, you need to score 5 symptoms of 9 symptoms in the DSM-5 checklist.

Here an overview:

  • Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
  • Mood represents a change from the person’s baseline.
  • Impaired function: social, occupational, educational.
  • Specific symptoms, at least 5 of these 9, present nearly every day :
  1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
  2. Decreased interest or pleasure in most activities, most of each day
  3. Significant weight change (5 %) or change in appetite
  4. Change in sleep : Insomnia (not sleeping enough) or hypersomnia (sleeping too long)
  5. Change in activity : Psychomotor agitation (series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual) or retardation (visible slowing of physical and emotional reactions, including speech and affect)
  6. Fatigue or loss of energy
  7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
  8. Concentration: diminished ability to think or concentrate, or more indecisiveness
  9. Suicidality: Thoughts of death or suicide, or has suicide plan
The Depression lable

You might notice that you yourself have several of those symptoms, maybe even the 5 which are needed for a diagnosis.

Sadness is a part of human existence that the majority of the time does not necessitate treatment. These periods should not be diagnosed as a depressive episode if they do not met criteria for severity and duration, and include clinically significant distress or impairment (American Psychiatric Association, 2013).

Have you ever felt lonely, moved to new place, failed a goal you put yourself, disappointed someone, had problems with sleeping, could not concentrate anymore, and so on? Life is not always easy for some of us, and that is okay, it is a part of life. The good news are that those feelings and those periods are present and painful BUT they will disappear. After bad times, good will follow.

Some of us do need treatment and that is nothing to be ashamed of! Others will manage it with the help of their strong social and family bonds, with meditation, with travel or any other factors which are important to them. However, only because you are not being treated with medication or have not seen a psychiatrist does not mean you feeling depressed is not serious. The difference might only be a lable put by the physician.

I am determined to be cheerful and happy in whatever situation I may find myself. For I have learned that the greater part of our misery or unhappiness is determined not by our circumstance but by our disposition.
– Martha Washington

So not having the depression lable but feeling depressed and unhappy with the life you are living is nothing uncommon. At one point we all fight and fight and just become exhausted and need a break, recharge our battaries, and just step back for a while and observe. Observe ourselves, why are we doing things the way we do, why are we coping in an unhealthy way with things, can we choose to handle things differently? Or do we just have to make a desicion and change the things we are unhappy about. Sometimes it can be that simple. However for others it may improve the situation but not solve it, and thats when medication might be needed.

Take home message: You are not alone! 

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