“Depression is anger turned inward.” – Freud
Clinical Depression, also known as Major Depression, or Major Depressive Disorder, sits on a continuum of severity ranging from mild to severe. It is important to distinguish this form of depression with grief, a sense of despair caused by the loss of a loved one. Clinical Depression as a diagnosis has both endogenous and psycho-social features. This is important when considering treatment – Medication is one component in a comprehensive set to tools, used as part of a holistic biopsychosocial approach to care.
Left untreated, depression can lead to problems with performance at work, discord in personal relationships, measurable detriments in physical health, and sometimes suicide. Understanding sings and symptoms is critical for successful early intervention.
Critical Signs & Symptoms
The field of Psychiatry and Clinical Psychology uses the standards put forth by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is important to note that depression can effect people of all ages, even children. The following individual symptoms do not stand on their own – During psychiatric assessment, your doctor will look for a collection of symptoms as seen over time:
- Persistent sad, or empty mood
- Feelings of hopelessness and helplessness (pessimism)
- Irritability, especially in men
- Feelings of guilt and/or worthlessness
- Anhedonia – Loss of interest or pleasure in activities
- Decreased energy or fatigue
- Psychomotor slowing
- Difficulty concentrating and making decisions
- Difficulty sleeping and/or “early morning awakening” syndrome
- Weight changes due to appetite (increased or decreased)
- Thoughts of death, suicide or possible attempts
- Pain, headaches, or cramps with no other known physical cause
**Important: Some may experience only a few symptoms with increased severity when feeling depressed, others with a broad collection of symptoms. It is important to see a mental health professional when formulating a diagnosis of clinical depression. The inclusion of this list does not condone self-diagnosis.
Clinical Observations To Consider
Above and beyond the critical signs listed above, it is important to understand the following four (5) clinical observations regarding clinical depression:
1- Anxiety Comorbidity: In, “Comorbidity Patterns of Anxiety and Depressive Disorders in a a Large Cohort Study,” (Lamb, et al, 2011), findings indicated that 75% of the participating cohort had a lifetime co-morbid anxiety disorder. Anecdotal accounts indicate rates upwards of 80% – Out of all clients presenting with major depressive symptoms, the majority showed signs of chronic anxiety.
2- Insidious Nature: Awareness of symptoms is often a challenge. Depression tends to, “creep up on us.” Individuals can go months with symptoms increasing in severity very slowly. It is often observed that in hindsight.
3- Family History: In, “Genetic Epidemiology of Major Depression: Review and Meta-Analysis,” ( Sullivan, et al, 2000), Major Depression is a familial disorder. Environmental factors are etiologically significant, but not mutually exclusive to understanding individual patters and presentations. Depression is a complex disorder with both genetic and environmental influences.
4- Substance Misuse: Coping comes in all forms. An overwhelming proportion of individuals struggling with substance misuse, describe chronic feelings of depression and anxiety. Substance dependance is often a consequence resulting from overuse of substances to mitigate symptoms. This is particularly influenced by the shame based nature of dependance.
Getting Help – What To Do When Feeling Depressed
Feeling depressed? See a mental health professional in order to make a proper diagnosis. You will go through a comprehensive assessment that takes in to account your family and medial history. If you are experiencing thoughts of death, suicide, or have recently made an attempt, please consider the following resources:
- CASP/ACPS Suicide Crisis Centers (Canadian).
- Your Life Counts – Crisis Line Near You (International)
- Canada Suicide Prevention Service (National) – 1-833-456-4566
- National Suicide Prevention Lifeline (USA) – 1-800-273-8255
- Crisis Text Line 24/7 (USA) – 741741
**The above should only be considered as a set of suggestions – It is critical that you reach out to a provider in your area, or go to your local emergency room for urgent issues. If you or someone you know is in a life-threatening situation, PLEASE CALL 911 IMMEDIATELY.
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