“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 from 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 biopsychosocial approach to care.
Left untreated, depression can lead to problems with performance at work, discord in personal relationships, measurable decrements 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, while others experience 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 mean we 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 the result of using substances to mitigate symptoms. This is particularly exacerbated 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 into account your family and medial history. If you are experiencing mild thoughts of death, self-harm, suicide, or have recently made an attempt, please consider the following resources:
- Your Life Counts – Crisis Line Near You (International)
- National Suicide Prevention Lifeline (USA) – 1-800-273-8255
- Crisis Text Line 24/7 (USA) – 741741
**The above should only be considered as part of a strategy to address mild symptoms – If you are experiencing serious symptoms, 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.
Get Our 25 Self-Care Suggestions
We recently published an article called, “25 Easy to Follow Tips for Battling Clinical Depression.” Check-out our biopsychosocial approach to self-care, guaranteed to improve your mood as part of a wellness focused lifestyle. Also, If you think you might have Seasonal Affective Disorder, we have an article describing the typical SAD presentation and treatments you might find helpful.