Depression

Symptoms

These are the symptoms of depression required for diagnosis, per the Diagnostic and Statistical Manual, Fifth Edition (DSM5). 

  · Feeling depressed most of the day, nearly every day (i.e., most of the time)

  · Significant loss of interest or lack of pleasure in activities

  · Significant change in weight (up or down) or significant change in appetite (up

    or down)

  · Insomnia (not being able to sleep) or hypersomnia (sleeping too much)

  · Slowing of thoughts and a reduction in physical movement, or physical

    restlessness

  · Fatigue or loss of energy

  · Feeling worthless or having excessive or inappropriate guilt

  · Decrease in concentration or an increase in being indecisive

  · Recurrent thoughts of death or suicide (with or without a plan)

To receive a diagnosis of depression, 5 or more of these symptoms need to be present during the same 2-week period, with at least one symptom being depressed mood or loss of interest/pleasure. These symptoms must occur most of the time and must cause significant distress or impairment in functioning, either socially, at work, or in other important areas. 

Things to Consider

We all have moments of sadness, times when we do not have an interest in activities that we normally enjoy, appetite changes, and days when we feel tired; that does not always mean that we are experiencing a clinical episode of depression. The DSM5 emphasizes that the symptoms listed must occur most of the time for at least 2 weeks. It is also important to consider whether these symptoms are an expected response to life circumstances; for example, when experiencing the loss of a loved one, it is expected that one will feel sad, have a change in appetite, and have a change in sleep patterns, etc. However, some individuals who are experiencing grief will also meet criteria for a Major Depressive Episode; this is especially the case when atypical symptoms (e.g., feeling worthless) or severe symptoms (e.g., suicidal thoughts) are part of the response to grief. 

Depression can occur in response to major life challenges, such as struggling in an unhealthy relationship, losing a job, or having a medical condition that limits life activities. Depression can also occur “out of the blue,” with no identifiable trigger or “reason” for the depression. 

Treatment

Regardless of whether depression is triggered by an obvious life event or occurs simply out of the blue, treatment can be helpful. For severe depression, medication may be helpful, especially in combination with therapy; for mild to moderate depression, therapy can sometimes be just as effective as medication. Combining medication with therapy, such as cognitive behavioral therapy (CBT), results in greater improvement than just taking medication. Therapy can also give longer-lasting relief from depression, compared to medication. 

It is unfortunate that many people only receive medication as treatment for their depression, without receiving counseling; this is sometimes due to a lack of interest in therapy but is also often due to a lack of access to therapy, or even never having been told that therapy was important. 

If you struggle with depression, please know that there is hope. If available, talk to your physician, contact your local community mental health clinic, or seek a therapist; if you do not have access to these things, continue seeking information from reliable sources on the internet or via books on Amazon or from your local library. 

If you are experiencing suicidal ideations, DIAL 988 (the National Suicide Prevention Lifeline) to call, text, or chat with a trained counselor.