So I have decided to start off by actually explaining what depression is and I will talk about what anxiety is next week. Depression is a word that gets tossed around a lot. Some people use it correctly while others use it as a replacement for sad or bummed. I believe this is where a good deal of the confusion about depression and other mental illnesses come from. Before you can understand something you need to have a working idea of the definition. When most people think of depression they are thinking of the Major Depressive Disorder.
DSM-IV defines MDD as having a depressed mood or loss of interest or pleasure in daily activities and this must occur for more than two weeks. This is subjective, but the easiest way to gauge this is by having a baseline and noticing a departure from it. MDD will cause impaired social, occupational, and educational function. There are nine major symptoms to look for and if five or more of these is present nearly every day the person may be dealing with MDD and a psychologist or psychiatrist should be contacted. The nine symptoms are listed below taken directly from the DSM-IV (American Psychiatric Association, 2013).
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 or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
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
While no one symptom is able to definitively diagnosis MDD, if you start to notice any of these in yourself or others it is a good indication to start watching for the other symptoms so that the problem doesn't escalate to a dangerous level before it is noticed. Personally, when I was in the worst of my depression I was dealing with depressed mood, decreased interest, change in sleep, fatigue, guilt/worthlessness, and difficulty concentrating. While mine was part of MDD, others can go through a depressive episode as an isolated episode.
A depressive episode can come in differing levels of severity and display differing symptoms. I have listed below the guide to identify a depressive episode. I have not placed this here for you to start diagnosing yourself or others, but rather to give you an idea of what someone with MDD or going through a depressive episode is experiencing. If you do notice these symptoms regularly I highly recommend seeking out mental health resources (American Psychiatric Association, 2013).
Category A:
Depressed Mood
Loss of interest and enjoyment in usual activities
Reduced energy and
Category B:
Reduced self-esteem and confidence
Ideas of guilt and unworthiness
Pessimistic thoughts
Disturbed sleep
Diminished appetite
Ideas of self-harm
Severity of Depressive Episode:
Mild: More than 1 from category A plus 1-2 from category B. Or 5-6 symptoms but mild in severity and functional impairment.
Moderate: More than 1 from category A plus 2-3 from category B. Or 7-8 symptoms but moderate functional impairment.
Severe: All 3 from category A plus more than 3 from category B. Or fewer symptoms but any of these: severe functional impairment, psychotic symptoms, recent suicide attempt, or has specific suicide plan or clear intent (American Psychiatric Association, 2013).
Depression can look many different ways from totally withdrawing from society to being hidden behind the smiling face of those closest to you. While a number things can lead to depression (we will look at causes in a later blog) it can effect anyone. I am not advocating interrogating your family and friends to see if they struggle with depression. I am advocating making it know that your door is always open and that you care about them so much that you would be happy to listen if they ever want to talk. If you are out there needing someone to listen I am more than happy to listen. If you need more immediate help this I have listed below the number for the National Suicide Prevention Hotline. If you have a mental health question please submit it for Sunday's post!
Resources:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
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