Depression leads to missed days at work, children who act out and who are confused by mommy or daddy's behavior. Not wanting to pry, relatives will instead egg-shell walk around what is obvious: help is needed.
It's not about being sad, lazy, or mean. It isn't even about overeating or skimping on meals. The signs and symptoms of depression are real, dangerous and affect millions each year.
Loved ones for years will go from tiptoeing around a depressed person only to aggressively hurl accusations at victims of depression as the disease progresses. Undiagnosed, unchecked depression worsens. It does not clear itself up but many times it will be written off as a personality quirk.
Anyone can have sad feelings or mood swings connected with a specific or series of events but these types of feelings pass. Clinical depression may be diagnosed when the irritability, emptiness, anxiety or feelings of hopelessness or worthlessness do not go away, according to Mental Health Today, but last for at least two weeks.
Symptoms of Depression
So what is the difference between a sad mood or reaction to a specific event or events? A persistence and length in reported or observed symptoms. In order for doctors to find a diagnosis of depression, five or more specific symptoms have to be present during the same two-week period and represent a change from previous functioning.
Doctors base their diagnosis on information from the Diagnostic and Statistical Manual of Mental Disorders. One of the symptoms is either depressed mood or loss of interest or pleasure which means having a depressed mood most of the day, nearly every day for two weeks--as indicated by either subjective report (self-report) or observation made by others. Friends may notice you no longer want to do things.
Significant weight loss when not dieting or weight gain --a change of more than five percent of body weight in a month--or decrease or increase in appetite nearly every day is another symptom of depression. In children, consider failure to make expected weight gains.
Doctors also look for sleeping too much or not enough every day. They also look for psychomotor agitation or retardation nearly every day. That means the person is either moving around too much, restless with meaningless movements because of anxiety or not performing self-care activities like eating or bathing or changing clothes because they are hardly moving at all.
It is remarkable because healthy people perform self-care duties without thought or effort appropriately--based on culture and preference. This is not so if the person is suffering from depression. A great deal of effort is needed to get through daily tasks.
Doctors also look for signs of fatigue or loss of energy nearly every day. Other symptoms to watch are inappropriate feelings of worthlessness; excessive or delusional guilt (holding steadfast to ideas that are clearly not true), daily diminished ability to think or concentrate; indecisiveness, and recurrent thoughts of death--not just a fear of dying.
Doctors especially look for recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. Suicidal and homicidal thoughts and actions may require emergency medical intervention to prevent harm and for further observation.
These symptoms have to cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. This means stopping value-based activities like work, taking children to school, housekeeping or any other responsibility assigned. Not performing daily required activities for an extended period may be seen as a sign to contact a physician.
These symptoms should not be due to the physiological effects of substance abuse or a physical medical condition. Binge drinking or drug use may mask or mimic symptoms.
Doctors look at and place on a scale, these symptoms before making a diagnosis of depression. Other things like grief or psychosis may explain some symptoms. Depression falls somewhere in the middle--more than sadness and grief and not quite psychosis (distorted reality, out-of-step with what is actual). That is why it is important to talk to a doctor right away about symptoms observed or felt.
According to the National Institutes of Mental Health, a Major Depressive Disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally.
Types of Depression
This means, if a person is responsible for running a household and has not been doing so in spite of best efforts, or rule an office staff by mood--to the point of getting varied negative feedback--a doctor’s consultation may be in order to be safe. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.
Dysthymic Disorder, also called dysthymia, is characterized by depressive symptoms that are long-term (two years or longer) but less severe than those of major depression. Dysthymia may not disable a person, but it prevents one from functioning normally or feeling well leading to numerous complaints of physical ailments. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.
Symptoms of minor depression are similar to Major Depression and Dysthymia, but they are less severe or are usually shorter term.
Symptoms to watch:
- Persistent sad, anxious or “empty” feelings
- Feelings of hopelessness and/or pessimism
- Irritability, restlessness, anxiety
- Feelings of guilt, worthlessness and/or helplessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details and making decisions
- Insomnia, waking up during the night, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
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