What Is Depression?
Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles, or an injured self-esteem.
But when feelings of intense sadness -- including feeling helpless, hopeless, and worthless -- last for many days to weeks and keep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression -- a treatable medical condition.
How Do I Know If I Have Depression?
According to the DSM-5, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following symptoms at the same time:
- A depressed mood during most of the day, particularly in the morning
- Fatigue or loss of energy almost every day
- Feelings of worthlessness or guilt almost every day
- Impaired concentration, indecisiveness
- Insomnia (an inability to sleep) or hypersomnia (excessive sleeping) almost every day
- Markedly diminished interest or pleasure in almost all activities nearly every day
- Recurring thoughts of death or suicide (not just fearing death)
- A sense of restlessness or being slowed down
- Significant weight loss or weight gain
A key sign of depression is either depressed mood or loss of interest in activities you once enjoyed. For a diagnosis of depression, these signs should be present most of the day either daily or nearly daily for at least two weeks. In addition, the depressive symptoms need to cause clinically significant distress or impairment. They cannot be due to the direct effects of a substance, for example, a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism.
Symptoms of Depression
According to the National Institute of Mental Health, people with depressive illnesses don't all experience the same symptoms. How severe they are, how frequent, and how long they last will vary depending on the individual and his or her particular illness. Here are common symptoms people with depression experience:
- Difficulty concentrating, remembering details, and making decisions
- Fatigue and decreased energy
- Feelings of guilt, worthlessness, and/or helplessness
- Feelings of hopelessness and/or pessimism
- Insomnia, early morning wakefulness, or excessive sleeping
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Loss of pleasure in life
- Overeating or appetite loss
- Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
- Persistent sad, anxious, or "empty" feelings
- Thoughts of suicide or suicide attempts
While these are common symptoms of depression, they may also occur in patterns. For example, a person may experience depression with mania or hypomania -- a condition sometimes called manic depression or bipolar disorder. Or the symptoms may be seasonal as in the case of seasonal affective disorder.
There are several types of manic depression. People with bipolar II disorder have at least one episode of major depression and at least one hypomanic -- mild elation or high -- episode. People with bipolar I disorder have a history of at least one manic -- extreme elation or high -- episode, with or without past major depressive episodes. A patient with unipolar depression has major depression only and has never had a full hypomanic or manic episode. A new category, though, in the DSM-5 allows for the presence of some symptoms of mania or hypomania during a full depressive episode in someone who technically hasn't met the full criteria for bipolar disorder. That suggests the line between unipolar and bipolar disorder can sometimes be blurry..