Many people who have suffered from the signs of depression for week, months, or years, don’t think of themselves as clinically depressed. Depression is a monster unlike the sadness that naturally comes from life’s hard knocks. While ordinary sadness can be like a hit and run slam, clinical depression is more like a collision in which the car (depression) ends up in your living room and gets stuck there.
Because clinical depression can create emotional numbing, the irratble depression that friends and family see becomes a major blindspot for the person experiencing the painful signs of depression.
When do the signs of depression become a serious medical syndrome that requires treatment? For starters, there are two important criteria which must hold true at the same time:
- The mood change becomes disruptive to important areas of a person’s life; the signs of depression negatively and noticeably impact relationships, work, or school
- The signs of depression last for several days (at least 2 weeks)
To make things more confusing, a man or a woman can be clinically depressed without feeling appearing sad. This can seem ver odd because one of the signs of depression most distinctive of depression is sadness! This makes people around the depressed person scratch their heads as they puzzle over, “what’s gotten into” him/her.
Everyone experiences mood changes as a part of living life. Life happens. But depression involves a bundle of symptoms of which a sad mood is only one. Clinical depression, or Major Depressive Disorder, is usually defined as a combination of any five of the following signs of depression that persist for more than 2 weeks:
- Diminished ability to think or concentrate or indecisiveness, nearly every day
- Noticeable loss of interest or pleasure in nearly all activities most of every day
- Significant change in weight not due to dieting (weight gain or loss of more than 5% of body weight in a month)
- Sleep problems nearly every day (excessive sleeping or insomnia)
- Agitation (REALLY irritable or physically wound-up tight with stress and tension) or marked slowing of one’s thoughts and actions (e.g., much more difficulty getting started on something than usual)
- Sad mood most of the day, nearly every day
- Fatigue or loss of energy every day
- Feelings of worthlessness or excessive (or inappropriate) guilt nearly every day
- Recurrent thoughts of death (not just fear of dying), recurring thoughts about suicide, or a suicidal gesture (deliberate carelessness in dangerous situations) or an attempt, or specific plans.
Most people have experienced one or more of these signs of depression at some time in their lives. But when five or more of them combine and take hold, they can cause agonizing distress and can disrupt one’s ability to function well at work, at school, or socially. When this happens the depression is considered “clinical” because it holds on tightly enough to need some type of intervention. If a person is having thoughts about death that keep returning, this is almost certainly an indicator of clinical depression, whether or not the person can recognize any other signs of depression.
Generally, it’s the number and the combination of signs of depression that make a person begin to see the impact on his or her life. When we have normal, everyday sadness or the blues, our brain bounces back. With clinical depression, our brain starts working in a different way and gets stuck in a mode that displays the signs of depression.
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