Working Well

Depression means many things to many different people.  Some people describe themselves as being depressed when they've heard bad news or when things just aren't going right, however usually they pick up again in a few days.  This reaction is seen as a normal response to difficult or sad situations and is sometimes described as ‘normal depression'.

Many people at various times in their lives will experience ‘the blues', a drop in self-esteem or self-value, feel self-critical, lack pleasure in life and feel pessimistic about the future.  Often this is transient in nature and feelings are not disabling.  On the other hand, someone with clinical depression will experience these types of symptoms for more than 2 weeks and often they are unable to function at their normal social and psychological level.

The World Health Organisation defines clinical depression as:

• - Two weeks of an abnormal depressed mood 
• - Loss of interest or pleasure in activities that used to be enjoyable 
• - Reduced energy, or feeling tired

• - Loss of confidence and self-esteem
• - Feeling guilty and unworthy
• - Recurrent thoughts of death or suicide, or any suicidal/self-harming behaviour
• - Reduced ability to think or concentrate 
• - Agitated or slow movements
• - Disturbed sleep (not enough/too much/poor quality)
• - Change in appetite (increase or decrease) with weight change
• - Decreased libido
• - Unexplained physical symptoms

Minor depression includes two of the first three symptoms and at least two others.

Moderate depression includes two of the first three symptoms and at least four others.

Severe depression includes all of the first three symptoms and at least five others.

Debate and variances in opinion

Some healthcare systems and professionals hold the view that depression is one condition and that it varies in severity, while others believe that it is a more complex issue.  Many professionals now support the view that depression is not a single, distinct medical condition, that it has many causes and that it can be classified in many ways.

Limiting diagnosis to severity based classifications may hinder a professional from establishing and treating the cause of an individual's depression, however, understanding the severity of symptoms is useful for establishing what kind of urgency is required when seeking help and treatment.

Diagnosis

In order to properly diagnose depression it is important to visit a GP who is able to conduct preliminary tests (some symptoms of depression may be caused by an underlying medical problem) and if appropriate, discuss possible treatment options.

See your GP:

• - If your symptoms have lasted for at least 2 weeks 
• - When your work or social functioning is impaired 
• - If your mood is not explained by your normal life stressors 
• - When rest and relaxation have not helped your mood

References:

Dealing with depression - A common sense guide to mood disorders
Gordon Parker
2005

The ICD-10 Classification of Mental and Behavioural Disorders
World Health Organisation
1993

Understanding Depression
Maria Prendergast
2006