Depression:  Identifying and Understanding

Clinical depression is one of the most common psychiatric illnesses.  It affects approximately 10% of the population during a person’s lifetime.  A depressive episode is defined as a period of time lasting at least two weeks during which a person experiences five or more depressive symptoms.  At least one of those symptoms has to be either feeling a depressed mood or a lack of ability to experience pleasure, known as anhedonia.  Other symptoms include:  lack of energy, changes in sleep patterns, changes in appetite or eating patterns, slowing down physically, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.  


Symptoms of depression can range quite a bit in severity.  Some people with mild depression may feel persistently irritable, difficult to please, generally pessimistic.  Others with more severe symptoms may find themselves crying a lot, feel profound sadness and disinterest in things that used to bring them pleasure.  They may spend more time in isolation, finding it excessively effortful to spend time with friends and family.  In extreme cases people with depression may stay in bed for stretches of days, eat minimally, and see no hope for their future.  

Naturally, the symptom mental health professionals worry the most about is suicidal thoughts and the potential for depressed people to attempt suicide.  It is very difficult to predict that someone is going to attempt suicide.  The best predictor of future suicidal risk is a history of previous suicide attempts.  While it is not possible to predict when a person is going to attempt suicide, it is important for professionals to ask about whether a person is having thoughts of suicide.  Family members and friends often worry that asking about the issue will plant the seed in the minds of their loved one.  One should not worry about that as the chances are that they have already had those thoughts.  Talking about it can be helpful to them. It can also give their loved ones an understanding of the issue. It may also help them know whether they should take further steps to reduce the potential for self-harm.


There is very good treatment for clinical depression.  Medications have made great strides over recent decades.  Contemporary antidepressants are safe and effective.  Psychotherapy, or counseling, is also an effective treatment.  Research shows that both treatments lead to changes in the brain that demonstrate the effectiveness of those treatments.  While medication and psychotherapy both have benefits on their own, research has also consistently shown that the two treatments combined are more effective than either alone.  

So it is important to recognize symptoms of depression, whether in oneself or a loved one.  Talking about those symptoms is important.  Awareness of the problem is the first step in developing a plan to treat it.  It is essential at that point to consult a mental health professional to discuss treatment options.  Whether that is seeing a medical doctor or a therapist as the first step, starting the process is essential.  Then one must be open to different treatment options.  Depression can be treated effectively but only if a person is ready to accept treatment.  

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