Few people go through life without a bout of “the blues.” Feeling sad or down is a normal and often healthy human emotion. Feeling depressed, as it’s often described, is typically a normal reaction to distressing events in our lives such as loss – be that a job or a loved one – or a reaction to many of life’s difficult changes such as children leaving home or parents getting older. Depending on the situation and the individual, these feelings are temporary and usually resolved within a few days or so, and then we’re back to our normal selves.
Depression, however, is not the blues. It’s also not grief; a normal reaction to loss. Moreover, depression is rarely caused by a single event. Depression is caused by a combination of biological, psychological and social factors that together, interfere with a person’s ability to work, sleep, study, eat, and enjoy once-pleasurable activities. It can go on for weeks, months or in cases of chronic depression, a lifetime.
There are several different types of depression which are generally characterized by the severity of the impact in our lives and the duration:
Major Depressive Disorder
Major Depressive Disorder is one of the most common mental disorders in the United States. According to the Centers for Disease Control and Prevention (CDC), 9.1% of surveyed adults across 49 states, nearly 1 in ten Americans, met the criteria for current major depression. Over a lifetime, it’s estimated that over 15% of the population will experience major depression. Major Depressive Disorder is characterized by depressed mood and loss of interest that persists for two weeks or longer, and creates significant stress or impairment managing usual activities day-to-day.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), Major Depressive Disorder is indicated if at least five of the following symptoms are present during the same two-week period, and it must represent a change from that individual’s previous behavior.
- Depressed mood
- Diminished interest or pleasure in activities
- Significant appetite/weight loss or gain
- Insomnia or hypersomnia
- Feelings of worthlessness or excessive guilt
- Diminished ability to think or concentrate
- Recurrent thoughts of death or suicide
While some people may experience only one episode of major depression in their lifetime, more often if a person has one episode they will experience multiple episodes.
Also known as dysthymia, Chronic Depression is less severe than major depression and typically does not disable the person. However, most people with dysthymia will also experience multiple episodes of major depression. Chronic Depression is characterized by depressed mood on most days for at least two years. Some days the individual may feel well and happy, but the good mood ends after a few weeks or months. Signs of chronic depression include low self-esteem, plummeting energy, poor concentration, hopelessness, irritability and insomnia among others.
Studies reveal that dysthymia frequently has a devastating impact on people’s lives. Individuals with dysthymia are more likely to receive government assistance, have high healthcare costs and have elevated rates of unemployment. If they do work, they can often under-achieve because of emotional problems. Because depression can make communication more challenging, many sufferers experience constant problems in relationships, and a disproportionate number are single when compared to the general population.
Other Types of Depression
Some forms of depression are slightly different, or they may develop under unique circumstances. These include Psychotic depression, which occurs when a person has severe depression plus some form of psychosis; Postpartum depression, which is much more serious than the baby blues that many women experience after giving birth; and Seasonal affective disorder (SAD), which is characterized by the onset of depression during changes in the season, particularly in the winter months.
No matter the type, depression can cause the affected person to suffer greatly and function poorly at work, at school, in the family, and can be devastating in all areas of a person’s life. Its impact can be felt both physically and socially. Long-term depression is known to negatively impact the heart. Depression causes inappropriate release of adrenaline which, over time, damages the cardiovascular system. An increase in artery and blood vessel stress are further health effects of depression. This can increase the risk of blood clots and heart attack.
The social effects of depression change how a person functions in the world and their relationship with others. Social effects of depression include substance use and abuse, social and family withdrawal, divorce, and decreased performance at work or school.
The most serious effect of depression is a suicide attempt or completion. It’s estimated that 15% of people with affective disorders, like depression, commit suicide.
Sadly, misunderstandings and misconceptions about depression are the norm. There’s a common myth that looking on the bright side cures depression – that if you think positively enough, you’ll simply snap out of it. But individuals can’t snap out of depression any more than they can think themselves out of chronic asthma. Many people don’t ask for help because they’re embarrassed about what they’re going through. In many cases, individuals suffering from depression don’t know why they’re depressed, or are themselves unaware that they are clinically depressed. Thinking that depression, or asking for help, is a sign of weakness only demonstrates a lack of understanding about the clinical facts of depression.
It’s important to recognize and not ignore the signs. One of the symptoms of clinical depression is wanting to be left alone, which is another reason why asking for help can be so difficult. But when the impact to your life, health and happiness are on the line, the consequences of not talking about it can be tragic.
One tool that clinicians use to assist in diagnosing depression is the Patient Health Questionnaire (PHQ-9.) This short, nine question screening can be self-administered, and has been proven to be a reliable and valid measure of depression severity. You can take the PHQ-9 depression screening now, or print it for someone else. If after reviewing the results you have addition question, you can confidentially contact a Capital EAP counselor through our website, or by calling (518) 465-3813 and dialing Option 2.