How Do I Know if I’m Sad or Clinically Depressed?
Published on Oct 10, 2021

I feel sad. How do I know if it’s just a passing feeling or if it’s clinical depression that requires medication?

Depressive disorder, which is frequently referred to as depression, is more than just feeling sad. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when recurrent and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to function poorly at work, school, and/or with family and loved ones.

At its worst depression can lead to suicide. Each year, over 700,000 people die from suicide, making it the fourth leading cause of death in 15-29 year-olds. Though there are known and effective treatments for mental disorders, more than 75% of people in low and middle-income countries receive no treatment.

In countries of all income levels (i.e. the United States), people who experience depression are often incorrectly diagnosed and others who do not have the disorder are often prescribed antidepressants. This is where consulting with a specialized healthcare professional is important. 

Symptoms can be psychological or physical and sometimes can fall under different types of depression.

psychological symptoms

  • Continuous low mood or sadness
  • Feeling hopeless and helpless
  • Having low self-esteem
  • Feeling tearful (as in teary-eyed)
  • Feeling guilt-ridden
  • Feeling irritable and intolerant of others
  • Having no motivation or interest in things
  • Finding it difficult to make decisions
  • Not getting any enjoyment out of life
  • Feeling anxious or worried
  • Having suicidal thoughts or thoughts of harming yourself

physical symptoms

  • Moving or speaking slower than normal
  • Changes in appetite or weight (increase or decrease)
  • Constipation
  • Unexplained aches and pains
  • Lack of energy
  • Low sex drive
  • Changes to your menstrual cycle
  • Disturbed sleep – cannot sleep or stay asleep, for example

other types of depression

There are different types of depression and some conditions where depression may be a symptom of a different disorder. These include:

Postnatal Depression – sometimes new mothers, fathers, or partners develop depression after they have a baby; this is known as postnatal depression and it’s treated in a similar way to other types of depression, with talking therapies and antidepressant medicines

Bipolar Disorder – also known as “manic depression”, in bipolar disorder there are spells of both depression and excessively high mood (mania); the depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behavior, such as gambling, going on spending sprees and having unsafe sex

Seasonal Affective Disorder (SAD) – also known as “winter depression”, SAD is a type of depression with a seasonal pattern usually related to winter months.

Persistent Depressive Disorder (or dysthymia) – a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.

Psychotic Depression – occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.

causes

Depression does not have a single cause. It can be triggered by a life crisis, physical illness, or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:

  • Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
  • Genetics. Mood disorders, such as depression, tend to run in families.
  • Life circumstances. Marital status, relationship changes, financial standing, and where a person lives influence whether a person develops depression.
  • Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
  • Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
  • Drug and alcohol misuse. 21% of adults with a substance use disorder also experienced a major depressive episode in 2018. Co-occurring disorders require coordinated treatment for both conditions, as alcohol can worsen depressive symptoms.

Source: NAMI.org

how is depression syndrome diagnosed?

Everyone may feel sad or down from time to time. However, clinical depression has more intense symptoms that last two weeks or longer. To determine whether you have clinical depression, your healthcare provider will ask questions. You may complete a questionnaire and provide a family history. Your healthcare provider may also perform an exam or order lab tests to see if you have another medical condition. Source: Cleveland Clinic

Treatment:

  • Psychotherapy including cognitive behavioral therapy, family-focused therapy, and interpersonal therapy.
  • Medications including antidepressants, mood stabilizers, and antipsychotic medications.
  • Exercise can help with prevention and mild-to-moderate symptoms.
  • Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
  • Light therapy, which uses a light box to expose a person to full-spectrum light in an effort to regulate the hormone melatonin.
  • Alternative approaches including acupuncture, meditation, faith, and nutrition can be part of a comprehensive treatment plan.

RESOURCES

SAMHSA’s National Helpline: 1-800-662-HELP (4357)

SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

National Text Line: https://www.crisistextline.org/

National Suicide Prevention Lifeline

https://suicidepreventionlifeline.org/talk-to-someone-now/

Hours: Available 24 hours. Languages: English, Spanish. 

800-273-8255

Call (800) 273-8255

Text (208) 398-4357

The Friendship Line

For 60 and over: https://www.ioaging.org/services/all-inclusive-health-care__trashed/friendship-line

The Friendship Line is both a crisis intervention hotline and a warmline for non-emergency emotional support calls: 1.800.971.0016

LGBTQ+ National Hotline: https://www.glbthotline.org/ 

Written with guidance from Dr. Edwards