Life is a series of ups and downs. We get promotions, find love, reconnect with old friends, and have unexpectedly pleasant Sunday afternoons of doing absolutely nothing but recharging. We also get fired, experience breakups, drift apart, and occasionally have one of those terrible, no good, very bad days that are hard because lots of small things go wrong. Feeling sad or down is a normal emotion to feel. When something very bad happens, it’s also normal to grieve. But, when more days feel down than up, it can cause a person to wonder. When does being bummed out turn into sadness, and when does sadness grow into clinical depression? Even though feelings can be blurry, professional diagnoses are not.
Depression is not unusual, and it remains very treatable. In fact, most people see improvements in their symptoms when treated with medication, psychotherapy, or a combination of the two.
But treatment should be personalized because what works for one person might not necessarily work for another. There are many treatments, but therapy for depression is by far the most common and effective.
But first, how do you even know if you have depression?
Depression (major depressive disorder) is a common, yet serious medical illness that negatively affects how you feel, think and act. This disorder causes feelings of sadness and/or a loss of interest in activities previously enjoyed. It can be seen in a variety of emotional and physical signs that notably decrease a person’s ability to function at work and at home. Depression symptoms can vary from mild to severe and can include feeling sad or having a depressed mood, loss of interest or pleasure in activities once enjoyed, changes in appetite — weight loss or gain, trouble sleeping or sleeping too much. Even more specifically, depression can lead to an increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others), feeling worthless or guilty, difficulty thinking, concentrating or making decisions, and in some extreme cases, houghts of death or suicide
It’s also important to consider other medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic depression symptoms. Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. It’s also been observed that women are more likely than men to experience depression.
For some people, grief can lead to depression. For instance, the death of a loved one can bring on major depression. Losing a job or being a victim of a physical assault or a major disaster can absolutely bring on a depressive episode. Unfortunately, when grief and depression coexist, the grief is more severe and lasts longer than grief without depression. Despite overlap between grief and depression symptoms, they remain different diagnoses. Distinguishing between the two can help people find the help, support or treatment they need.
You must be experiencing symptoms for at least two weeks for a clinical diagnosis of depression. But before a diagnosis or treatment is given, a physician should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination. In some cases, a blood test might be done to rule out any medical conditions. The evaluation will help identify specific symptoms, medical and family history, cultural factors and environmental factors to arrive at a diagnosis and plan a course of action, which will usually involve some type of therapy for depression.
Symptoms caused by major depression can vary, so some clinicians may evaluate for more specifiers to help come up with a more targeted treatment plan. A specifier means that you have depression with specific features, such as anxious distress — depression with unusual restlessness or worry about possible events or loss of control, mixed features — simultaneous depression and 