Overwhelming sadness or depression is a normal response of the body to pain, suffering, loss, or other issues. It is normal to experience limited sorrow or grief every once in a while. However, when the feeling of sadness is prolonged or interferes with normal activities of life it could indicate a physical or emotional pathology.
Clinical depression is a mental disorder diagnosed by fulfilling a set of criteria. In general, it is characterized by the following symptoms:
- Severe sadness for more than two weeks
- Lack of interest in daily activities
- Inability to function properly at work or at school
These general characteristics should be associated with 5 out of 9 of the following specific symptoms that should be experienced almost every day:
- Irritable or depressed (either voluntarily expressed or observed by others)
- Lack of interest in daily activities or inability to find pleasure in things that were previously considered pleasurable
- Weight loss or weight gain associated with change in appetite
- Difficulty in sleeping or oversleeping
- Restlessness and agitation or sluggishness and feeling slow
- Tiredness or lack of energy
- Feeling of guilt or worthlessness
- Difficulty in concentrating or thinking
- Suicidal ideations
In children and adolescents, symptoms of depression can present differently and might include the following:
- Refusal to go to school
- Poor performance in school
- Engaging in risky behaviors like alcohol and drugs
- Withdrawal from social interactions
The exact cause of clinical depression is still not known. People with depression have an altered balance of chemicals in the brain and hormones in the body. This could potentially be the reason for depression.
Certain factors increase the chance of a person to be depressed:
- Negative outlook in life, pessimism, lack of self-confidence
- Traumatic experience in the past like abuse or death of a loved one
- Long standing illness like cancer
- Family history or relatives who are also suffering from depression
- Other mental disorders like anxiety disorder
- Substance abuse
When to see a doctor
If you suspect that you are suffering from depression, make an appointment with your doctor as soon as you can. Treatments are effective and the sooner you seek help the better. Do not feel embarrassed or judge yourself negatively for seeking help. This is one of the most common conditions physicians treat. Depression may have obvious triggers such as a death in the family, or a break-up in relationship, or sometimes the cause is not clear and apparent but is related to your inherent biological makeup and potential inherited factors.
If you are having pervasive suicidal ideas you must seek help immediately whether through a family member, friend, health professional, emergency room or even community emergency services such as the police.
Diagnosis of clinical depression is largely based on history and on the fulfillment of its diagnostic criteria. However, some physicians might request for other tests to rule out the possibility of other contributing conditions for the observed symptoms. For example, thyroid hormone problems can also cause weight change, agitation or sluggishness, tiredness, thinking difficulties, and sleeping difficulties. A simple blood test can check for thyroid hormone levels in the blood and rule out the possibility of hypothyroidism.
Treatment of depression is based on two primary therapies: counseling and medications. Counseling or psychotherapy involves talking to a medical counselor or psychiatrist who discusses with the patient about his feelings and about ways to understand and deal with these feelings.
Antidepressant medications like Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, or Paxil, Serotonin-norepinephrine reuptake inhibitors (SNRIs), and older generations of drugs such as Tricyclic antidepressants (TCAs), and Monoamine oxidase inhibitors (MAOIs) are extremely effective in most cases but can take 1-3 weeks for improvement of symptoms to be felt. The newer drugs (SSRIs, SNRIs) are preferred due to lower incidence of side effects.
- Aside from psychotherapy and medications, other steps that can be done to help address depression are:
- Keep a healthy and active lifestyle
- Minimize stressors in your life
- Avoid smoking and alcohol
- Find a support group or be part of a circle of friends
- Avoid making major decisions when you’re depressed because chances are, you will make a regrettable decision that might only add up to your depression.