What is Depression? (Part 1)

Introductions to nurture issues

Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles...

Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles, or an injured self-esteem.

But when feelings of intense sadness -- including feeling helpless, hopeless, and worthless -- last for days to weeks and keep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression -- a treatable medical condition.

What is depression?

According to the DSM-IV, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following nine symptoms at the same time:

• a depressed mood during most of the day, particularly in the morning

• fatigue or loss of energy almost every day

• feelings of worthlessness or guilt almost every day

• impaired concentration, indecisiveness

• insomnia or hypersomnia (excessive sleeping) almost every day

• markedly diminished interest or pleasure in almost all activities nearly every day

• recurring thoughts of death or suicide (not just fearing death)

• a sense of restlessness -- known as psychomotor agitation -- or being slowed down -- retardation

• significant weight loss or gain (a change of more than 5% of body weight in a month)

How long do these signs have to be present before they are diagnosed as depression?

With major or clinical depression, one of the key signs is either depressed mood or loss of interest. For a diagnosis of depression, these signs should be present most of the day either daily or nearly daily for at least two weeks. In addition, the depressive symptoms need to cause clinically significant distress or impairment. They cannot be due to the direct effects of a substance, for example, a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism. Finally, if the symptoms occur within two months of the loss of a loved one, they will not be diagnosed as depression.

What are some common feelings associated with depression?

According to the National Institute of Mental Health, people with depressive illnesses do not all experience the same symptoms. How severe they are, how frequent, and how long they last will vary. It depends on the individual and his or her particular illness. Here are common symptoms people with depression experience:

• difficulty concentrating, remembering details, and making decisions

• fatigue and decreased energy

• feelings of guilt, worthlessness, and/or helplessness

• feelings of hopelessness and/or pessimism

• insomnia, early morning wakefulness, or excessive sleeping

• irritability, restlessness

• loss of interest in activities or hobbies once pleasurable

• no pleasure left in life any more

• overeating or appetite loss

• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

• persistent sad, anxious, or "empty" feelings

• thoughts of suicide, suicide attempts

While these are common symptoms of depression, they may also occur in patterns. For example, a person may experience depression with mania or hypomania -- a condition sometimes called manic depression. Or the symptoms may be seasonal as in the case of seasonal affective disorder.

There are several types of manic depression. People with bipolar II disorder have at least one episode of major depression and at least one hypomanic -- mild elation or high -- episode. People with bipolar I disorder have a history of at least one manic -- extreme elation or high -- episode, with or without past major depressive episodes. A patient with unipolar depression has major depression only but does not have hypomania or mania.

Is childhood depression common?

Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. If your child is sad, this does not necessarily mean he or she has significant depression. It's when the sadness becomes persistent -- day after day -- that depression may be an issue. Or, if your child has disruptive behavior that interferes with normal social activities, interests, schoolwork, or family life, it may indicate that he or she has a depressive illness.

Keep in mind that while depression is a serious illness, it is also a treatable one.

What about depression in teens?

It is common for teens to occasionally feel unhappy. However, when the unhappiness lasts for more than two weeks and the teen experiences other symptoms of depression, then he or she may be suffering from adolescent depression. Because as many as one in every 33 children and one in eight adolescents suffer with depression, talk to your doctor and find out if your teen may be depressed. There is effective treatment available to help teens move beyond depression as they grow older.

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