Clinical Depression - When It’s More Than Just Feeling Down

By: Sarah Fader

Updated February 10, 2021

Medically Reviewed By: Richard Jackson

It is an unfortunate guarantee of being human that from time to time we will all feel down. The upside of this is that it helps us to appreciate the good times when we feel happy by contrast. Sometimes we know we're feeling sad for a reason, whether it be loss or death of a loved one, failure to achieve goals or one of many other life events.

Sometimes hormones or medical disorders such as thyroid disorder may cause us to feel down. Yet other times we can't even pinpoint what's causing us to feel this way. Sadness can be mild or severe, and it can be brief or ongoing. It is important to know when you are just feeling down and when it's something more.

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So what is clinical depression? Clinical depression is also known as major depressive disorder or major depression. We can define clinical depression as a mood disorder which causes severe symptoms that occur most days and last for at least two weeks, which affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. It involves low mood and loss of interest or pleasure in activities which you usually enjoy, and it can impact all aspects of a person's life.

According to the World Health Organization, more than 300 million people worldwide experience depression. It's also the world's leading cause of disability. The National Institute of Mental Health has found that around 6.7% of Americans may have depression at any one time. To give a complete clinical depression definition, we must also look at the signs any symptoms of the disorder.

Signs and Symptoms of Clinical Depression

It is important to understand signs and symptoms of clinical depression in order to be able to recognize them in yourself or those close to you. The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) which outlines symptoms of disorders including clinical depression, in order for mental health professionals to correctly diagnose patients. In order to be diagnosed with clinical depression a person must experience at least five of the following symptoms nearly every day, for a large part of the day over a period of two weeks or longer:

• Persistent sad mood
• Reduced or complete loss of pleasure or interest in activities
• Weight loss, weight gain or change in appetite
• Changes in sleep such as insomnia or increased sleeping
• Restlessness or slow movement or speech
• Feeling tired and having no energy
• Feeling guilty or worthless
• Difficulty making decisions, remembering things or concentrating
• Thinking about or attempting suicide

At least one of the clinical depression symptoms must be a loss of interest or pleasure in activities or a depressed mood. Other signs of clinical depression include:

• Leaving the house less often than usual
• Reduced motivation at school or work
• Becoming withdrawn from family and friends
• Increased alcohol use
• Loss of confidence
• Experiencing aches and pains
• Feeling hopeless
• No longer taking pride in physical appearance

Risk Factors of Clinical Depression

Whilst it is difficult to say exactly what causes clinical depression, there are a number of risk factors which can be linked to the development of the illness. It usually results from a combination of a predisposition to depression and life choices and events.

Statistics show that women are twice as likely to be clinically depressed as men are, although in children males and females are affected at the same rate. One argument is that this is due to female hormones, yet it has also been suggested that women are simply more likely to report depression and seek help whilst men may feel too embarrassed. Statistics suggest that in both genders clinical depression is most common in those aged 25-44.

However, depression can affect any person of any age and statistics should not be taken as absolute fact. Relationships also factor in, with statistics showing that clinical depression is least common in those who are married, and more common in those who are divorced.

Depression can run in families, suggesting that there may be a genetic predisposition to the illness. However, that does not mean that if a parent or relative has depression, then you will automatically become depressed too, as it is a complex illness most likely linked to a combination of genes and not just one. Whilst an abundance of research has been conducted into this, the genetic influence is still uncertain. Personality traits including introversion and neuroticism can also predispose some individuals to clinical depression, and the following characteristics are also related:

• Tendency to worry a lot
• Low self-esteem
• Perfectionism
• Sensitive to criticism
• Self-critical

It is important to keep in mind that these are some of many related factors, and you should not be concerned about someone just because they possess these personality traits.

There has been a large amount of research into the biology associated with clinical depression, and it is believed to be linked to chemicals and hormones in the brain. However, the links are complex and unclear at this time.

If a person has a predisposition to depression as a result of genes or personality traits, there are several factors which may trigger the illness. For example, it is normal to feel sad after the death or loss of a loved one, but in some individuals, this could increase the risk of depression. Physical, sexual or emotional abuse may also trigger depression, whether it occurs soon after or later on in life. Major life events can sometimes trigger depression, even happy events such as getting married or starting a new job. However, unsurprisingly, stressful events such as getting divorced or losing a job are more likely to trigger depression than happy events.

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Clinical depression can also be triggered by serious illness and is often linked to another medical condition. Certain medications, including Isotretinoin, interferon-alpha, and corticosteroids can trigger clinical depression in some individuals. If you take any of these medications and experience symptoms, it is important to contact your doctor before you stop taking the medication, and they will advise you on the best course of action. Substance abuse is another major risk factor, and up to a third of clinically depressed people engage in drug or alcohol abuse. It is important to remember that clinical depression is an illness and not a normal reaction to life events, even those which would cause great sadness such as the death of a loved one. The causes and triggers will differ from person to person, and therapies can help those with depression to discover the cause of their illness.

Diagnosing Clinical Depression

If you are concerned that you may be experiencing depression you may look for a clinical depression test online, as many people do. Whilst there are many of these easily available, and they can give you some indication of whether you may be depressed, it is always best to visit a professional in person for an accurate diagnosis and treatment recommendations. In most cases, a doctor will start with blood tests to find out if your symptoms are due to a medical condition such as thyroid disease or vitamin D deficiency, as these conditions can affect your mood and should be ruled out before a diagnosis of depression is made.

Your doctor will ask you about your mood, symptoms you are experiencing, and how this is affecting your day to day life including work and relationships. It is likely that your doctor may ask you to complete a questionnaire about how often you have experienced specific symptoms in order to reach a diagnosis.

This may include questions relating to anxiety disorders, which are common in those who are clinically depressed. It's normal to feel uncomfortable or exposed answering such personal questions; however, it is very important to answer honestly as you are now with a professional who can ensure that you receive the help you may need. You will be asked about your mood over the last two weeks and whether you have experienced and loss or reduction of pleasure or enjoyment in activities.

It is likely that you will also be asked about whether you have experienced any difficulty sleeping or changes in weight. Other questions may ask if you have experienced any difficulty concentrating, making decisions or remembering. Following your appointment, the doctor should be able to determine whether or not you are clinically depressed and the severity of your depression. Based on this your doctor should recommend treatment options.

Clinical Depression Treatment

Whilst some people simply recover from depression over time, clinical depression can go on for years if you do not receive help. The good news is that there are things you can do yourself to relieve symptoms of depression and assist your return back to your normal self. Maintaining a healthy lifestyle can help so try to eat a healthy, balanced diet and engage in regular exercise or physical activity.

Try to get a good night's sleep. If this is something you struggle with (as many with depression do), then decide on a regular bedtime and bedtime routine to help you to wind down, and try to cut down on caffeine as this can cause difficulty sleeping. Reducing and managing stress levels can also help to relieve the symptoms of depression - try to tackle your stress head on by addressing problems and making plans to overcome them. You may also find relaxation training useful in order to calm your body and mind. Many useful free resources for this are available via the internet and app store. Spending more time with family and friends can also aid your recovery.

Letting them know what you're going through can help them to support you, and just spending time with people is likely to make you feel better even if you feel like you want to be alone. Opening up to someone close to you will make you realize that you are not alone, which can help with your recovery. If you worry that someone close to you may be experiencing depression, try to encourage them to spend time with you and open up to you.

If you are experiencing severe clinical depression, taking these steps may not be enough for you to completely get better. As clinical depression is such a complex mental illness, different treatments work for different people. Antidepressant medication can be prescribed with SSRIs (selective serotonin reuptake inhibitors) being the most common.

These are very effective in treating moderate to severe clinical depression, and even anxiety disorders. Unfortunately, whilst this is often a very effective treatment it often takes at least 2 weeks to begin to have an effect on symptoms, and they do not work for everybody. This is because depression is a complex mental illness which cannot always be treated biologically in the same way that physical illness can be. In the event that one particular anti-depressant does not help you, there are others which your doctor may prescribe in order to find something that works for you.

It is likely that if a certain treatment worked for a family member, then it may also be effective for you, as there appears to be a genetic factor related to this. It is very important that even if you start to feel much better, you do not stop taking medication without consulting your doctor, as this can lead to a sudden worsening of symptoms. Antidepressants will often be prescribed alongside other treatments or if other treatments have been unsuccessful.

Psychological Treatments

Psychological treatments aim to treat clinical depression by talking about your condition and related issues with a mental health professional. These treatments can help you to:

• Adjust to life changes in a positive way
• Identify negative thought and behavior patterns and replace them with positive ones
• Improve your coping skills to help you better cope with stress and problems
• Identify factors which contribute to your symptoms and find ways to change this
• Regain a sense of satisfaction and control in your life
• Learn to set realistic, achievable life goals

One of the most common psychological treatments is cognitive behavioral therapy (CBT), which involves a therapist helping you to identify thought and behaviors which are contributing to your symptoms. The therapist will help you to change these thought and behavior patterns into positive, problem-solving techniques.

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Another common psychological treatment is Interpersonal Therapy (IPT). This is a structured psychological therapy based on relationships. Relationships can have a significant effect on someone experiencing clinical depression and can even contribute to the onset of depression. IPT helps you to recognize patterns in relationships which may be affecting your depression, and change these patterns to improve relationships, and in turn, improve your symptoms.

BetterHelp

Unfortunately, there are many factors which may stand in the way of someone receiving the help they need. Some people may not want to take time out of work for therapy and have to answer questions about where they're going. Some people may simply not be able to afford treatment. BetterHelp aims to overcome these barriers so that everyone can receive the necessary help.

It is an online counseling platform which was launched in 2013 to help to provide those experiencing clinical depression and other illnesses and issues, including anxiety, addiction and many more, to easily access the help they need. BetterHelp does this by providing easy, affordable and discreet access to licensed therapists anytime, anywhere. Patients receive professional counseling via a computer, tablet or mobile phone making it much easier to access help.

BetterHelp has assisted over 200,000 people so far and received glowing reviews from patients who have experienced huge improvements as a result. Licensed, trained, experienced counselors, specialize in different areas to ensure that all patients can be matched to a highly qualified professional who fits your requirements. In the unlikely event that you are unhappy with your counselor, you can easily change to a new one. The goal is to help you to feel better as soon as possible, and BetterHelp are just here to help you.

Experiencing clinical depression is very common and is nothing to be ashamed of; however, it is a serious condition and should be treated. Ensure that you are aware of the signs and symptoms so that you can recognize them should they occur in yourself or someone close to you.

If you experience symptoms for more than two weeks, then it is very important that you receive help. If you are worried that a loved one may be Experiencing clinical depression, then urge them to get the help they need. BetterHelp are here to help you return to your usual self and improve your quality of life, so don't hesitate to get your life back on track.