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

Updated March 20, 2023by BetterHelp Editorial Team

We all feel down from time to time. Sadness can be mild or severe, and it can be brief or ongoing, but it is essential to know when you are just feeling sad and down and when you may be dealing with clinical depression.

Clinical depression is also called 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. According to the World Health Organization, more than 300 million people worldwide suffer from depressive disorders. To understand more about clinical depression and when to seek help, it is important to know the symptoms.

There's A Difference Between Feeling Low And Being Depressed

Signs And Symptoms Of Clinical Depression

It is important to understand the signs and symptoms of clinical depression to be able to recognize them in yourself or those close to you. Sometimes people don't even realize they're struggling with depression because they've been living with it for so long that when depression feels normal, they don't recognize it as a problem.

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM), which outlines symptoms of mental disorders, including clinical depression. For a health care professional to diagnose clinical depression, a person must experience at least five of the following symptoms nearly every day, for most 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

  • Feelings of worthlessness

  • Difficulty making decisions, remembering things, or concentrating

  • Suicidal thoughts or suicide attempts

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 988 and is available 24/7.

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

Other common signs of clinical depression can include:

  • Leaving the house less often than usual

  • Reduced motivation at school or work

  • Becoming withdrawn from family and friends

  • Alcohol use

  • Loss of confidence

  • Experiencing aches and pains

  • Feeling hopeless

  • Physical problems like heart disease or chronic pain

  • No longer taking pride in physical appearance

  • Recurrent thoughts of death

Risk Factors Of Clinical Depression

While it is difficult to say what causes clinical depression, several risk factors can be linked to the development of the illness.

Statistics show that women are nearly twice as likely to be clinically depressed as men, although males and females are affected at the same rate as children. One possible explanation is that this is due to female hormones, but it has also been suggested that women are simply more likely to report depression and seek help than men, who may feel too embarrassed. Relationships also factor in, with statistics showing that married people are less likely to be depressed

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, you will automatically become depressed, too. Depression is a complex illness most likely linked to a combination of genes. While abundant research has been conducted on this, the genetic influence is still uncertain

Personality traits, including introversion and neuroticism, can also predispose some individuals to clinical depression. The following characteristics are also related:

  • Tendency to worry a lot

  • Low self-esteem

  • Perfectionism

  • Sensitive to criticism

  • Self-critical

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

If a person has a predisposition to depression due to genes or personality traits, several factors may trigger the illness. For example, most people 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 soon after or later in life. Major life events can sometimes trigger depression, even happy occasions 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.

If you or someone you know is experiencing abuse, please call the National Domestic Violence Hotline, available 24/7, at 1.800.799.SAFE (7233) or text "START" to 88788. Live chat is also available on the National Domestic Violence Hotline website.

Clinical depression can also be triggered by serious illness and is often linked to another medical condition. Certain medications can trigger clinical depression in some individuals. If you take any of these medications and experience symptoms, it is essential to contact your doctor before you stop taking the medication, and they will advise you on the best course of action. 

Substance use is another significant risk factor; up to a third of clinically depressed people engage in drug or alcohol use. 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. While there are many of these readily available, and they can indicate 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 determine if your symptoms are due to a medical condition, like a 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, when symptoms occur, and how this affects your daily life, including work and relationships with friends and family. Your doctor may likely ask you to complete a questionnaire about how often you have experienced specific symptoms to reach a diagnosis.

Your doctor may also ask questions about anxiety disorders, which are common in those with clinical depression. It's normal to feel uncomfortable or exposed answering such personal questions; however, it is imperative to answer honestly to get the help you may need. You will be asked about your mood over the last two weeks and whether you have experienced loss or reduction of pleasure or enjoyment in activities.

Likely, you will also be asked whether you have experienced any difficulty sleeping or weight changes. 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

While some people 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 usual self. Maintaining a healthy lifestyle can help, so try to eat a 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 routine to help you wind down. Try to cut down on caffeine, as it 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. Relaxation training is also useful to calm your body and mind. 

Spending more time with family and friends can also aid your recovery. Letting them know what you're going through can help them support you. Opening up to someone close to you can help you realize that you are not alone.

There's A Difference Between Feeling Low And Being Depressed

If you are experiencing clinical depression, taking these steps may not be enough for you to ultimately get better. As clinical depression is such a complex mental illness, different treatments affect people differently. 

Your doctor can prescribe antidepressant medication, with selective serotonin reuptake inhibitors (SSRIs) being one of the most common. Medications are very effective in treating moderate to severe clinical depression and even anxiety disorders. 

Unfortunately, while this is often a very effective treatment, medication often takes at least two weeks to begin to affect symptoms, and they do not work for everybody. Depression is a complex mental illness that cannot always be treated biologically in the same way that a physical illness can. If one particular antidepressant does not help you, your doctor may prescribe others to find something that works for you.

If a particular treatment worked for someone in your family, it may also be effective for you, as there appears to be a genetic factor related to this. It is crucial that even if you start to feel much better, you do not stop taking the medication without consulting your doctor, as this can lead to a sudden worsening of symptoms.

Psychological Treatments

Psychological treatments aim to treat clinical depression by discussing 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 that 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 identify thoughts and behaviors contributing to your symptoms. The therapist will help you to change these thought and behavior patterns into positive, problem-solving techniques.

Another common psychological treatment is interpersonal therapy (IPT), a structured psychological therapy based on relationships. Relationships can significantly affect someone who is experiencing clinical depression and can even contribute to the onset of depression. IPT helps you to recognize patterns in relationships that may be affecting your depression and change these patterns to improve relationships and, in turn, improve your symptoms.

You could also join support groups. There are various support groups for people with depression, such as the Depression and Bipolar Support Alliance. Support groups are also available for the family of those with depression, such as the National Alliance on Mental Illness.

Online Therapy With BetterHelp

Unfortunately, many factors can 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 simply may not be able to afford treatment. BetterHelp aims to overcome these barriers so everyone can receive the necessary help.

Some people with depression have a hard time getting motivated to get out of bed, and the thought of getting dressed and commuting to an office for therapy might be overwhelming. With BetterHelp, you can attend sessions from the comfort of home or anywhere you have an internet connection. You can communicate with your therapist via online chat, phone, text, or video sessions. Plus, you can reach out to your therapist any time, day or night, and they will get back to you as soon as they can. 

Studies show that online therapy is effective. In fact, one review of 17 studies found that online CBT for depression may even be more effective than in-person treatment. If you want to learn more, reach out to a BetterHelp therapist to get started.


Experiencing persistent depression is very common and is nothing to be ashamed of; however, it is a serious condition and should be treated. Make sure you are aware of the signs and symptoms of major depressive disorder so that you can recognize them in yourself or someone else.

You Don’t Have To Face Depression Alone. Our Experienced Counselors Can Help.

The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
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