As a clinical psychologist, I’ve had extensive training in the diagnosis and treatment of depressive disorders. I’ve had the opportunity to teach Abnormal Psychology, at two universities, in both Illinois and in New York. I’ve published a journal article regarding the accurate diagnosis of depression in females with medical disorders.
I’ve also personally struggled with recurrent major depression. My first episode of depression occurred when I was only age sixteen.
I strongly believe that my symptoms of depression have been a main symptom of my diagnosis of relapsing-remitting MS. I also have been diagnosed with Hashimoto’s thyroiditis, an autoimmune form of hypothyroidism. Depression is a common symptom of this illness, too.
In my professional and personal experience, there are many ways of defining what depression actually means. If we’re honest with ourselves, we’ll admit that everyone “feels depressed” from time to time. We may describe this as feeling down, blue, or blah. Depression may be characterized by varying degrees of sadness.
Occasionally feeling blue is distinctly different from meeting the formal diagnostic criteria for a depressive disorder. Mental health practitioners utilize the Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM-V), to formally diagnose varying types of depressive disorders.
According to the DSM-V, individuals must experience increased depressive symptoms for a period of at least two weeks in order to meet the criteria for a diagnosis of a major depressive episode. The symptoms of hopelessness and helplessness must be sufficiently severe so as to interfere with daily functioning.
Some individuals suffer from milder forms of depression, over longer periods of time. This type of depression is known as dysthymia. In order to receive this diagnosis, individuals must have experienced a depressed mood for a period of at least two years.
Other individuals experience heightened depressive symptoms after a major adjustment in their lives. They may receive a diagnosis of adjustment disorder with depressed mood. This diagnosis requires that symptoms persist for a period of three months, following the experience of a significant period of transition or personal upheaval.
Bipolar disorder is yet another type of mood disorder. It involves cycling between periods of intensely elevated moods, formally known as mania, and periods of depression. The most common type of bipolar disorder involves predominately depressive episodes that are interspersed with periods of relatively less intense mania, known as hypomania. Media attention regarding bipolar types of mood disorders rarely addresses this important distinction.
I’ve definitely noticed that those who struggle with depression long-term tend to exhibit an “absence of joy,” as opposed to the “presence of sadness.” Significantly impaired levels of motivation, as well as decreased interest in formerly enjoyable activities, are hallmarks of long-term depressive disorders.
The natural history of depressive disorders may change significantly with the passage of time. As more time elapses in our lives, we are all faced with grieving a number of different types of losses, both actual and/or symbolic. Such losses may involve the death of close family members and/or friends. Those with chronic illness are engaged in an extended form of grieving for their former capabilities. To varying degrees, the aging process involves the loss of our physical and/or cognitive abilities.
It has been my experience that some individuals who have been diagnosed with a depressive disorder are actually in the midst of actively grieving some type of significant loss in their lives. Multiple symptoms of acute grief mirror those of major depression, after all.
It’s important to remember that symptoms of depression may be manifested in many different ways, including increased irritability, pervasive anhedonia, and/or heightened somatic complaints.
Depression is truly a mind-body disorder, as opposed to merely a mental illness. Individuals who manifest increased depressive symptoms also display alterations in their sleep and/or appetite patterns. When we’re depressed, we may exhibit insomnia, or hypersomnia. Our appetites may be decreased or increased. Depression is associated with increased feelings of fatigue. Increased pain may be a manifestation of heightened depression, too.
Cognitive changes are an additional manifestation of depression. When we’re clinically depressed, we tend to exhibit very negative types of thoughts. We also tend to discount the positive events that are taking place in our lives. As a result, developing an attitude toward gratitude in our lives is tremendously important for fighting depression. Counting our blessings truly does positively impact our moods.