Are You Depressed?

Ever felt sad, down, in the dumps? Have things gotten so dark that you've felt like giving up? It's not an uncommon sight with almost 460,000 Australians aged 16 to 60 suffering from an affective disorder (disorders centred around mood, including Major Depressive Disorder (MDD)) of some kind at one point in their lives.

It's said that in Australia roughly one in four people have suffered from anxiety-related symptoms at some point within the last year, and about one in 20 have suffered from depression-related symptoms in the same time frame. Again, it's not an uncommon sight.

Let's get things straight, when we're talking about depression what do we even mean? Well, the term depression is actually an Anglo-French word (depressio) that came about in the 14th century. It's noted as meaning to be "pressed down".

What have some people identified as feeling when they're depressed? You got it, 'down'. We hear that word tossed around without understanding its inception, but that's beyond the point of this post. What I'm going to focus on here is what depression actually means in the clinical sense, and how it might apply to you!

The DSM-5 notes that affective disorders have a number of common features: feelings of sadness, emptiness, irritability, all accompanied by physiological and cognitive (i.e. pertaining to our thought processes) changes that limit the person's capability to function (APA, 2013). What differs between these disorders are their temporal duration, timing, and presumed cause.

But what are these disorders? We've already mentioned MDD, but surely there are others. After all, the DSM doesn't do things half the velocity... 

You'll see a list of just a few of them below:

1. Disruptive Mood Dysregulation Disorder (a new addition to the DSM-5 that has come under scrutiny given the potential to diagnose temper tantrums as mental disorders)

2. Dysthymia (a prolonged period of depressive symptoms)

3. Premenstrual Dysphoric Disorder (basically the mood swings that include depression-like symptoms when a female's on her period)

You can see why everyone's not too convinced with the DSM's way of pathologising behaviour. But that's fodder for another post (I've summarily discussed some changes in the new DSM and the scrutiny they've endured in a previous post). 

In all seriousness I'm now going to run through the new DSM requirements for the diagnosis of MDD, an increasingly lethal disorder.

In order to be diagnosed with MDD, the person needs to satisfy at least five of the following criteria over a two-week period:

1. Depressed mood observable to others and/or self

2. Decreased interest in activities you once found enjoyable

3. Weight loss or weight gain

4. Insomnia or hypersomnia

5. Motor agitation (observable agitation in terms of movement in the body)

6. Fatigue

7. Worthlessness and guilt

8. Lessened cognitive ability

9. Recurring thoughts about death and suicide (a clinician's guide to suicide risk assessment can be found here)

In terms of making a diagnosis, the clinician will attempt to ascertain a plethora of other details (e.g. whether there are psychotic or melancholic features), but for this post's purposes, the latter criteria is sufficient.

Depressive disorders have been associated with a largely increased suicide risk (although there are many factors involved to determine that risk), therefore if a person identifies with the latter criteria it'll be in their best effort to seek professional help, wherever they reside.

It's my advice that if you've read this post and have found these symptoms in yourself or somebody that you care about, seeking local medical and psychological/psychiatric help would be something to consider seriously. 

I'm sure you've heard somebody respond 'I'm fine!' with agitation in their voice when asking them how they are. What I like to remind people is that when some of us say that we really mean 'I'm frustrated, insecure, neurotic, and emotional!'. A little acronym that just about sums up this post.

References

American Psychiatric Association (APA). (2013). Diagnostic and Statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Images retrieved from:

http://angryjogger.com/wp-content/uploads/2012/07/running-to-overcome-depression.jpg

http://www.perthbraincentre.com.au/wp-content/uploads/Constraint-Induced-Therapy.jpg