Start Here: Recognizing and Diagnosing Depression

The Lady of Shalott Looking at Lancelot by John William Waterhouse

At any given time, 19 million Americans are suffering from a form of depression. Not only does this affect their lives, but the lives of those around them.

Since depressive disorders are also are a major cause of lost productivity in the workplace, there is an economic impact on all of us as well as a personal one.

Depression is also one of the few potentially fatal illnesses that is treatable. It’s impossible to know how many suicides could be prevented by proper diagnosis and treatment, but the tragedy is that there are certainly many that could be prevented, but aren’t.

Depression is under-diagnosed and under-treated. There are several factors at work here. One is the failure of many general practitioners to recognize depression in a patient.

Another factor is the lack of understanding most people have about the symptoms of the illness, which prevents them from seeing depression symptoms for what they are. Also, the general inertia created by being depressed is itself a barrier to taking action.

If you think you have depression, or know someone who does, it is important that you know as much as possible about the different kinds of depression to determine whether the doctor is diagnosing and treating it properly. You are, in essence, your own second opinion.

Next: Depression Diagnosis



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Real-Life Depression Symptoms

Yellow and Lilac Water Lilies by Claude Monet

I think that one reason it took so long for my depression to be diagnosed is that depression symptoms lists can be kind of out of touch with a large number of people. I can look at them now and see why nothing clicked with me. Appetite problems? Nope. Sleeping problems? Nope. Suicidal thoughts? Nope. Loss of interest in things previously enjoyed? Well, when you’ve been depressed since childhood, that’s kind of hard to say.

And the lists leave a lot of real-life depression symptoms out. What about “don’t like to be around other people”? Or “read way too many romance novels/play too much Dungeons and Dragons.” And where was “wear dark clothes most of the time”? (Actually, if you live in a major city, wearing dark colors doesn’t necessarily mean you’re depressed. It just makes sense, since otherwise your clothes always look grimy).

Here’s one of the problems. Those lists are, more often than not, lifted right from the Diagnostic and Statistical Manual of Mental Disorders. This is the big, thick book that doctors use to diagnose mental illness. As you can tell by its name, it’s pretty darn technical. And dry. But that’s really no surprise, since it’s written by doctors for the benefit of doctors and insurance companies.

I figured that I couldn’t be the only one who didn’t recognize my own depression in those dry, technical lists, so here is my partial list of real-life depression symptoms:

  • Things just seem to be “off” somehow.
  • You cry frequently for no apparent reason, and it’s not the good kind of crying you get from watching “The Notebook”.
  • You look around your house at the end of the weekend and wonder why you didn’t get anything done, even though you weren’t busy.
  • Everything is a monumental effort. It’s the mental equivalent of having the flu.
  • You let little things that really shouldn’t be a problem slide for months, like registering your car. (Ask me how I know that you can get huge ticket from the nice state cop from this.)
  • You’re very irritable. (Let’s face it, if everyone is irritating you, it’s probably you, not them).
  • Your issues of Allure/GQ are piling up unread because you really couldn’t care less about your appearance. And if you’re not the Allure/GQ type, you’re not keeping up with your average hygiene routine – hair cut, waxing, plucking, trimming nose hair, etc. You don’t smell or anything, but just doing the shower/tooth brushing is about as much as you can handle.
  • You constantly feel like something bad has happened, or that you’re worried about something, but there’s really nothing you can put your finger on.
  • You can’t make a decision to save your life, even if it’s only to respond to “fries with that?”
  • You’re anxious and worried all the time over things that normally don’t make you fret.
  • Your feelings toward your spouse/significant other have changed. You may feel yourself withdrawing emotionally.
  • Your concentration is shot and/or you’re forgetful.
  • Your senses are dulled – nothing looks colorful, food doesn’t have much taste, etc.

I hope that this list has been somewhat helpful. Let me know what I left off – I’m interested in hearing other people’s symptoms.

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DSM-IV Criteria for Depressive Disorders

Major Depressive Disorder, Single Episode

A. Presence of a single Major Depressive Episode.

B. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

Image: Flora by Lawrence Alma-Tadema
Flora by Lawrence Alma-Tadema

C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition.

Major Depressive Disorder, Recurrent

A. Presence of a two or more Major Depressive Episodes.

B. The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

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Depression Symptoms and Screening

“I am the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be a cheerful face on earth. Whether I shall ever be better I cannot tell; I awfully forbode I shall not. To remain as I am is impossible. I must die or be better.” – Abraham Lincoln

Image: The Sorceress by John William Waterhouse
The Sorceress by John William Waterhouse

Depression falls into two major categories; unipolar depression and bipolar disorder (previously known as “manic depression.”) The first is characterized by a persistent low mood, and the second is characterized by extremes in both low and high moods.

Major Depression Symptoms

If five or more of the following symptoms have been present in either you or someone you know for more than two weeks*, please talk to your doctor about the possibility of depression being present. Keep in mind that these symptoms could indicate a medical condition other than depression.

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