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Depression

Brief periods of sadness happen at times because life happens.  But a major depressive episode lasts longer than two weeks.  The individual feels depressed most of the time or loses interest or pleasure in most activities.  Children and adolescents may show irritability rather than sadness.  The depressed person will also show other symptoms that are described in the following table, How Do You Know You're Depressed?

Ethnicity, education, income, and marital status are unrelated to the prevalence of depression.  However, gender is.  Women show depressive moods more than men do.  Yet many depressed men are more likely to be irritable rather than sad, when depressed.  Consequently, their depression may go unrecognized and untreated.

Depression does not indicate a moral or spiritual failing.  Many people are genetically predisposed to becoming depressed.  A depressed person is more likely to have a parent, child, and/or sibling who has been depressed.  Chronic stress, trauma, other anxiety disorders, attention deficit, learning disabilities, eating disorders, social rejection, major loss, general medical conditions, and family problems are just some of the situations that can lead to depression.

How Do You Know You’re Depressed?

 
Mild Form of DepressionModerate Form of Depression Severe Form of Depression 
Blue, down, or neutral mood Cry more easilySevere sadness
Not in the mood to socializeLess involved with othersLack of interest in usual activities 
Usual activities are not as fun as expected Have fun until activity is overDecreased pleasure
Blame self more readily when things go wrong; see own faults Self-criticalExcessive and inappropriate guilt
Not as hungry as usual; can skip meals occasionally and not feel hungry   Eating brings less pleasureDecreased appetite
Not dieting but clothes fit slightly looser, no big weight loss (e.g., 1 to 3 pounds) Noticeable weight loss, but not dietingSignificant weight loss, but not dieting
Sleep seems less restful; ruminating at bed time; falling asleep takes a little longer Takes much longer to fall asleep; wake up briefly during the nightInsomnia---cannot fall asleep easily, wake up during the night and stay awake
Lose interest in tasks such as reading; get frustrated with tasks that are lengthy Must reread text; thoughts cannot focus wellImpaired concentration
Feel as if moving slowly; not mentally sharpSlowness in movement is noticeable to others; long pauses before answering questions Psychomotor retardation
Wish emotional pain would go away; thoughts of running away; pessimisticThoughts that life may not be worth living; hopeless; can’t imagine feeling better Suicidal ideas or attempts; not caring if they died
Self-doubt; some self-criticismLow self-esteem, dislike appearance, feel like a loserFeelings of worthlessness
 From Monica Ramirez Basco and A. John Rush.  2005.  Cognitive-Behavioral Therapy for Bipolar Disorder, Second Edition.  Page 131.  New York:  The Guilford Press.