Depression is the most common end result of untreated, longterm, neglected stress. Depression used to be divided into exogenous depression mainly developing in response to environmental or external causes and endogenous depression developing due to internal neurotransmitter deficiencies. Nowadays the general term of clinical depression applies after it became clear that a definite distinguishing type seldom exists alone in a depressive patient. The American Psychiatric Association recommends treatment for anybody suffering from four or more of the symptoms as set out in its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV 1994), for longer than 2 weeks. Clinical depression means that the diagnosis of depression is made according to the DSM-IV scale and is based on the following criteria: - Persistent and pervasive feelings of sadness for most of the day
- Changes in appetite with either weight gain or weight loss
- Altered sleeping patterns with either oversleeping, insomnia or disturbed sleep
- Inability to concentrate, think or make decisions
- Feelings of worthlessness, hopelessness, helplessness or inappropriate guilt
- Increase in irritability, feeling edgy or slowed down
- Loss of energy with chronic fatigue
- Physical hyperactivity or inactivity
- Diminished interest or pleasure in previously enjoyed activities with loss of enthusiasm or decrease in libido (sexual drive)
- Recurrent thoughts of death or suicide
Most of us suffer from either one or more of these feelings at times in our lives, especially when we’ve been overdoing it, or when we’re having trouble with our relationships or when having financial problems. Remember that the diagnosis of clinical depression is only made once 4 or more of the symptoms persist for longer than 2 weeks – mostly present for up to a month. Less than 4 symptoms for a shorter period might be indicative of dysthymia (mild or moderate) depression, functioning as possible warning signals from your body and mind that something is wrong in your life. All is not in balance. Do something about it before you suffer from true depression. Clinical depression is also referred to as major or unipolar depression. The spectrum of clinical depression that ranges from mild depressed feelings to serious considerations of suicide is known as mild depression or dysthymia. Mild depression is diagnosed according to the DSM-IV scale when a patient has been suffering for at least 2 years (1 year for children or adolescents) of at least 3 of the symptoms. When you suspect that you or someone close to you is suffering from clinical depression, it is important to see a primary care physician to make a positive diagnosis by ruling out any physical causes such as low thyroid function (hypothyroidism), low blood sugar (hypoglycaemia), a chronic subacute infection such as brucellosis, OTC (over-the-counter) drugs that may cause depression, recreational drugs, caffeine and alcohol abuse. Never start using medication whether it is St John’s Wort or prescription antidepressants, before other causes of depression have not been ruled out. |
