Clinical Depression Symptoms

Clinical Depression symptoms are officially defined by the Diagnostic and Statistical Manual for Mental Disorders IV or DSM IV as symptoms that meet the criteria for a depressive disorder.

I will list the symptoms that apply to several types of clinical depressive disorders.

Clinical depression usually refer to a mood that is depressive but, not a temporary, normal response to difficult life events or grieving.

This page lists many clinical depression symptoms and several types of depressive disorders.

Major Depression

In order to have a diagnosis of Major Depression, a person must have five or more of the following symptoms for more than 2 weeks:

*a feeling sadness for no apparent reason
*a lack of energy, feeling unable to do the simplest task
*an inability to enjoy the things that used to bring pleasure
*a lack of desire to be with friends or family members
*irritability, anger, or anxiety
*an inability to concentrate
*a marked weight gain or loss (or failure to gain weight as expected), and little or too much interest in eating
*a significant change in sleep habits, such as trouble falling asleep or getting up
*feelings of guilt or worthlessness
*aches and pains even though nothing is physically wrong
*indifference about the future
*frequent thoughts about death or suicide

Although major depression can be treated effectively, individuals who suffer from it feel as though they are falling into an ever widening black hole with no way out. In an agitated depression, both mania and depression happen at the same time. This is also called a mixed state.

Fact: 15% of the population of most developed countries demonstrate clinical depression symptoms. [1]

Dysthymia

For a diagnosis of dysthymia, a person must have at least two of the following symptoms almost all the time for at least 1 year:
- feelings of hopelessness
- low self-esteem
- sleeping too much or being unable to sleep - extreme fatigue
- difficulty concentrating
- lack of appetite or overeating

Clinical depression symptoms can indicate Mild, Severe or Chronic forms of depression.

Mild Depression
The first stage of depressive illness where only a few symptoms are noticed. This stage may be overcome with self-help tips.

Severe Depression

Severe depression happens when a depressed mood is intense enough to impair functioning in relationships, performance at work, school or with daily tasks at home, or even leisure.

Chronic Depression

Chronic Depression is longstanding depression. The longer it goes untreated, the more difficult it may be to resolve.

Manic Depression also known as Bipolar Depression

* A diagnosis of bipolar I disorder requires at least one manic episode.
* Bipolar II disorder is defined as hypomania plus at least one episode of major depression.

Bipolar II depression is more common. The spectrum of bi polar disorder appears to be consistently expanding so I've included in this list not only signs to be aware of, but also other types of depression or mental disorders that may be co-occurring.[2]

Clinical depression symptoms of bipolar depression:

Three or more failed treatment attempts with anti-depressants.
Symptoms start after treating depression with antidepressants.
Panic disorder and generalized anxiety disorder are resistant to antidepressants
A person is restless, irritable, has difficulty sleeping, and experiences worsening panic attacks while gradually increasing depression medication doses.
Behavioral problems: difficult interpersonal, legal, or occupational histories
Attention-deficit/hyperactivity disorder
Borderline Personality Disorder
A first-degree relative (father, mother, sibling) with an established diagnosis of bipolar[3]
Bipolar depressions may be periodic or seasonal
Bipolar disorders typically appear prior to age 25.

Although major depression can be treated effectively, individuals who suffer from it feel as though they are falling into an ever widening black hole with no way out. In an agitated depression, both mania and depression happen at the same time. This is also called a mixed state.

Clinical depression symptoms can also involve coming to tears while manic, or racing thoughts while in a depressed mood are examples of agitated depression. Of all the types of depression, a mixed state can be the most dangerous because it so often involves substance abuse, panic disorder, and suicidal thoughts or gestures.

Seasonal Depression
Seasonal depression or winter depression may be mild types of depression. If clinical depression symptoms that are seasonal are severe enough to cause problems in relationships, or performance at work, home or school, or in recreational activities, Seasonal Affective Disorder (SAD) may be an appropriate diagnosis.

The lack of sunlight during winter months can contribute to feelings of depression. Exposure to bright light - phototherapy - and cognitive therapy can help in these cases.

December is designated as Seasonal Depression Awareness Month. The Substance Abuse and Mental Health Services Administration is offering information and resources about SAD among the special monthly features on the National Mental Health Information Center web site.

Psychotic Depression

One of the most severe forms of mental illness, psychotic depression is a chronic condition. A person may have general depressive periods with nothing major happening and then periods when severe psychotic features break out.

Psychotic Depression

People who demonstrate clinical depression symptoms with psychosis are the most likely of anyone with a depressive disorder to be suicidal. A psychotic episode can be triggered by stress and substance abuse and can present very much like other types of depression including Bipolar Disorder.

Common symptoms of Psychotic Depression
agitation
psychomotor Problems
unreasonable feelings of guilt
suicidal gestures and thinking
audio and or visual hallucination
a feeling of general malaise
aggressiveness
frustration
hopelessness

Atypical Depression happens when mood improves mood improves in response to a positive event but they are still in a major depression.

Clinical symptoms of depression that are atypical are overeating and excessive sleeping.

Even though it's called "atypical" it's actually the most common subtype of depression[4][5] — up to 40% of the depressed population may be classified as having atypical depression.

Exogenous depression means "from the environment", and is also known as situational depression or reactive depression.

Causes of situational or reactive depression

loss such as the loss of a loved one,
moving from one house to another (especially with children)
disillusionment about one's career prospects
Domestic disputes
Financial difficulties
living in an uncaring environment
holiday depression

Endogenous depression happens when there are no apparent environmental causes but instead come from a person's biochemistry.

**The types of clinical depression symptoms headlined on this page are essentially endogenous forms of depression.

It's important to know the difference so that we can treat the cause of the depression rather than the symptom.

Depression Facts

#1 About 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year will be affected by a depression disorder. This includes major depressive disorder, and bipolar disorder. [6]

#2 Everyone, will at some time in their life be affected by some type or level of depression -- their own or someone else's, according to Australian Government statistics. (Depression statistics in Australia are comparable to those of the US and UK.) [7]

References

[1] NIMH. “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series.

[2] Bipolar disorder in primary care: the bipolar spectrum is larger than was once believed, and mis-diagnosis can lead to an unfavorable treatment response - Foundational treatment Journal of Family Practice, March, 2003 by J. Sloan Manning

[3] Lapalme M, Hodgins S, LaRouch C. Children of parents with bipolar disorder; a meta-analysis of risk for mental disorders. Can J Psychiatry 1997;42:623-31.

[4] http://www.biopsychiatry.com/atypical.htm Course and treatment of atypical depression

[5] http://www.mcmanweb.com/article-200.htm Atypical Depression

[6] Australian Institute of Health and Welfare, 1998. “National Health Priority Areas Mental Health: A Report Focusing on Depression.” Depression statistics in Australia are comparable to those of the US and UK.

[7] NIMH. “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series.

Other Depression Pages on this Site