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Clinical Depression

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Clinical Depression

Depression is a mood disorder than can affect anyone at any time. According to the World Health Organisation, around 5% of adults in the world suffer from depression. What are the characteristics of clinical depression? How does clinical depression affect a person's daily life? Can we treat clinical depression?

At times, you may find yourself experiencing feelings of sadness that do not disappear after a few hours, days, or even weeks. You might feel overwhelmed, unable to concentrate and utterly unmotivated. So what does this mean? Are you just ‘sad’, or is there something else going on? Let’s find out.

  • We will first aim to understand the difference between depression and clinical depression, by using the definitions of both, along with some examples. This section will also cover the differences between sadness, unipolar depression and bipolar depression.
  • Next, we will look at the symptoms one experiences if they are suffering from depression.
  • Having understood this, we will move on to the causes of clinical depression.
  • Finally, we will explore various treatment methods used to manage the condition.

Characteristics of clinical depression, woman sitting on a box being comforted by another woman and a cat, StudySmarterDepression affects many people around the world, freepik.com/pch.vector

Clinical Depression vs Depression

Imagine you are experiencing feelings of sadness and hopelessness along with anxiety after going through a traumatic experience, such as a bereavement, long after the loss occurred. If this is the case, then these feelings may be described as depression.

Depression is a mood disorder that causes feelings of sadness and hopelessness and is notably different from previous functioning.

When these feelings of sadness, hopelessness and anxiety are heightened, to the point where you may be feeling this way for at least two weeks, you may be experiencing a major depressive episode, sometimes also known as clinical depression.

These symptoms are often accompanied by sleep problems, loss of interest in normal activities and changes in appetite, to name a few.

Clinical Depression Definition

According to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, clinical depression is:

Clinical Depression is a more severe form of depression and is characterised by at least two weeks of continuously having a low mood, low self-esteem, feeling hopeless and losing interest in daily activities.

It is important to understand that as a whole, depression ranges from mild, temporary episodes of sadness all the way to severe and persistent feelings of sadness. Here, we will be discussing this severe form of depression, i.e., Clinical Depression or Major Depressive Disorder.

Differences between Sadness, Unipolar Depression and Bipolar Depression

Having briefly understood the characteristics of clinical depression, and the feelings associated with it, we should be aware that not all depression is the same - it varies in severity, and even though they may look the same, there are some differences. Let's discuss this in further detail below.

Sadness

Sadness is a human emotion and is characterised by feeling unhappy or having a low mood. When someone goes through a situation that is upsetting or painful, it is normal for them to experience this emotion. Sadness is temporary, but if it carries on for long enough, then there are chances that it could lead to depression.

Unipolar Depression

This is another name for clinical depression, in addition to major depressive disorder. It is characterised by continuous feelings of sadness and/or lack of interest in pursuing activities that one would normally enjoy. Further, an individual with a diagnosis of unipolar depression will only experience negative feelings and emotions, as opposed to a variety of them.

The experience of intense negative emotions towards oneself may lead to someone believing that they are worthless, a waste of space and have no real purpose in life.

Bipolar Depression

Bipolar Depression is a mood disorder that causes stark shifts in an individual's mood, levels of energy and thoughts and behaviours. These shifts can last for a range of time, from a few hours at a time to a few weeks. Due to the intensity of these shifts, they almost always impact one's ability to carry out regular, day-to-day tasks.

Bipolar Depression is characterised by manic and depressive episodes; when someone experiences abnormally high levels of energy, or irritability, along with changes in levels of activity and emotions, they may be experiencing what is known as mania. When in a manic state, individuals tend to carry out activities that could potentially cause them some form of harm, be it physical, mental or financial.

Someone in a manic episode might suddenly spend an exorbitant amount of money on buying things they don't need, or may even go to a casino and gamble funds away

When said individual switches from mania to a depressive episode, they tend to experience the same negative feelings that one would experience if they were only suffering from unipolar depression, i.e., negative thoughts about themselves, continuous sadness and lack of interest in activities.

Clinical Depression Symptoms

Most of us will feel sad or lonely from time to time, often due to a specific event in our life such as loss, low self-esteem or other struggles. These feelings of sadness, although not pleasant, are normal. However, when these feelings become overwhelming, it may be time to seek help. How do you know what signs to watch out for?

The International Classification of Diseases (ICD-10) mentions three core symptoms that one must experience in order to be considered for a diagnosis of depression. These are:

  • Depressed mood
  • Loss of interest
  • Reduced energy

In addition to these, there are a further seven symptoms that are known as associated symptoms which should be considered:

  • Unreasonable feelings of remorse and/or inappropriate guilt
  • Recurrent thoughts of death/suicide
  • Reduced ability to think or concentrate
  • Changes in psychomotor activity
  • Disturbances in sleep
  • Changes in appetite accompanied by changes in weight

The number of symptoms one experiences, then, goes on to inform how severe their level of depression is. This can be divided into three categories:

  • Mild - 4 symptoms
  • Moderate - 5-6 symptoms
  • Severe - More than 7 symptoms

The diagnostic criteria further state that out of the core symptoms, the individual must experience at least two, and a further two out of the seven associated symptoms. These symptoms must last for at least two weeks, although if the symptoms start rapidly and/or cause a drastic impact on one's life, as opposed to a gradual change, then this time frame can be shorter. These specifications must be filled in order for an official diagnosis to be made.

Clinical Depression Causes

Due to its complex nature, identifying one specific cause of depression is extremely difficult. The 'cause' varies from individual to individual, and for some, there may be a combination of factors that contribute to the disorder. Some of these are explained below.

Childhood Experiences

Struggling with some form of adverse childhood experience(s) can have a large impact on how vulnerable you are to developing depression later in life. Such experiences can be described as:

  • Abuse (Physical, Sexual, Emotional)
  • Neglect
  • Losing a loved one
  • An unstable family situation

Experiencing a difficult situation may cause you to question your self-esteem, and may also impact your ability to cope with difficult emotions and situations; if this ability is hampered, then you might be at a higher risk for developing depression when struggling with a difficult situation, because you will not know how to deal with it in a healthy manner

Traumatic Life Events

As you grow older, there are different things that you prioritise and some that matter to you more than others. The disruption of any one of these things, or more, can result in feelings of depression. These situations could be:

  • The end of a relationship
  • The loss of a job
  • Moving houses
  • Getting married
  • Assault (Physical or Verbal, including racism)

Physical Health Problems

If you struggle with a physical health problem that is difficult to manage, it may have a large impact on your mood, thereby increasing your risk of developing depression.

Having a chronic illness can make it impossible to do things you once enjoyed; with a chronic illness comes tremendous life changes, which could limit your mobility and independence, thereby destroying your self-confidence and your hope for the future.

Genetics

Even though no specific genes for depression have been identified yet, research on the topic has shown that if you have a family member with a diagnosis of depression, then you are more likely to experience it yourself as well.

Clinical Depression Treatments

The most effective treatment methods for those suffering from clinical depression include medication and psychotherapy. While medication will alleviate symptoms, it is always beneficial to speak to a psychiatrist as well, so that you are able to address the root cause of your feelings and prevent relapse.

Depending on how severe your symptoms are, you might benefit from in-patient therapy at a rehabilitation clinic or hospital, but remember, most cases can be managed without this level of intervention. Here's a closer look at some of the treatment options that are available.

Medication

Many antidepressants are available on prescription, with the most common being Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norephinephrine Reuptake Inhibitors (SNRIs).

These names may sound complicated, but they have a rather simple process of how they work; essentially, they increase the serotonin levels in the brain, which in turn improves mood.

Serotonin is a neurotransmitter - a chemical that carries signals between the nerves and the brain - and is thought to influence mood, emotion and sleep. After a message is carried, serotonin is usually reabsorbed by the nerve cells, and this is known as 'reuptake'.

So what does an SSRI/SNRI really do? It blocks this reuptake, making more serotonin available to pass more messages between the nerve cells.

Psychotherapy

You might be wondering what 'Psychotherapy' really is, and what it constitutes. Let's have a look.

Psychotherapy is a form of talking therapy, wherein an individual and a psychotherapist sit together in a room and engage in conversation. It involves the treatment of psychological disorders by use of verbal and psychological techniques, which the therapist is qualified in.

There are different forms of psychotherapy that could be used to treat depression, and we will now discuss six of these in greater detail.

Cognitive Therapy: The basis for cognitive therapy revolves around the fact that our thoughts can affect our emotions.

When experiencing a difficult situation, if you manage to identify the silver lining, then you will be more likely to experience positive feelings (even though the situation you're in may be frustrating). Whereas, if you have negative thoughts, then the emotions you experience will be negative too.

So how does cognitive therapy work? The therapist helps an individual identify common patterns of their negative thinking, and provides them with effective tips that can help them turn these negative thoughts into positive ones; changing their negative thoughts to positive ones will thereby change their negative emotions into positive ones too.

Behaviour Therapy: The main focus of behavioural therapy is behavioural activation, which helps individuals engage in activities that will enhance their feelings of well-being.

Behavioural activation involves identifying specific goals, one week at a time, and then making a conscious effort to work towards those goals. These goals are ones which would normally be pleasurable for the individual.

If being a compassionate person gives you pleasure, then one of your goals for the week could be volunteering or helping a friend out.

Cognitive-Behavioural Therapy (CBT): This is a combination of cognitive therapy and behavioural therapy, hence the name! It not only addresses your negative thoughts but also your behaviours.

In order to do this, the therapist may ask you to keep a journal which will help you track the events that take place in a week, and your reactions to them. Once you are able to recognise these response patterns, your therapist will help you identify new ways of thinking and responding.

Dialectical Behaviour Therapy (DBT): It is based on CBT, but is different because instead of changing your negative thoughts and behaviours to positive ones, it encourages you to accept and acknowledge that they exist. This process of validation can help you come to terms with your negative emotions, learn how to cope with stressful situations and manage your reactions.

Mindfulness training within DBT is actually informed by Buddhist crisis coaching - an individual is able to contact their therapist in order to receive guidance on how to handle a difficult situation they may be encountering at a particular time.

Psychodynamic Therapy: Psychodynamic therapy is also known as psychoanalytic therapy and assumes that the feelings of depression are caused due to unresolved disputes, which originate from one's childhood. The goal of this therapy is to help you become more aware of all your emotions, including the difficult ones, so that you are able to effectively manage these feelings and use them to your advantage.

Interpersonal Therapy: Interpersonal therapy focuses on issues of conflict and poor social support by addressing past and present social interactions. It can help individuals understand how relationships affect their lives, and works under the assumption that one's feelings of depression occur in the conditions of their relationships.

Having discussed these, it is important to remember that everyone is different, and what work for you may not necessarily work for someone else. Oftentimes, a combination of medication and therapy needs to be adopted as treatment methods for the most effective result.

Characteristics of clinical depression - Key takeaways

  • Clinical Depression is a more severe form of depression, and is characterised by at least two weeks of continuously having a low mood, low self-esteem, feeling hopeless and losing interest in daily activities.
  • The signs and symptoms of clinical depression include continuous low mood, feelings of guilt, hopelessness and worthlessness, irritability, changes in appetite and in severe cases, suicidal thoughts or attempts.
  • One single cause for clinical depression has not yet been identified, however, there are different factors which can contribute to it, such as childhood experiences, traumatic life events, physical health problems and genetics.
  • The most common medications used for the treatment of clinical depression are classed as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norephinephrine Reuptake Inhibitors (SNRIs).
  • There are six different forms of psychotherapy that are effective in treating depression, and these are cognitive therapy, behaviour therapy, cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), psychodynamic therapy and interpersonal therapy.

Frequently Asked Questions about Clinical Depression

Clinical Depression is a more severe form of depression, and is characterised by at least two weeks of continuously having a low mood, low self-esteem, feeling hopeless and losing interest in daily activities. 

Most people will struggle with periods of feeling low and being sad, but these will normally be temporary. When such sadness starts lasting for long periods of time, more specifically at least two weeks, that is when it is characterised as clinical depression. 

An example of Clinical Depression can be feeling hopeless, helpless and worthless.

There is no one cause of Clinical Depression, but the factors that can contribute to it are - 

  • Childhood experiences
  • Traumatic life events
  • Physical health problems
  • Genetics

According to the Equality Act of 2010, a mental health condition is classed as a disability if it has a long-term impact on your day-to-day activities. Therefore, yes, clinical depression can be classed as a disability. 

Final Clinical Depression Quiz

Question

What is sadness?

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Answer

Sadness is a common emotion. It is typically situational and transient. Similarly to other emotions, sadness can impact your physiology, behaviour and cognitive processes, including perception, logical thinking and memory. 


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Question

What is the difference between emotions and mood?

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Answer

Mood is typically more stable than emotions and persists over time.

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Question

Is low mood sufficient for a diagnosis of depression?

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Answer

No, to diagnose depression, multiple symptoms are required, which need to persist for a specific period.

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Question

Is sadness adaptive?

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Answer

Yes, it can help us avoid future negative experiences and evoke sympathy in others.

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Question

What is depression?

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Answer

Depression is a mood disorder; a core feature of the illness is a persistent experience of low mood or sadness. 

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Question

What are the similarities between sadness and depression?

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Answer

Both sadness and depression involve changes in our emotions, cognitions, physiology and behaviour. 

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What are the differences between sadness and depression?

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Answer

The key difference is the time for which the symptoms persist, the degree to which it impairs our daily functioning and the number of associated symptoms.

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Question

What is functional impairment?

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Answer

Functional impairment refers to difficulties fulfilling one's social, educational or occupational responsibilities and engaging in everyday activities. 

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Question

What are the three key symptoms of depression identified in ICD-11?

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Answer

Persistent low mood, low energy or fatigue, and loss of interest and pleasure from activities.

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Question

What are the associated symptoms of depression identified in ICD-11?

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Answer

Changes in sleep, changes in appetite, poor concentration, low confidence, suicidal thoughts or acts, changes in motor movements as well as feelings of guilt and self-blame.

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Question

What therapies are recommended for depression treatment by the National Institue for Health and Care Excellence?

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Answer

Cognitive Behavioural Therapy, Behavioural Activation and Interpersonal Psychotherapy.

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Question

What is the difference between unipolar and bipolar depression?

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Answer

Unipolar depression involves episodes of low moods but not high moods (mania). In contrast, bipolar disorder also referred to as bipolar depression, involves both periods of high mood (mania or hypomania) and periods of low mood (depression).

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Question

What is a manic episode?

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Answer

Mania occurs when persistent high mood, and other associated symptoms, start to interfere with one's life. 

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What is the main difference between mania and hypomania?

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Answer

Hypomania does not lead to impaired functioning, but mania does.

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Question

What are the two mood disorders identified by the ICD-11?

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Answer

Depression and bipolar disorder.

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Question

When does Depression become Clinical Depression? 

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Answer

Depression becomes Clinical Depression when the symptoms of feeling low, helpless and worthless last for at least two weeks continuously. 

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Question

Identify the symptoms that are not associated with depression.

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Answer

Guilt

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Question

How do physical health problems contribute towards clinical depression?

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Answer

Let's say you have a chronic illness. If said illness impacts you in a manner that you are dependent on others to get around and do things you could do by yourself had you not had the illness, then this could destroy your self-confidence and hope.

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Question

What are the two most common medications used for the treatment of clinical depression?

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Answer

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norephinephrine Reuptake Inhibitors (SNRIs).

Show question

Question

Choose the form of therapy that is not used to treat clinical depression.

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Answer

Cognitive Behavioural Therapy (CBT)

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