Depression is common. According to the National Survey on Drug Use and Health, an estimated 16.1 million American adults and 3 million adolescents experienced depression in 2015, affecting 6.7% of adults and 12.5% of adolescents. Unfortunately, depression discourse must also include the topic of suicide.
According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death among Americans aged 10-34 years, fourth among 35-54-year-olds, and tenth overall in the United States. Suicide rates have increased by 24% from 2000 to 2014, and the male suicide rate has remained consistently four times higher than the female suicide rate.
In 2014, the number of suicides was more than double the number of homicides. Depression is common, yet most people do not know the difference between being "down in the dumps" and being clinically depressed. Depression can be treated, but only if it is recognized and acted upon.
Most of us have experienced symptoms of depression at some point, but that doesn't mean it's clinical depression. For example, there are medical conditions that can present with symptoms of depression, such as hypothyroidism.
My own personal experience is with vitamin D deficiency, which can be confirmed with a simple blood test and treated with supplements. Some people get depressed every winter, but the symptoms vanish with spring and increased exposure to sun--and vitamin D.
It's important to know what depression is so that we can understand when we need to see a physician or mental health professional. The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides clear diagnostic criteria for mental health professionals to evaluate symptoms and determine which disorder qualifies, if any, based on information from the patient.
Firstly and most importantly, a depressed mood or loss of interest or pleasure in activities must be present nearly every day for AT LEAST TWO WEEKS and represent a change from previous functioning. It is important to note that the depressed mood can be presented as sadness, hopelessness, emptiness, irritability, or bodily aches and pains. In adolescents, depression may present as irritability rather than sadness, in a manner that is different from how a spoiled child becomes irritated.
- In addition to depressed mood or loss of interest, clinical depression presents with at least four of the listed symptoms which interfere with important areas of functioning such as social and work environments:
- significant weight loss or gain defined as more than 5% of body weight in a month, or decreased or increased appetite nearly every day,
- not sleeping or sleeping too much nearly every day,
- being physically agitated or slowed down, often noticeable by others,
- fatigue or low energy nearly every day,
- feeling worthless or excessively and inappropriately feeling guilty nearly every day,
- difficulty thinking, concentrating, or making decisions nearly every day,
- recurrent thoughts of death or suicide, with or without a plan.
Symptoms present due to drug abuse, medications, or medical conditions do not constitute clinical depression. The loss of a loved one can lead to symptoms of depression, and is not considered clinical depression until the symptoms last longer than two months or previous functioning has been seriously impaired.
We can experience environmental factors that can present as multiple symptoms of depression without qualifying as clinical depression. This is why the interview with a physician or mental health professional is so important. It can help determine if the patient is "down in the dumps," clinically depressed, or experiencing a different disorder or medical condition.
These moods and symptoms might not be recognized in the person experiencing them but might be noticed by others. This is why it is important to understand what depression is so that we can better recognize it in ourselves or those we see regularly. This understanding helps in seeking out appropriate assessment and treatment from a physician or mental health professional.