How to Know the Difference between Normal Depression and Major Depression

Health may be defined as being of sound body and sound mind. Depression is one of such conditions in which you apparently have nothing wrong with your body yet you feel miserable. Depression can make you appreciate how important it is to be healthy.

Each one of us feels depressed once in a while especially when there is a reason to be sad, yet we may not be experiencing true depression. In other words, one can be depressed without actually suffering from depression. Then the question is, what is the difference between being depressed and suffering from depression? This article may help you answer this question. My main focus will be on the clinical features and diagnosis of depression.

Please know that depression is not a state of mind, it is a disease. Clinicians, therefore, must use a tight scale to diagnose it. I am an internist, and I would like to share an incidence with you that I came across recently. While rounding on my patients I was asked by my nurse if she could start one of our patients on 'some antidepressants' because she felt that he was suffering from depression. During my interview with the patient I learned that he had lost his wife not more than a month ago. I, however, did not start him on any antidepressant medication because according to my assessment he was only experiencing 'normal grief' which usually subsides within two months of a painful life event. The patient was discharged home in a few days and returned to my clinic for a follow-up after almost two months. He was feeling better, had normal sleep and normal appetite. The point to be noted here is if I had started him on 'some antidepressant' in the first place he probably would have carried the label of 'depression' for the rest of his life.

Difficulty: Moderately Challenging

Instructions

Things You'll Need:

• knowledge

1. Know the DEFINITION of Major Depression:
   
   Depression is a syndrome, a constellation of signs and symptoms. It may be the consequence of one of several disorders known to cause it, such as idiopathic or 'primary' depressive disorder, 'secondary' depression due to a general medical condition or substance intoxication, bipolar disorder, etc. To qualify for major depression' you MUST at least have five of the following nine symptoms. They should be present most of the day nearly every day for a minimum of two consecutive weeks:
   
   1. Depressed mood
   2. Loss of interests or pleasure
   3. Change in sleep pattern (both increase and decrease)
   4. Change in appetite or weight (both increase and decrease)
   5. Change in psychomotor activity (physical gestures)
   6. Loss of energy
   7. Trouble concentrating
   8. Thoughts of worthlessness or guilt
   9. Thoughts about death or suicide

2. KNOW THE CAUSE OF THE MAJOR DEPRESSION:
   
   Medical research suggests that depression occurs as a result of an imbalance between various neurochemicals in the brain, especially norepinephrine, serotonin, and dopamine. The function of these neurochemicals is to enable the brain cells to communicate with each other and maintain a happy state of mind. Therefore, depression is an actual biological disorder. This statement is supported by multiple genetic studies and the fact that depression responds not only to drug therapy but also electrical as well as surgical therapies such as Electro Convulsive Therapy, Repetitive transcranial magnetic stimulation, cingulotomy- surgically destroying a small portion of the brain called Cingulate gyrus; all these techniques alter levels of these brain neurochemicals.

3. KNOW THE MAJOR AND THE MINOR RISK FACTORS FOR MAJOR DEPRESSION:
   
   Can you predict if a person is likely going to have an episode of major depression in his lifetime? The answer is yes. - Although anyone can develop depression, certain factors increase a person's chance for developing depression:
   
   Major risk factors:
   
   1. Female sex
   2. History of prior episode of major depression
   3. History of depression in a first degree relative
   
   Minor risk factors:
   
   1. History of depression in other family members not qualifying as first degree relative
   2. Being unmarried or without significant other; basically, lack of social supports
   3. Significant stressful episode in life
   4. Ongoing alcohol or substance abuse