Saturday, September 7, 2013

Do I Have Clinical Depression?

We all go through times when we feel sad or really upset about something. Life can be full of exhilarating, joyful moments but also bring us periods of time when we feel utterly distraught. These lower moments can cause us great pain, bring flowing torrents of tears and even cause us to lose our appetites. So how do you know if you are "clinically" depressed or reacting in an expected manner to an external life event? A person can receive a diagnosis for Major Depressive Disorder under very specific conditions that I'll discuss in this article. I'll also review a few coping skills to employ immediately should you suspect you might fall into this category.

I've heard people describe depression as a "black cloud" following them - or a "pit" in their stomach that doesn't go away. The intensity of this feeling is usually associated with Major Depressive Disorder - otherwise known as "clinical depression." People who struggle with this can have a range of symptoms - from mild to severe - but they must meet specific criteria to receive this diagnosis. The following is a condensed and summarized version from the DSM-IV-TR (Diagnostic Criteria from the American Psychiatric Association) of the criteria for Major Depressive Disorder.

You must have five of the nine criteria which are:

1) Depressed mood most of the day, nearly every day.

2) Diminished interest in your usual activities.

3) Significant weight loss or gain; or increase or decrease in appetite.

4) Sleeping too much or too little every day.

5) Appearing to others to be restlessness or slowed down in your movement or speech.

6) Fatigue or loss of energy nearly every day.

7) Feelings of worthlessness or guilt nearly every day.

8) Decrease in concentration nearly every day.

9) Thoughts or plan of your own death.

In addition, you must have these symptoms for a minimum of two weeks.

If you feel as though you fit the criteria for clinical depression, you should seek out the help of a psychotherapist to assess the level of your depression. Some people prefer to try to get control of their depression with talk therapy alone. Others want to try the medication route and talk therapy. There are also people who take medication to combat their symptoms but choose not to proceed with talk therapy. I personally believe - and many studies have shown - that the best treatment for clinical depression is a combination of medication and talk therapy. A psychiatrist can be helpful to educate you about the chemistry around depression and the brain - as well as what medications are available, possible side effects, etc. However, if you're firmly attached to the idea of avoiding medication, a good therapist can work with you around the issues underlying your depression. Cognitive behavioral therapy - changing unhelpful and irrational thinking styles - has also been shown to be very helpful.

So what can you do right this minute to help to start to decrease some of your symptoms? The following are three initial steps you can take right away to feel better - and the great news is, you absolutely can!

1) Walk Around the Block: People who are truly depressed often struggle with the motivation they need to do their normal activities. Even if you have never been someone particularly interested in exercise, get outside and walk around the block. Even if it's only a five minute jaunt to the end of the block and back, the purpose is to get good oxygen into your blood and brain - which automatically impacts your physiology and has a feel-good effect.

2) Set Your Priorities: People who find themselves depressed often feel overwhelmed or out of control. Sit down with pen and paper in hand. Make a list of things that need to happen vs. things that can wait. The more order you feel - the more in control you'll feel.

3) Reach out to Someone: Depressed people sometimes feel so low they begin to isolate themselves. Reach out to someone you trust - friend or family member. Pick up the phone and be honest with how you're feeling. Keeping an active support network, whether it is one person or five, is very important.

According to the National Institute of Mental Health, major depressive disorder affects approximately 14.8 million American adults a year! Try to remember to be kind and gentle to yourself and make sure to get the help you need, whether it's a therapist, counselor, support group, psychiatrist or your general medical practitioner. You absolutely can feel better!

**If you are actively suicidal, please dial 911 to get help right away.

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