Being sad or down can be a normal response to certain events. When this feeling lasts for days on end, however, and is accompanied by feelings of hopelessness, helplessness, and sometimes suicidal thoughts, we are no longer talking about a mood state, but a medical condition with potentially life threatening consequences known as Depression.

The diagnosis of Depression requires a careful and thorough history and evaluation. There are certain signs and symptoms that must be present for a specific amount of time according to the DSM V Diagnostic Statistical Manual of Mental Disorders in order to satisfy the criteria to make a diagnosis of Depression.
These may include what we collectively refer to as “neuro-vegetative” signs and symptoms such as:

  • changes in an individual’s energy level
  • sleep
  • weight and appetite
  • concentration
  • loss of interest, enjoyment and pleasure
  • changes in sexual appetite (libido)
  • As well as other important markers that are reviewed and asked about in the consultation.

Additionally, prior history, alcohol and drug usage, genetic / family history is all extremely relevant and useful in evaluating the symptoms and the person. Relevant too, is the individual’s social situation…current state of relationships, career, recent stressors and possible triggers for the onset of the depression.
A psychiatrist, like a good detective, always asks, “Why now?”

Interestingly, there are subtypes of depression. There are chronic low-grade long-term character based depressions called Dysthymic Disorders. There are individuals who have bipolar depression, in other words they suffer from mood Swings and their depressions may alternate with periods of euphoria.
Other individuals may have depression triggered by substances or underlying disease states, some by medications while others chemically induced and related to addictions.
Severely distorted forms of thinking, known clinically as Major Depressive Disorder with Psychotic features, can accompany depression. These types of depression along with depressions with suicidal thinking constitute psychiatric emergencies and require immediate medical attention.

Depression is a treatable disorder and there are a variety of different treatments available ranging from the psychotherapies to psychopharmacology and more.
Accurate and correct diagnosis of the depression along with identifying the subtype is essential to making proper treatment decisions and essential to restoring good mental health.