It is normal to experience periods of sadness or loss of enthusiasm from time to time. When these feelings are caused by a particular event or identifiable stressor, they tend to abate with time and enable one to return to a healthy level of functioning. However, when these feelings persist, become debilitating, or produce clinically significant distress that interferes with social, occupational, or other important areas of life, one may be experiencing a depressive episode.
In spite of the fact that these depressive episodes fall outside the range of normal mood, they are actually quite common. In fact, depression is so common that 20% of all adults will experience it at some point in their lifetime. For all of its prevalence, however, depression is an extremely impairing disorder and continues to be one of the top five leading causes of disability worldwide.
So the question remains: How can one tell the difference between normal feelings of sadness and a more extreme experience of depression? That is, how does one know when it has become urgent enough to seek medical help?
To properly classify as a major depressive episode, the feelings of depressed mood or loss of interest in everyday activities must consume the majority of each day, and persist for at least two weeks. Additionally, this must be accompanied by a number of other symptoms, which include: changes in sleep patterns, such as insomnia or hypersomnia, changes in eating patterns, such as decreased appetite or hyperphagia, fatigue, decreased energy, impaired concentration, feelings of worthlessness or guilt, somatic complaints, and even sometimes thoughts of death or suicide. When patients experience all, or some combination of these symptoms, it is highly recommended to seek help from a mental health professional.
In other cases, symptoms may be less acute, but persist over longer periods of time. Even with milder symptoms, when one experiences a chronically depressed mood most of the day, for more days than not, over a period of at least two years, one may be suffering from dysthymia. Although patients may have learned to tolerate the symptoms of dysthymia, a psychiatrist or mental health professional can often help to alleviate the depressed mood and foster a more optimal level of functioning.
There is no one, single treatment for depression. A careful psychiatric evaluation is essential to identify symptoms and ultimately make an accurate diagnosis. Once any underlying physical cause is ruled out, the severity of the depression, as well as the particular combination of symptoms, will dictate the appropriate treatment plan. Typically, when the depression is mild to moderate, we begin treatment with psychotherapy. When it is moderate to severe, treatment may require psychotherapy and medication, or a combination of medications.
There are a wide variety of highly effective antidepressants, and each one targets a specific cluster of symptoms. Here, the pharmacology is very specific, and a good psychiatrist will consider a number of factors before prescribing a particular medication or combination of medications. The best way to find the right treatment plan to ameliorate the symptoms of depression is to see a psychiatrist or mental health professional.