Is It Clinical Depression or Sadness?
Although depression is often thought of a
being an extreme state of sadness, there is a vast difference
between clinical depression and sadness. Sadness is a part of
being human, a natural reaction to painful circumstances. All of
us will experience sadness at some point in our lives.
Depression, however, is a physical illness with many more
symptoms than an unhappy mood. The person with clinical
depression finds that there is not always a logical reason for
his dark feelings. Exhortations from well-meaning friends and
family for him to "snap out of it" provide only frustration for
he can no more "snap out of it" than the diabetic can will his
pancreas to produce more insulin. Sadness is a transient feeling
that passes as a person comes to term with his troubles.
Depression can linger for weeks, months or even
years. The sad person feels bad, but continues to cope with
living. A person with clinical depression may feel overwhelmed
To clarify the differences between normal
sadness and depression, the DSM-IV* defines specific criteria
for the diagnosis of major depression. A person who suffers from
a major depressive disorder must either have a depressed mood or
a loss of interest or pleasure in daily activities consistently
for at least a two week period. This mood must represent a
change from the person's normal mood and impair his functioning
in his daily life. A depressed mood caused by substances such as
drugs, alcohol, or medications is not considered a major
depressive disorder, nor is one which is caused by a general
medical condition. Major depressive disorder cannot be diagnosed
if a person has a history of bipolar disorder (ie. manic,
hypomanic or mixed episodes) or if the depressed mood is better
accounted for by schizoaffective disorder and is not
superimposed on schizophrenia. Further, t he symptoms should not
be better accounted for by bereavement, i.e., after the loss of
a loved one, the symptoms persist for longer than 2 months or
are characterized by marked functional impairment, morbid
preoccupation with worthlessness, suicidal ideation, psychotic
symptoms, or psychomotor retardation.
This disorder is characterized by the presence
of 5 or more of the following symptoms:
•Depressed mood most of the day, nearly every
day, as indicated by either subjective report (e.g. feels sad or
empty) or observation made by others (e.g. appears tearful).
Children and adolescents may exhibit irritability.
•Markedly diminished interest or pleasure in
all, or most, daily activities most of the day, nearly every
•Significant weight changes (e.g. a change of
more than 5% of body weight in a month), or decrease or increase
in appetite nearly every day.
•Insomnia or hypersomnia (sleeping too much)
nearly every day.
•Psychomotor agitation or retardation nearly
•Fatigue or loss of energy nearly every day.
•Feelings of worthlessness or excessive or
inappropriate guilt nearly every day.
•Diminished ability to think or concentrate,
or indecisiveness, nearly every day.
•Recurrent thoughts of death, recurrent
suicidal ideation without a specific plan, or a suicide attempt
or a specific plan for committing suicide.
If you are still uncertain as to whether you
may be suffering from depression, screening tests exist which
can help you determine whether you should seek a professional
evaluation. There is a test provided on this site which is
simple to use and completely confidential.