Depression is a sneaky disorder, one which can fly under the radar, completely undetected until it’s too late. Have you found yourself feeling very downcast of late for no reason? Nothing seems to appeal to you or interest you anymore, and you can’t seem to pinpoint why? Perhaps you may even be agitated without cause, and everyone stays away from you because they don’t want to get on your wrong side? Have these feelings have persisted for around two weeks and you see no end in sight?
If you’re being brutally honest with yourself and you don’t see an end in sight, and it seems everything is getting worse as the days go by. These are tell-tale signs of depression.
According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), depression is classified within a cluster of depressive disorders like disruptive mood dysregulation disorder, major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, and substance induced depressive disorder, among others. The major difference amongst these different kinds of depression lies in the underlying cause (trigger), and the severity and duration of the altered moods.
In the next section, we shall briefly look at the characteristics of the different kinds of depression.
Major depressive disorder (MDD):
This is an episode which persists for at least two weeks and is characterized by drastic changes in cognition. The symptoms of depression are present for most of the days within that two-week period and are present for many hours during the day. This sadness and melancholy are not to be confused with the one experienced in response to triggers such as mourning. You may naturally be sad because of a loss or unpleasant occurrence, but not necessarily depressed. For you to be diagnosed with major depressive disorder (MDD), which occurs in 8.4% of all adults (and is higher in females at 10.5% compared to males at 6.2%), you should have at least five of the following symptoms for a period of two weeks, and these symptoms should be interfering with your usual/normal functioning.
- Feelings of sadness, emptiness, or hopelessness most of the day, nearly every day.
- Reduced interest and pleasure in most activities, even those which previously interested you.
- Significant weight loss without being on a diet.
- Difficulty sleeping or excessive sleeping nearly every day.
- Psychomotor agitation/retardation (like pacing around nervously), restlessness, significant slowing down, etc.
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or inappropriate guilt almost every day.
- Diminished ability to concentrate or make decisions.
- Suicidal ideations and recurring intrusive thoughts about death.
A combination of the above symptoms which seem to have no apparent trigger (like death of a loved one, financial loss, or heartbreak), and persist consistently for two weeks or longer, is an indication you may be depressed. These symptoms can be identified by a subjective self-report or observation by an outsider.
Persistent depressive disorder (PDD) (Dysthymia).
This is a condition also known as clinical depression, whereby one exhibits depressive symptoms for a period of about two years in adults, and one year in children and adolescents. These symptoms can occur for most of the day, and are present for more days than not present in the period of two years. While PDD may last for a significantly longer period, the severity of the symptoms is not as extreme as those which can be exhibited in MDD. However, PDD can severely impair your relationships, career, social life, and cognitive functioning due to its persistent nature.
Most of the symptoms of PDD are similar to those of MDD. One should show one or two of the following symptoms to be classified as having PDD for the duration of two years or more.
- Poor appetite or overeating
- Trouble falling or staying asleep or oversleeping
- Fatigue or low energy
- Low self esteem
- Trouble concentrating on things and making decisions
- Feelings of hopelessness
- Overall loss of interest or Little interest or pleasure in doing things such as reading the newspaper or watching television
Premenstrual dysphoric disorder
According to DSM 5, these symptoms are present in women in the weeks leading up to the onset of menses, begin to improve within a few days after the onset of menses, and are minimal or absent in the week after the menses. One or more of the following symptoms should be present to be classified as premenstrual dysphoric disorder.
- Mood swings and drastic shifts in emotions
- Marked irritability/anger and increased interpersonal conflicts
- Feelings of hopelessness and self-deprecating thoughts
- Marked anxiety and tension
Also present can be any one or more of the symptoms of MDD.
Substance induced depressive disorder:
This is characterized by a marked shift in your emotions which is triggered by the ingestion of certain medications (anti-depressants, birth control pills, painkillers) or drugs (marijuana, cocaine, heroin, alcohol). Upon ingestion, you experience changes in your mood which are not a direct effect for which the medication/substance was taken. Also, this form of depression can be triggered by withdrawal of certain drugs or substances from which your body has grown dependent on for normal functioning, like opioid withdrawal, alcohol withdrawal, etc. Your body has grown accustomed to the substance inducing certain moods and when withdrawn, your body must return to producing the necessary hormones in order to regulate itself.
Another common form of depression which hasn’t been mentioned above, but is characterized by similar symptoms, is post-partum depression. This is triggered after a period of pregnancy and childbirth. The symptoms are similar to those of the other depressive episodes.
I think I have depression, what should I do now?
In case you or someone you know has been exhibiting these symptoms for the stated duration, it is advisable to seek professional help from a therapist near you. By no means is this a diagnostic tool, and it cannot be a substitute for an actual assessment by a mental health professional. This is meant for informational purposes to indicate whether there is an issue to be handled, and to give some insight into the nature of your symptoms.
Therapy works to fix depression
Depending on the severity of the symptoms and the duration they have been present, you may be given talk-based therapy like cognitive behavioural therapy (CBT) by a mental health professional. This is a goal-based therapy aimed at exploring the connection between thoughts and behaviors, and deals with things like cognitive restructuring, journaling, and mindfulness meditations to reduce prevalence of negative and intrusive thoughts.
Medication to fight depression
In cases where symptoms persist even after having therapy, you may have to see a psychiatrist. A psychiatrist is qualified to write prescriptions and give medications such as anti-depressants for depression, which is hard to control in any other way.
Diet helps against depression
Alternative methods for treatment of depressive symptoms are also available in cases where the depression hasn’t lasted long. Such methods include a change in diet. Processed foods, energy drinks, alcohol, and canned drinks like soda are all hazardous to the body when fighting depression. This is because they contain a mix of sugars which can alter your moods drastically. Fresh fruits, vegetables, and foods heavy in proteins are helpful to the body because they provide the nutrients it needs to regulate moods.
Exercise to help against depression
Exercise is also helpful to the body in combatting depression, as it helps in enhancing the production of endorphins which improve your sense of wellbeing.
Prayer to fight depression
For christians, prayer is a very helpful way of seeking help from God, who lifts the spirit of heaviness and replaces it with garments of praise (Isaiah 61:3). In prayer, we admit our weakness and dependence on God for our sustenance, and gain strength when we are weak. Meditating on God’s word also helps us to take captive any thoughts which are negative and perpetuate the depressive loop of thought and behavior. It gives us a different outlook on life and perspective for our suffering.
Although depression and other mental ailments are prevalent in this day and age, so too are remedies and resources with information on how we can overcome mental health struggles. There are people willing to provide help via hotlines such as the Lighthouse Network, and there are online therapists like Better Help, ReGain and Faithful Counseling, amongst others. Also, awareness about depression is growing. Gone are the days when you had to suffer in silence. Now, you can reach out and there will always be a hand reaching back to hold you in your time of need.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Fact Sheets on Sustainable Development Goals (SDGs), n.d.;