Depression
What is meant by the term "depression?"
The medical condition referred to as clinical depression is not to be confused with the transitory everyday experience of a mild mood swing that everyone experiences during difficulties. Just as we feel happy or fearful or jealous or angry, we are all "depressed" from time to time.
On the other hand, clinical depressive illness is a very disabling, unpleasant and prolonged state.
Clinical depression may bring on a variety of physical and psychological symptoms. Psychological symptoms may include:
- sadness and gloom
- spells of crying (often without a cause)
- insomnia or restless sleep, or sleeping too much
- loss of appetite, or eating too much
- uneasiness or anxiety
- irritability
- feelings of guilt or regret
- lowered self-esteem
- inability to concentrate
- diminished memory and recall
- indecisiveness
- lack of interest in things formerly enjoyed
- fatigue
Physical symptoms may include:
- headache
- heart palpitations
- diminished sexual interest and/or performance
- body aches and pains
- indigestion
- constipation
- diarrhea
Not all people who suffer from clinical depression have all of the above symptoms.
Patients are considered to be clinically depressed when they have:
- a depressed mood
- disturbances in sleep and appetite, and
- at least one or two of the symptoms mentioned above which last for several weeks and are severe enough to disrupt daily life.
The challenges of diagnosing depression
Even in those individuals without chronic medical conditions, most cases of depressive illness go unrecognized and untreated until the later stages of the illness. This is when the severity of the depression becomes unbearable to the patient, and/or until the family or physician can no longer ignore it.
In fact, several studies indicate that 30-50 percent of cases of major depressive illness go undiagnosed in medical settings. Perhaps more disturbing is that many studies indicate that even when recognized, major depressive disorders in the medically ill are undertreated and/or inadequately treated.