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Depression is a complex disorder and its symptoms express themselves on many levels. Depression creates physical problems, behavioral problems, distorted thinking, changes in emotional well being, troubled relationships and spiritual emptiness. The information that follows is not meant to evaluate or diagnose depression, but is only meant to serve as a general guideline.
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The symptoms of major depression can be divided into three categories:
- disturbances of emotion and mood
- changes in the “housekeeping” functions of the brain—those that regulate sleep, appetite, energy and sexual function
- disturbances of thinking and concentration
The most common symptoms of clinical depression include:
- chronically sad or empty mood
- loss of interest in ordinary pleasurable activities, including sex
- decreased energy, fatigue, feeling slowed down, slowed movement, slurred speech
- sleep disturbances (insomnia, early morning waking, or oversleeping)
- eating disturbances (loss of appetite, significant weight loss or weight gain)
- difficulty concentrating, impaired memory, difficulty in making decisions
- agitated actions (pacing, hand-wringing, etc.)
- feelings of guilt, worthlessness or helplessness
- feelings of hopelessness and despair
- thoughts and/or talk of death and suicide
- irritability or excessive crying
- social withdrawal or isolation
- chronic aches and pains that don’t respond to treatment
- suicide attempts
- increase in addictive behavior
In the workplace, depression can be recognized by the following symptoms:
- morale problems/lack of cooperation
- difficulty concentrating
- safety problems, accidents, listlessness
- absenteeism
- frequent complaints of being tired all the time
- complaints of unexplained aches and pains
- alcohol or drug abuse
- blaming others
- increased complaints about a spouse or significant others
For those who are at home, these symptoms may appear as:
- a lack of interest in daily self-care routines
- less attention paid to children (dependents)
- not wanting to go out of the house
- not finding any meaning to one’s day
- increased addictive behavior kept a secret
- feeling overwhelmed by ordinary tasks
- feelings of guilt and worthlessness
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In order to best apply this cluster of symptoms to your own situation, think of your symptoms in terms of three words—number, duration and intensity.
1) Number. The symptoms of depression are “additive”—that is, the greater the number of symptoms you have, the more likely you are to be clinically depressed. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), five or more of these symptoms should be present for a person or someone close to that person to consider him or herself “clinically depressed.”
2) Duration. The longer you have been down in the dumps, the more likely it is that you are clinically depressed. According to the DSM IV, the five or more symptoms must exist for at least two weeks for a diagnosis of major depression to be made. (In the case of dysthymia or chronic low-grade depression, symptoms must be present for two years or more.)
3) Intensity. Many of us can feel emotional pain and still cope with our daily existence. Some experiences of depression are within the normal course of living. The pain of major depression can be so great, however, that its intensity (along with the number and duration of symptoms) can significantly impair one’s ability to cope.
Getting proper help for depression begins with proper diagnosis. Of the 17 million people who suffer from depressive illnesses, over two thirds (about 12 million) receive no treatment whatsoever. The minority who do seek help typically consult a number of doctors over many years before the proper diagnosis is made. This is why if you think that you may suffer from depression, you should seek out professional help from a qualified mental health professional.
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