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Dispelling Depression by Dr Julie Jordan
“Do you think it could be depression?” Nowadays this is not an uncommon question. And for good reason. Depression is a common condition that affects 15% of people at some stage of their lives. This means depression is more common than asthma or diabetes in our community. But how do you know if you or a loved one has true depression or are just going through a down time? How is it different to the everyday blues we all experience from time to time? 
As a doctor, the way I generally distinguish depression is by looking at the duration of the symptoms, the individual’s circumstances and what symptoms other than a depressed mood the person is experiencing.
Knowing the Circumstances
Looking at an individual’s circumstances can be a useful place to start.
A person who has recently lost a loved one may experience in the short term many of the symptoms of depression. In bereavement, people often describe overwhelming sadness, shock, anger and loneliness, particularly in the early weeks. They are often tearful and find it difficult to sleep. But by knowing their situation, we can see these symptoms are likely to be a normal part of grief and would be experienced by most people going through similar circumstances.
Generally people who are grieving, experience these symptoms for days to weeks rather than for months at a time and for most people they gradually improve over time without treatment.
True Depression
People suffering from true depression however tend to experience their symptoms for months on end. Patients describe waking up every morning feeling “flat”, “depressed”, “worried” or “irritable” and these feelings occur day after day. They may appear to no longer enjoy their interests that once gave them pleasure. They may seem very “negative” – appearing to have a low self esteem or a negative attitude towards their circumstances or the future.
Often people struggling with depression also come across as being very anxious. They may seem excessively worried about small things or be fearful of the future, expecting something “terrible” to happen to them or to someone they love. Generally a major episode of depression would not be diagnosed by a doctor unless the patient had experienced these symptoms consistently for two weeks or longer. So looking at the duration of the depressed mood and the circumstances can be very important in distinguishing a true depression.
Same Illness Different Look
Depression can behave differently in different people. For some people it can occur for no apparent reason. It is not uncommon for a patient to say “I have no excuse to feel depressed. I have a good job, a supportive spouse … I just don’t understand why I feel so down all the time?”
Other people may have an episode of depression with a very clear starting point. It may be the breakdown of a relationship or the loss of a job that marks the start of their struggles. They may be someone who has always coped well with stress but this time feels overwhelmed. Or they may find themselves “sweating the small stuff”, experiencing small irritations in life as major stressors.
Men and women can also experience depression differently. Women are often sad, anxious and tearful when they are struggling with depression. Men, on the other hand often describe feeling more “mad” than sad when they are depressed, struggling with increasing anger, frustration or irritability.
So depression has many different faces and two people can be having a different experience but still be struggling with the same illness.
True Diagnosis
Finally the presence of any other symptoms can also shed light on to a possible diagnosis of depression. To be diagnosed with a true depression, a person must also be experiencing physical symptoms such as fatigue, difficulty sleeping or excessive sleepiness, a loss of appetite or overeating, weight gain or weight loss, difficulty concentrating or deterioration in memory. In fact to fulfill the criteria of a major depression, a person must have experienced a combination of these other symptoms for at least two weeks.
At its worst, depression can make a person feel that life is not worth living. Suicide is a real risk if depression is severe and left untreated. If you or someone you know experience thoughts of this nature, it is a medical emergency and you should consult a doctor immediately.
We all feel “down” from time to time, but if you or a loved one are feeling depressed, it is lasting for more than a week or two and you have experienced any of these other physical symptoms, it is really important to consult your family doctor to be properly assessed for a possible depression.
Depression is a medical condition that responds well to the right treatment. Treatment options will be discussed in the next article but it is important to know that there are many very effective treatments available. With the help of your doctor, you can be back on top of things and feeling like your old self again soon.
This is general medical advice designed for public educational purposes only. It does not in any way constitute individual medical advice and does not replace thorough consultation with a medical practitioner.
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