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Have I Got Signs of Depression?

If you have been feeling down, or out-of-sorts, your thoughts can easily turn to whether you are depressed or not. This first section will take you through the signs of depression and how depression is diagnosed.

However, whether you 'fit' the depression diagnosis or not is unimportant. If you are feeling so down that you need to do something about it, that is enough.

Usually, our clients report one or more of the following:

• Exhaustion on waking
• Disrupted sleep, sometimes through upsetting dreams
• Early morning waking and difficulty getting back to sleep
• Doing less of what they used to enjoy
• Difficulty concentrating during the day
• Improved energy as the day goes on
• Anxious worrying and intrusive upsetting thoughts
• Becoming emotional or upset for no particular reason
• Shortness of temper, or irritability

Not all people have all of these, and some have different signs, but if you are depressed, at least some of these will probably ring true with you.

Only a qualified doctor or health practitioner can formally diagnose you with clinical depression. However, how they reach this diagnosis gives an incredibly important insight into how to treat depression.

Diagnosing Depression

According to the definitions of most medical, psychological and psychiatric bodies, there is a commonality in the diagnosis of depression. Most depression tests have a very similar framework.
Almost without exception, clinical depression will be diagnosed if a certain number of feelings that are signs of depression are present over a certain period of time.

Below is the 'official' guide for diagnosing clinical depression: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association, 1994

A person can be diagnosed as suffering from clinical depression if:
(A) Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure

(1) 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). Note: In children and adolescents, can be irritable mood

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

(B) The symptoms do not meet criteria for a Mixed Episode.

(C) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

(D) The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

(E) The symptoms are not 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.