James M. Greenblatt - The Breakthrough Depression Solution: A Personalized 9-Step Method for Beating the Physical Causes of Your Depression

What Is Depression?

Almost everybody experiences depression now and again: those feelings of sadness, a lack of energy, fatigue, and sometimes even hopelessness. Depression, which comes from the Latin word deprimere , meaning pressing down, certainly can feel as if a heavy weight were pressing on your head, shoulders, or heart.

In difficult or frustrating situations such as the death of a loved one, loss of a job, or divorce, these sad or down feelings are perfectly normal reactions. But when the sad feelings are stronger, they settle in for no apparent reason, or they go on longer than a situation seems to warrant, they can indicate the presence of a depressive disorder.

This chapter introduces the various types of depression, their symptoms, and possible causes, as described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) the bible of the mental health professionand in psychiatric literature. Look upon this chapter as Depression 101, an introduction to the disease that will help you discuss depression with your doctor and other mental health professionals. It may also help you understand why some current views of the disorder hamper treatment.

Symptoms of Depression

You know it if you feel down. But how do you know if youre truly suffering from depression? There is no test or objective criteria that can firmly establish the presence of depression, since it isnt a disease like diabetes or rheumatoid arthritis with a common, identifiable mechanism. Depression is different things to different people: It can show
up as any combination of symptoms that range from the emotional
to the behavioral to the physical. In some people these symptoms
are obvious, but in others they are quite vague, making an accurate
diagnosis difficult.

Still, certain symptoms are likely indicators of depression. According to the DSM-IV, a major depressive episode is characterized by the presence of five of the following symptoms during the same two-week period, including at least one of the first two symptoms on the list:

Persistent sadness, anxiety, or feeling of emptiness most of the day, nearly every day

Marked decrease in interest or pleasure in almost all activities nearly every day

Binge eating/weight gain or anorexia/weight loss

Sleeping too much or experiencing insomnia

Fatigue, lethargy

Feeling restless or inordinately slowed down

Feelings of worthlessness or inappropriate guilt

Trouble concentrating and remembering

Feeling suicidal

(Note that these symptoms, with the exception of suicidal feelings, are considered normal for up to two months after the loss of a loved one.)

So does it mean that you arent depressed if you arent experiencing any of the above symptoms? Not necessarily. Many less obvious symptoms may also point to depression, but they arent on the above list. These include physical symptoms such as a persistent stomachache, emotional symptoms like irritability, and behavioral symptoms like throwing yourself into your work. (Then again, these symptoms might be indicative of something entirely apart from depression.)

Here are some of the wide-ranging symptoms that may indicate depression:

Aches and pains, digestive problems, or other physical complaints that are unresponsive to treatment