Depression

Depression must be differentiated from ordinary grief when there has been a loss, change, trauma, or significant frustration of some goal.  The defining features of depression are sadness, emptiness, or irritability. It can also manifest as a loss of interest in or lack of pleasure from activities in which the individual had previously been avid. In order for depression to warrant treatment, it must be prevalent for a minimum of two weeks and be in sharp contrast to the individual’s ordinary level of functioning.  Even still, medical explanations including drug use must be explored before deciding about a diagnosis of depression.

Signs of Depression include the following:

• A sense of being down with feelings of sadness and emptiness. This is sometimes not noticed by the depressed person and is instead recognized by a parent or person close to the individual as tearfulness, isolation, lethargy, or more often in children, Irritability.

• An obvious loss of 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).

• 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. In children this may manifest as not attaining their expected growth.

• Sleep disturbance including one or more of the following:

  • Difficulty falling asleep due to depressing/anxious thoughts or memories.

  • Middle of the night waking with difficulty falling back to sleep.

  • Early waking with inability to return to sleep.

  • Difficulty waking in the morning

  • Oversleeping

  • Sleeping at inappropriate times

In order to be symptomatic any of the above must happen more days than not.

• Restlessness / inability to be still (e.g. fidgeting, hand wringing, nail biting) or slowed movement (person seems to be dragging themselves around) nearly every day.

• Fatigue or loss of energy nearly every day.

• Feelings of worthlessness or excessive or inappropriate guilt nearly every day (not merely self-reproach or guilt about being sick)

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

• 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

These signs of depression are presented to alert the reader to possible indicators of depression.  Several of these signs must be present in order to meet the clinical criteria for Depression. Depression is a psychiatric disorder that must be diagnosed by a trained mental health professional.

Treatment of Depression

Methods of treating Depression that have demonstrated efficacy in scientific investigations include:

• Interpersonal Therapy (IPT)
• Cognitive Behavioral Therapy (CBT)
• Brief Dynamic Therapy