Common Characteristics of Depression
Depression is our most common mental disorder. It afflicts an estimated 50 million Americans,
35 million of whom receive some form of treatment. All of us can be affected, regardless of age
and social or economic status. Although it is generally assumed that the disorder is more
prevalent among women than men, it may well be that men are equally affected, but that women
are more likely to seek help.
Now and then, everyone feels down; differentiating normal sadness from clinical depression is
sometimes difficult. In response to life circumstances--for example, the loss of a loved one or
job, or an illness--all of us become sad, and some of us become depressed--a condition commonly
referred to as reactive depression. Others, particularly people with a family history of depression,
seem to have an inherited tendency for depression and may become depressed in the absence of obvious
external distress or upset.
Diagnosis of Depression
The American Psychiatric Association has defined depression, in part, as "loss of interest or
pleasure in all or almost all usual activities and pastimes." As a clinical condition, depression
is usually identified by the extent to which its symptoms interfere with normal functioning.
In contrast, the feelings of melancholy that are a natural consequence of stressful or sorrowful
life events are more transitory. Grief is dealt with more or less philosophically, the sense of
self remains intact and the daily round of involvements is resumed.
Stressful circumstances that can result in depression may occur at any age from infancy through
old age. Hereditary depression also may occur at any age, and it tends to recur. Very often, it
alternates with periods of extreme euphoria--a condition often referred to as manic-depression.
In diagnosing depression, at least four of the following symptoms must be present most of the time
for a minimum of two weeks (except in children under 6 years of age, in which case at least three
of the first four must be noted): (1) altered eating habits, manifested by marked increase or
decrease in appetite and significant change in weight; (2) insomnia or excessive sleepiness; (3)
hyperactivity or slowed movement; (4) loss of interest or pleasure in usual activities or decrease
in sexual drive; (5) loss of energy or fatigue; (6) feelings of worthlessness, guilt or self-reproach;
(7) reduced ability to concentrate or think, and (8) recurrent thoughts of death or suicide or
attempted suicide.
