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Clinical (Severe) Depression

People who suffer from depression describe it in a number of different ways. Some say it feels like a dark curtain has come down over their life. Some describe the overwhelming feelings of fatigue, lack of focus and inability to function. Others say they feel edgy and cranky all the time. With such diverse descriptions, it is no wonder depression often goes undiagnosed. Depression is not a "state of mind." It is a chemical imbalance in the brain. This imbalance can be hereditary, or it can come from traumatic or stressful experiences, or from a serious physical illness, to name a few sources. If you feel down and find it hard to concentrate; if you don’t have the energy to do the things you normally do, and this goes on for more than two weeks; if the symptoms interfere with your life, you may be clinically depressed.

If you have had one episode of depression, it is likely you will suffer from another at some point in your life. Once you learn the symptoms, you can work with your doctor to keep your depression under control. Though many people never seek treatment, of those who do, 80% report significant improvement.

What are the symptoms?

Clinical, or severe, depression usually manifests itself with a number of symptoms.

From person to person, the number and severity of these symptoms will vary, and can include some or all of the following:

  • Sad or anxious mood that lasts for more than a few days
  • Significant weight loss or gain, decrease or increase in appetite, or overeating that lasts for more than two weeks
  • Inability to focus or concentrate on a task, difficulty remembering things, or making a simple decision
  • Feeling restless, on edge or irritable frequently or every day Fatigue or low energy on a frequent or daily basis
  • Feeling depressed or low most days or every day
  • Thoughts of death or suicide or a plan for or attempt at suicide
  • Physical symptoms that do not respond to therapy or treatment (headaches, stomach problems, chronic pain)
  • Inability to sleep, or excessive sleep habits, early morning waking, or oversleeping on a frequent or daily basis
  • Decreased interest and pleasure in most, if not all activities, including sex, on a frequent or daily basis
  • Feeling negative, hopeless, pessimistic, inappropriately guilty, worthless or helpless
  • A feeling of emptiness

How is it diagnosed and treated?

Many people who suffer from depression don’t ask for help, even though nearly everyone who seeks treatment has some measure of success. Sometimes your family or doctor will not recognize the symptoms as depression. And often people are ashamed to seek help because they feel depression is a weakness or they are so affected by the illness that they can’t reach out and ask for help. Depression is often missed, because the symptoms can masquerade as physical ailments. To treat depression, your doctor must first recognize the symptoms.

You should first have a physical exam to determine if medication, infection or other physical problems may be causing your symptoms. Diagnosing depression will include an interview to discover what symptoms you have, how long you’ve had the symptoms, whether you have a family history of depression, and whether you use alcohol or drugs. An exam to review thought patterns, behavior and memory problems is also common. Treatment choices depend on the results of these examinations. Treatment options include:

  • Antidepressant medications like serotonin reuptake inhibitors (SSRI), and monoamine oxidase inhibitors (MAOI).
  • Psychotherapy
  • Anti-anxiety medication in combination with antidepressants
  • Electroconvulsive Therapy (ECT) in the most severe cases modern methods of ECT have been used with good results
  • Cognitive therapy to recognize problems as small or large and to problem solve areas that create stress
  • Amphetamines for medically ill, severely depressed patients

Index of Articles


16% of Americans will be diagnosed with depression, during their lifespan, though the effects are different for men than women and for the elderly versus children. Here’s how that 16% breaks down.

Compared to men, women are nearly two times more likely to suffer from depression. This may be due to hormonal changes experienced by women (menstruation, pregnancy).

Men have a tendency to go undiagnosed and their depression is often exhibited by anger or rage. And since men are 4 times more likely to commit suicide than women are, this hidden depression is worrisome at best.

Elderly people are often the silent victims of depression, as they adjust to losing spouses, living alone and suffering physical ailments that may curtail their previously active lifestyle. If these signs of depression are attributed to the aging process, parents and older friends may suffer needlessly.

As a group about 5% of Adolescents and Children suffer from depression. This can come from stress, learning or attention disorders or the loss of a parent or sibling. Teenage girls and minority teenagers are especially at risk.

If you are in a crisis please call:
1-800-SUICIDE (784-2433) or
1-800-273-TALK (8255)

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