In recent decades the term depression has become popular in such a way that it is now part of our everyday vocabulary . It is not unusual that when we feel melancholic or sad we use the typical expression of “I am sad.” However, depression is not that but, as the main reference manuals in psychiatry and psychology point out, it is a mood disorder that can be a big problem for many people.
Today, depression is, after anxiety disorders, the most common diagnosis in mental health clinics. It seems incredible that only a couple of centuries ago it was considered a very rare disorder. However, times change and this directly influences what we know as psychopathology.
What is depression?
Depression is a disorder characterized, normally, by a depressed mood or deep sadness that lasts over time and significantly affects a person’s life.
For clinical diagnosis there are two main reference manuals :
– The Diagnostic and Statistical Manual of Mental Disorders ( DSM ) edited by the American Psychiatric Association (APA).
– The International Classification of Mental Illnesses ( ICD ) edited by the World Health Organization (WHO).
To better specify which are the manifestations that define what we currently understand as depression, we will take these two manuals as a reference in their latest versions (DSM-5 and ICD-10).
Symptoms of depression
A typical depressive episode is characterized by the following symptoms (not having to give all, much less in the order presented, but in a considerable intensity that interferes with the person’s day-to-day life and that cannot be explained by other disorders or common medical illnesses):
– Persistent feelings of sadness, anxiety and / or emptiness .
– Feelings of hopelessness and / or pessimism about the future.
– Unjustified feelings of guilt , worthlessness and / or helplessness .
– Persistent irritability or restlessness .
– Loss of interest in activities or hobbies that were previously enjoyed (including sexual intercourse).
– Lack of energy and fatigue despite not having done anything all day.
– Concentration and memory problems (usually secondary to lack of attention to details) and difficulties in making decisions .
– Insomnia (usually the type of early awakenings, another type may appear or in combination) or hypersomnia (sleeping more than normal).
– Loss or increase in appetite / weight .
– Suicidal thoughts or attempts .
– Physical symptoms : headache, gastrointestinal upset or digestive problems … that are not normally alleviated with the treatment to use.
What types of depression are there?
Also taking the manuals as a reference, we find different types of presentation of this sadness disorder.
Major depressive disorder : with different levels of severity. It appears when the symptoms of the depressive episode occur beyond six months and it resolves with the appropriate professional intervention or, sometimes, it remits by itself. It can occur once in a lifetime or be repeated.
The dysthymia or disorder persistent depressive : This is a long – term depression (minimum two years) in which all the symptoms necessary are not met to diagnose a depressive episode or these too long are met to identify the person in the category previous.
Depression with psychotic symptoms : in very severe cases there may be symptoms such as delusions and hallucinations that we know as characteristic of other disorders such as schizophrenia.
Postpartum depression : appears in women who have recently given birth and experience an episode of intense sadness that begins within the first month after delivery . In recent years it has been proven that it is more common than previously thought.
Bipolar disorder : this type of disorder of which, in turn, there are different types, share the presence of the depressive episode with depressive disorders, however, they differ from these in that other episodes called manic or hypomanic also appear .
Who does it affect the most?
Depression is much more common in women than in men. Almost twice as many women are affected compared to the opposite sex. The factors that arise from the different psychiatric and psychological perspectives are varied. From biological or hormonal factors to psychosocial or cultural ones. This greater presence of the disorder in women has led to the inclusion of premenstrual dysphoric disorder in the latest edition of the DSM, which would become a serious form of what is popularly known as premenstrual syndrome.
Can it occur in children and adolescents?
Yes, in fact it is a disorder that can occur in all life stages . From infancy to old age, although its frequency varies remarkably throughout the life cycle. What also seems variable from one stage to another is the presentation of symptoms, because more than as a low mood, children tend to express their sadness through irritability and agitation or restlessness.
Especially in childhood and adolescence, early detection and intervention is important as it is a powerful predictor of other psychopathological disorders in adult life.