Let’s Get Clinical and Discuss Major Depressive Disorder

 

Let’s Get Clinical and Discuss Major Depressive Disorder 

By: Hillary House, MSN, PMHNP-BC

 

Did you know there are potentially 227 different ways depression can present? These variations are explained by the various clusters of symptoms that make up a depressive episode. It’s no wonder depression can look different from person to person, and sometimes be mistaken for or overlap with other mental health conditions. Consider this; Do you feel “blah” and tired most of the time with a preference towards sleeping on the weekends vs making plans with friends? Have you been increasingly irritated with reoccurring negative self-talk, difficulty sitting still, and problematic appetite? Or maybe you’ve experienced an emptiness in recent months and are losing enjoyment for the activities in which you’ve always engaged along with difficulty sleeping and making decisions? These varying presentations are all too common and might be a sign of depression.  

So, let’s break down depression, more specifically, what qualifies as a true depressive episode.  

Based on the diagnostic and statistical manual of mental health disorders, a diagnosis of major depressive disorder is made (or strongly considered) when an individual experiences five out of the following nine symptoms that are present most of the day on nearly every day during a 2-week period of time and cause significant impairment in functioning:  

1. Depressed Mood (which may manifest as sadness, emptiness, feeling “blah”, crying, or hopelessness as well as irritability which tends to happen often in children and adolescence)  
2. Markedly diminished interest or pleasure in all, or almost all, activities that were previously considered enjoyable 
3. Significant weight loss or weight gain (change of more than 5% of body weight) or increase or decrease in appetite 
4. Insomnia or hypersomnia nearly everyday  
5. Psychomotor retardation (talking slowly, moving slowly, delayed response, trouble writing or typing, difficulty with basic daily tasks like brushing teeth, showering, preparing meals) or psychomotor agitation (trouble sitting still, restlessness, hand wringing, tapping feet or hands, pacing, talking fast)  
6. Fatigue or loss of energy nearly every day (small tasks seem to require substantial effort)  
7. Feelings of worthlessness or excessive/inappropriate guilt (rumination over minor past failings – negative evaluation of one’s worth)  
8. Diminished ability to think or concentration or indecisiveness (trouble making even minor decisions, memory difficulties, trouble in work or school)   
9. Recurrent thoughts of death with or without a plan, or suicide attempt (passive suicidal thinking may also be present- thinking others would be better off if I were dead)  

Depression is complex. Layer in life circumstances, the winter months, and the sometimes-added stress of the holidays further complicate already complicated symptoms. If you or someone you know is struggling with some or the majority of the above symptoms, CRG can help. Schedule an appointment with one of our providers to sort through these symptoms and explore treatment options.