Depression Diagnosis: Everything you need to know
Everyone experiences sadness in their life, whether it be short or long term. Upsetting and distressing life events or experiences can take a toll on anyone and it’s something we all must cope with. But what about when the sadness you feel isn’t short term? What if this sadness hovers over you each and every day? There is a large difference between feeling sad and a depression diagnosis. So, what does it take to receive a depression diagnosis, and what can be done when that diagnosis is received? What does a depression diagnosis mean for your life and what makes it different from just feeling sad? We’ll delve into the depths of the darkness of depression and discuss the different forms depression takes and what can be done to overcome this disease that devastates so many.
Depression Diagnosis: What is depression?
Depression is a relatively common mood disorder which affects thinking, sleeping, diet, and productivity. It can be contributed to genetic or biological factors as well as traumatic life events, like a loss. A depression diagnosis often feels like a sense of hopelessness, lose interest in things they once cared about, and experience loss of energy and motivation, or even suicidal thoughts. Insomnia is also a common symptom of depression that can make this disorder even more debilitating. One of the most overarching symptoms of depression is constant sadness, and it can feel as if there is no way to cope with this dark feeling, but it is so important to remember that with the right treatment, depression can be managed and become less debilitating to your everyday life. It often feels like an uphill battle the height of Mount Everest, but receiving a depression diagnosis does not have to define your life. The sadness and worry you feel does not have to consume you.
Depression Diagnosis: Types of depression
There are multiple forms of depression, the most common being the umbrella that other forms fall under, Major Depressive Disorder (MDD). This is the most prevalent mental disorder in the United States and the leading cause of disability in the U.S. for people aged 15 to 44 according to the Anxiety and Depression Association of America. Depression is not just limited to this one diagnosis, however. Depression can be present in other forms as well. These forms include:
Depression Diagnosis: Persistent Depressive Disorder
Also known as dysthymia, this disorder is long-term but often less severe than MDD. Those with a depression diagnosis diagnosed of this type often find it difficult to be happy even during cheerful or fun occasions and events. This lack of happiness comes alongside a feeling of general hopelessness that interferes with day to day activities and relationships. PDD sufferers also experience sadness most of the day on most days. According to the Mayo Clinic, it is also possible for major depressive episodes to occur alongside this disorder, often referred to as double depression. Many of the symptoms of persistent depressive disorder are the same as those of MDD, like fatigue, hopelessness, decreased productivity, low self-esteem, and sadness.
Depression Diagnosis: Postpartum Depression
A majority of women have reported suffering from sadness after their baby is born, but between 15-20 percent of women have experienced more than just sadness. There are several types of postpartum disorders that women may experience after childbirth including:
- Pregnancy or Postpartum OCD
- Postpartum Post-Traumatic Stress Disorder
- Postpartum Psychosis
Postpartum depression, also a major depressive disorder, is often characterized by feelings of hopelessness, anxiety, tiredness, suicidal thoughts – not dissimilar from a diagnosis of other forms of depression – along with fear of hurting the baby, lack of connection or attachment to the baby, and lack in confidence of being able to care for the baby.
Depression Diagnosis: Psychotic Depression
Psychosis is typically characterized by disorganized thinking, delusions, and hallucinations. This is a rare disorder, but there are people diagnosed with major depressive disorder who experience a break from reality. Those with depression with psychotic features often neglect appearance, sleep excessively, may be difficult to communicate with, and fear that their thoughts are not their own or that people are out to get them. Unlike other psychotic disorders, like schizophrenia, the delusions or hallucinations experienced during depressive psychosis are often related to depression. This includes feelings of worthlessness, failure or guilt. It is not always clear what causes psychotic depression, but there are thoughts that it may be related to high cortisol levels. There may also be a genetic component as well.
Depression Diagnosis: Seasonal Affective Disorder
This depression diagnosis is given when the symptoms of depression are affected by the seasons, typically worse in the fall and winter seasons. Summer seasonal affective disorder is another form of SAD, but it is far less common. People diagnosed with seasonal affective disorder experience the symptoms of major depression but they are more affected during the fall and winter seasons. There is also a possibility that those suffering with SAD and depression may be deficient in vitamin D. According to the National Institute of Mental Health, those who suffer from SAD withdraw themselves from social activities, will often crave carbohydrates, and they experience hypersomnia.
Depression Diagnosis: Bipolar Disorder
Bipolar disorder is characterized by emotional highs and lows ranging from mania or hypomania to depression. When a person experiences the manic symptoms of bipolar disorder, they are often impulsive, angry or irritable, and begin to make poor or risky decisions. Those diagnosed will often feel over-confident and extremely talkative; they often lack sleep, and often judgment becomes impaired. The manic episodes of bipolar disorder may also even lead to psychosis. On the other end of the spectrum, depressive episodes include many of the symptoms of major depression including hopelessness, fatigue or lack of sleep, and even thoughts of suicide. However, thoughts of suicide may also occur during manic episodes as well. These mood swings can occur rarely throughout the course of a year, or more frequently.
How common is a depression diagnosis?
Depression affects millions of Americans and major depressive disorder is one of the most prevalent mental health disorders in the country. Over 16 million US adults have suffered from at least one major depressive episode in their lives, most of whom are women and people between the ages of 18-25. Prevalence of other forms of depression are as follows:
- Persistent Depressive Disorder: 1.5 percent of the US population or 3.3 million adults suffer from this form of depression.
- Postpartum Depression: According to the CDC, approximately 1 in 9 women experience symptoms of postpartum depression, while some studies claim it is as high as 15 percent of mothers. Symptoms can vary based on age, location, ethnicity, life events, and even if the pregnancy was unplanned versus planned.
- Psychotic Depression: It is estimated that about 20 percent of people who suffer from depression experience symptoms of psychosis.
- Seasonal Affective Disorder: SAD is 4 times more common in women than men and more common in younger adults. It is also found to increase with latitude. It’s been noted in multiple studies that about 1 percent of the Florida population suffers from SAD; meanwhile, that percentage jumps up to 9 percent in Alaska and 2 to 6 percent in Canada.
- Bipolar Disorder: Studies have found that just over 4 percent of US adults have experienced this disorder, while the prevalence in adolescents is just over 3 percent in adolescent females and over 2 percent in adolescent males.
What must be present for a depression diagnosis?
To be diagnosed with depression, symptoms must be present for a period of at least 2 weeks. Depression may be diagnosed if you are suffering from persistent sadness or loss of interest along with at least 5 factors that cause a change in functionality including:
- Feelings of hopelessness
- Loss of enjoyment of the things you once cared about
- Fatigue and lack of energy
- Weight loss or weight gain
- Difficulty concentrating
- Frequent thoughts of death or suicide
- Negative self-image
- Feelings of guilt and self-blame
- Unexplained physical aches
- Slowed down thoughts and movements
Requirements for a depression diagnosis
Depression Diagnosis for Persistent Depressive Disorder
To diagnose PDD, symptoms of sadness must be present for a period of at least 2 years for most of the day on most days. At least 2 of the present symptoms should include changes in appetite, problems sleeping or oversleeping, decreased energy levels, feelings of hopelessness, or difficulty concentrating. Periods, where these symptoms are not present, should last no more than 2 months.
Depression Diagnosis for Postpartum Depression
This form of depression does not have its own specific criteria. It is actually classified as depression with peripartum onset in the DSM-5. To receive a postpartum depression diagnosis, patients must show at least five symptoms of major depressive disorder which can be onset during pregnancy or shortly after childbirth. This form of depression can be diagnosed even months after the baby is born. Alternatively, about half of postpartum depressive episodes begin before the baby is even delivered, which is why they are referred to as peripartum episodes.
Depression Diagnosis for Psychotic Depression
Psychotic depression is not a technical diagnostic term; it is actually referred to as major depressive disorder with psychotic features in the psychiatry world. A psychotic depression diagnosis may often be difficult because patients may be ashamed and often try to hide their symptoms. To be diagnosed with this disorder, patients must first meet the criteria for MDD. Experienced mood-congruent or mood-incongruent hallucinations or delusions must also be present. Mood-congruent hallucinations or delusions show depression-related content, while mood-incongruent hallucinations or delusions are unrelated to any themes of depression.
Depression Diagnosis for Seasonal Affective Disorder
A diagnosis of SAD must include the presence of a diagnosis of major depression with the addition of these symptoms being exacerbated during the winter and fall. The presence of these symptoms must last at least two years to meet the criteria for diagnosis. SAD may be present in the spring and summer months, but this is much less common.
Depression Diagnosis for Bipolar Disorder
To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Bipolar disorder can often be hard to diagnose because it may appear as several different issues. Symptoms are noticeable but may be believed to have been caused by something else, so doctors might also perform physical exams to rule out alternative physical causes. Psychiatrists or psychologists may also conduct an evaluation to examine symptoms you may show along with disruptions they may cause in your life. It’s also important for them to hear from the people close to you as well. There are several forms of bipolar disorder which include:
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
- Bipolar Disorder “Other” or “Unspecified”
To determine which form of bipolar disorder a patient has, professionals will typically examine the patients’ most severe episodes and how they function, as well as the patterns of their episodes.
Comorbid factors along with depression diagnosis
Often times people suffer from more than one mental health disorder at a time. Studies have found that people who suffer from depression are also more likely to have a history with anxiety disorders (37.3 percent), substance use (57.9 percent), and personality disorders (31.9 percent). A few disorders that may be present in those diagnosed with depression include:
- General anxiety disorder
- Personality disorders
- Alcohol dependence
- Drug dependence
- Post-traumatic stress disorder
- Obsessive-compulsive disorder
It’s been reported that those who suffer from depression along with disorders like the ones mentioned above experience them on a higher level than those without comorbid disorders. Depression can also come along with physical disorders as well, such as cancer or strokes. It is thought that patients with physical disorders or chronic conditions are at a higher risk for depression. Patients diagnosed with a terminal illness are also at a higher risk for depression. Unfortunately, many of these patients may go undiagnosed because it can be difficult to determine if symptoms stem from their physical disorder or depression. Illnesses involving chronic pain can also lead to depression because of the inability to escape the physical pain and the exhaustion from fighting it every single day. Insomnia is both a symptom and a possible contributor to depression as well. Chronic insomnia exhausts the mind and the body which can lead to emotional distress, anxiety, and feelings of depression.
What can you do after receiving a depression diagnosis?
Receiving a diagnosis of depression can feel as if the floor has fallen out from underneath you. You may not agree with your diagnosis, or you may need time to adjust. An important thing to keep in mind when you’ve been diagnosed with depression is that you are not alone. Millions of Americans are living with this disorder and there is an abundance of resources to help treat it. From therapists to professional organizations, to the proper medication if required, help is out there for those who need it. It’s also important to note that the same treatment does not necessarily work for everyone. Each person has a different reaction to a depression diagnosis, to begin with, so it only makes sense that even from the beginning, cases should be treated on an individual basis. Emotions one feels upon diagnosis can range from relief for learning that what you have been feeling is treatable, to denial, to anger or guilt, or even to feelings of loss of control. Many of these feelings stem from the depression itself.
Seeking help is one of the best things you can do if you are struggling with depression. According to the NIMH and the ADAA, almost 40 percent of adults who have suffered from a major depressive episode is not receiving treatment. Even having someone to talk to who understands what you’re going through can help you cope and begin your treatment. You are not your diagnosis. It does not have to take over who you are and how you live your life. Help is out there, and you can get better.
Resources if you may be suffering from depression:
- National Alliance on Mental Illness (NAMI)
- Anxiety and Depression Association of America (ADAA)
- American Foundation for Suicide Prevention: 1-800-273-TALK (1-800-273-8255)
- Depression and Bipolar Support Alliance
- Mental Health America
- National Institute of Mental Health
Marisa is a recent Binghamton University graduate with a degree in both English and psychology. She is particularly interested in discussing matters of the brain, human behavior, and literature. Marisa enjoys creating informative content to share with others who may be interested in learning more about psychology.