Am I Depressed?
There have been many occasions when a client has come into my office asking, “Am I depressed?” It is definitely not always obvious if a person is depressed. Psychologists undergo years of training to learn how to tease out various everyday common symptoms into a diagnosable “disorder”. The DSM-5 classifies Major Depressive Disorder as “5 or more symptoms during a 2 week period that are a change from previous functioning that are not attributable to a medical condition”.
The 9 symptoms that are criteria for depression include:
depressed mood, loss of interest/pleasure
weight change (increase or decrease)
sleep change (insomnia or hypersomnia)
psychomotor agitation or retardation (restless or slowed movements)
fatigue
feelings of worthlessness or guilt
decrease concentration
thoughts of death or suicide
A Similar Counterpart
When a person is clinically depressed and exhibits such symptoms continuously for 2 weeks, others tend to notice and the person recognizes that he or she is suffering. What is not as obvious to others and to ourselves is when a person is experiencing what is called Dysthymia. In fact, whenever I have mentioned Dysthymia in therapy sessions, none of my clients have been familiar with this diagnosis. Unfortunately, Dysthymia tends to get missed or overlooked because it is more of a chronic low grade depression versus an acute distressing episode.
What is Dysthymia?
According to the DSM-5, Dysthymia is present when a person has a persistent depressed mood that lasts for most of the day, for more days than not for at least 2 years and is accompanied by only 2 of the above mentioned depressive symptoms. For example, if you or someone you know has had difficulty sleeping and an increase in appetite along with sadness or a person has had difficulty concentrating and feelings of low self esteem, this person may easily go on undiagnosed and untreated for years. Depression doesn’t always show up the way we expect it to. Depression can also manifest in a variety of ways that others do not consider to be classified as “depressive symptoms”. Such symptoms can include chronic pain, irritability, loss of interest in activities that used to be pleasurable, indecisiveness, withdrawal, guilt, restlessness, a feeling of being disconnected from feelings, substance abuse, risk-taking behaviors, and conflicted relationships. Dysthymia is a chronic condition that may last for years in a milder form than a major depressive episode. Therefore, this condition can be assumed to be nothing more than a person’s general demeanor or personality.
Recognizing the Symptoms
Recognizing these varied symptoms is crucial for understanding that depression can take on many presentations. Depression or Dysthymia is not always about the presence of sadness, but more so a general change in functioning that makes it difficult for a person to cope with everyday life. If you or someone you know displays symptoms of Dysthymia or Depression, psychotherapy and medication can help as well as other treatment modalities. It is important to approach depression with compassion and non judgment in order to make it more likely that a person can seek treatment with Depression Therapy and find relief.