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Occasional Sadness or Clinical Depression: When Should We Become Concerned?

April 08 2019 - by Denise Dumas-Koylass, Clinical Psychologist, Facilitator & an Alumna of CLP's Leadership Development Programme

There are times in one’s life when situations and events can bring you down.  Unfair situations in the workplace, conflicts with family, issues with one’s partner, loss of a loved one, or just overall dissatisfaction with life can periodically make you feel sad and discouraged. Life is not perfect. We have experienced difficult times and the probability exists that we will experience other challenges.  However, research shows that it is not the situation or the crisis that is the real issue, rather it is how we view and respond to the concern or situation. Two persons may have to deal with an authoritarian boss; one may adopt a dismissive attitude, whilst the other person may be triggered by childhood memories of living with a critical parent and feel completely dejected and just not “good enough”.  

So, what can we do to overcome discouraging situations and remain positive in the midst of all that we are facing?

Well, getting adequate sleep, exercise and a balanced diet have all been found to contribute to stabilizing our mood.  In addition, neuroscientists have found that saying positive affirmations such as “I accept and love myself, thoroughly and completely” on a regular basis helps to rewire our brain.  MRI evidence suggests that certain neural pathways are increased when we speak positively to ourselves about who we are (Cascio et al.; 2016).  Furthermore, regularly saying positive affirmations encourages the development of an optimistic mindset.  When we are optimistic, we learn to replace any negative messages that we receive from the world with more hopeful statements about who we are and about our future.

However, despite our best efforts to remain positive, there may be times when we continue to feel disheartened or discouraged.  The question is: when does this feeling of sadness become excessive?  When should we seek professional help? 

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, also referred to as the DSM-5, helps mental health professionals assess whether an individual is just experiencing a temporary sad mood or whether he or she is actually suffering from the effects of a disorder such as Depression.

Depression, which is also referred to as major depressive disorder or clinical depression, is a serious mood disorder.  When assessing for depression, clinical professionals look for the following symptoms as outlined in the DSM-5

  1. Depressed mood most of the day, nearly every day. 
  1. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. 
  1. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day. 
  1. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). 
  1. Fatigue or loss of energy nearly every day. 
  1. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. 
  1. Diminished ability to think or concentrate, or indecisiveness, nearly every day. 
  1. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. 

To receive a diagnosis of depression, you must be experiencing five (5) or more of the above-mentioned symptoms during the same two (2) week period, and, at least one of the symptoms should either be (1) depressed mood or (2) loss of interest or pleasure.  Furthermore, these symptoms must cause clinically significant distress or impairment in your social, occupational, or other important areas of functioning. The symptoms must also not be a result of abusing substances such as alcohol or another medical condition. 

If you recognize that you have been experiencing these symptoms, it is important to seek professional help.  Clinical depression has the potential to damage mental and physical health.  It can also cause problems at work and in our relationships. 

Let us continue to check ourselves and take the steps necessary to enjoy the mental and physical health that we deserve.

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