Mental Health What Is Clinical Depression? Also known as major depressive disorder By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Sherry Christiansen Published on December 21, 2020 Print Table of Contents View All What Is Clinical Depression? Symptoms Diagnosis Causes Types Treatment Coping Clinical depression, also called major depression or major depressive disorder (MDD), is often confused with having a sad or low mood. Although feeling sad is one symptom of clinical depression, there must be several other signs and symptoms—in addition to sadness—for someone to be formally diagnosed with clinical depression. Clinical depression is considered a chronic and severe disorder with medical comorbidities and high mortality. Understanding the signs and symptoms of clinical depression are important to ensure someone can receive an accurate diagnosis and treatment. martin-dm/Getty Images What Is Clinical Depression? Clinical depression is a serious form of mental illness that impacts more than just a person’s mood. It affects the way a person: ThinksActsFeelsManages their life A diagnosis of clinical depression means that a person has symptoms that interfere with the ability to function at work and home, which adversely impacts the way a person is able to enjoy hobbies and leisure activities, socialization, relationships, and more. Clinical depression involves more than just emotions, it encompasses physical abnormalities—such as inability to sleep and loss of appetite—as well. It’s important to note that clinical depression is a set of signs and symptoms that may add up to a chemical imbalance in the brain. This chemical imbalance is thought to be the underlying cause of clinical depression. Symptoms Some of the most persistent symptoms of clinical depression are a severe and persistent low mood, profound sadness, or a sense of despair. The characteristics, symptoms, or traits of depression may vary in severity from very mild to severe. Symptoms may include: An ongoing feeling of sadness or depressed moodLoss of interest in hobbies and activities that are usually enjoyableLow energy level or a feeling of fatigueInsomnia (trouble sleeping) or sleeping too muchLoss of appetite and subsequent weight lossEating too much, resulting in weight gainSlowed movement or speechIncrease in activity (pacing, nervous gestures such as wringing hands repeatedly)Feelings of guilt or worthlessnessTrouble concentratingDifficulty making decisionsThoughts of suicide (or an active plan to commit suicide)Obsession with death For a formal diagnosis of clinical depression, these symptoms must last at least two weeks and they must represent a change from the former level of functioning experienced before symptoms began and they must cause a person significant impairment or distress in their job, social situations, or other areas of functioning. The symptoms must not be caused by another medical condition, including substance abuse. Other physical conditions that can mimic the symptoms of depression include: Thyroid problemsA brain tumorA vitamin deficiency Diagnosis A diagnosis of clinical depression often begins with a physical examination, lab tests, and other diagnostic measures to rule out any physical conditions such as thyroid problems. After which, the primary health care provider may refer you to a psychiatrist or other mental health professional (such as a licensed clinical social worker or LICSW) for an evaluation. An evaluation by a mental health professional may include: A psychiatric evaluation: This includes a history of current symptoms and an assessment of your thoughts, feelings, and behaviors. You may be asked to answer some questions in written form.A family history: This is used to decipher whether there is any mental illness in your family.A diagnostic evaluation: This evaluates your symptoms as compared to the DSM-5, a diagnostic tool called the Diagnostic and Statistical Manual of Mental Disorders. Causes The exact cause of clinical depression is unknown, anyone can suffer from major depressive disorder. However, there are some known causes linked with clinical depression, these include: Biochemistry: Specific brain chemicals are thought to play a role in symptoms of depression.Genetics: Depression is known to run in the family, according to Stanford Medicine, if you have a parent or sibling with clinical depression, you have a two to three times higher likeliness of developing depression, compared to someone who does not have a family link.Environmental factors: Such as being exposed to violence, or abuse and neglect, particularly during childhood, can increase a person’s likeliness of depression. Poverty is also known to make a person more vulnerable to clinical depression. Risk Factors While no one can predict exactly if a person will become depressed, there are some risk factors that increase the likeliness of being diagnosed with depression, these include: Having had a previous clinical depression episodeHaving a family history of depression, alcoholism, bipolar disorder, or a family member who has committed suicideHaving substance abuse problemsGoing through significant life changes (such as the loss of a loved one)Having high levels of stress Having experienced a traumaHaving certain medical conditions (such as a brain tumor)Taking some types of medications known to cause depressionHaving certain personality characteristics (such as being extremely pessimistic or having low self-esteem) Types There are several different types of depression that a person can have; the primary difference is the features involved. You may or may not have what is called a specifier linked with depression, these specifiers may include: Anxious distress: Depression, along with feelings of restlessness, being worried, keyed up, or tense. Mixed features: Depression, along with increased energy, excessive talking, inflated sense of self-esteem (also referred to as mania or manic).Melancholic features: Severe depression, linked with early rising, loss of interest in things that were historically experienced as pleasant, worsened mood in the morning, and guilty feelings.Atypical features: Depression with features that are not typical, such as a happy mood in response to positive events, an increase in appetite, excessive sleep, a heavy feeling in the arms or legs (called leaden paralysis).Psychotic features: Depression accompanied by psychosis (such as hallucinations) or delusions.Catatonic features: Depression, along with either uncontrollable movements or periods in which they do not move at all, repeating behaviors over and over (such as grimacing or imitating others). Postpartum: Occurs within 4 weeks of giving birth, common symptoms include mood fluctuations and abnormal (excessive) preoccupation with the infant's well-being. May also involve psychotic features such as hallucinations or delusions.Seasonal Pattern: Also known as seasonal affective disorder, involves depression that is linked with a specific season of the year (usually with lower sunlight exposure, such as fall or winter). Symptoms may include trouble getting up and going to work during the winter months. Treatment Clinical depression is one of the most treatable of all mental health disorders. In fact, between 80 to 90% of people with depression respond favorably to treatment. Medication When the chemistry in the brain is contributing to a person’s depression, a type of medication called an antidepressant is usually ordered. Antidepressants are not considered mood-altering drugs (like stimulants or tranquilizers), they simply help to modify the brain chemistry, thus improving symptoms of depression. Antidepressants are not considered habit-forming. One drawback of antidepressants is that they can take up to several weeks to begin having a therapeutic effect (lowering symptoms of depression). If you start taking antidepressants and do not see any improvement in your symptoms after several weeks, your psychiatrist may adjust your dose, or change your prescription and start you on a different antidepressant. Usually, you will be instructed by your health care provider to take your antidepressants for at least six months (or longer) after you see improvement in symptoms; you may be advised to take the medication long-term, to reduce the risk of future episodes of depression. Psychotherapy Psychotherapy—sometimes referred to as “talk therapy"—is a common treatment for mild depression. If you have moderate to severe depression, you may be encouraged to engage in talk therapy, along with antidepressant medications. One of the most effective modes of talk therapy for depression is called cognitive behavioral therapy (CBT), a type of psychological treatment that has been found to be effective for many different issues, such as: DepressionAnxietyAlcohol and drug problems (such as substance use disorder)Eating disordersOther types of mental illness CBT therapy involves various strategies; some or all of these strategies may be employed during individual or group therapy, they include: Learning to recognize distortions in thinking that lead to problems and reevaluate these distortions, gaining a sense of realityLearning to change behavioral patterns (such as facing fears when a person suffers from severe anxiety)Learning problem-solving skills and how to employ them in specific situationsLearning how to gain confidence in one’s strengths and abilitiesAdopting improved insight into the motivation and behavior of othersLearning how to calm the mind and relax the body The time it takes for completion of treatment for depression can vary, depending on several factors including: The severity of clinical depressionThe extent of trauma one has experienced (such as child abuse)Whether a person has co-occurring conditions (such as drug or alcohol use and depression)The type of depression a person hasOther factors ECT Therapy Electroconvulsive therapy (ECT) is a treatment for depression that is usually reserved for those who do not respond well to other types of treatment (such as medication). ECT is much different today than historically when a person was awake during the process. This treatment modality began during the 1940s. Today, however, ECT is done under anesthesia. It involves a very brief electrical stimulation to the brain after the person has been put to sleep. ECT is usually comprised of approximately six to 12 sessions. Coping There are many things you can do to help you cope with clinical depression, some of the most common interventions include lifestyle changes such as: Ensuring that you get enough sleep each nightEating a healthy dietGetting involved in a daily physical workout routine (with the okay from your health care provider). Studies have shown that for some people with clinical depression, exercise is equally effective as medication.Avoiding the use of alcohol (which is a depressant) and other drugsAdopting measures to manage stress (such as deep breathing and relaxation techniques, yoga, or mindfulness practice. A Word From VeryWell Keep in mind that clinical depression is a serious illness and treatment is available. With an accurate diagnosis and proper treatment, most people can learn to live with clinical depression, and many get relief from their symptoms. If you have symptoms of clinical depression, be sure to talk to your primary doctor; don’t be afraid to ask for a referral to a mental health professional to get a thorough evaluation/diagnostic assessment. This is the first step to being proactive about your mental health. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gold PW, Machado-Vieira R, Pavlatou MG. Clinical and biochemical manifestations of depression: relation to the neurobiology of stress. Neural Plasticity. 2015;2015:1-11.doi:10.1155/2015/581976 American Psychiatric Association. What is depression? Updated October 2020. Harvard Medical School. Major depression: What is it? Updated December 2018. Truschel, J. Psycom. Depression definition and DSM-5 diagnostic criteria. Updated September 25, 2020. Gold PW, Machado-Vieira R, Pavlatou MG. Clinical and biochemical manifestations of depression: relation to the neurobiology of stress. Neural Plasticity. 2015;2015:1-11. doi:10.1155/2015/581976 Stanford Medicine. Genetics of brain function. 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