What Depression Really Is

Sad toy with a torned heart made from paper.
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What is depression?

There are many articles on internet that claims to provide a valid definition of depression. Some do provide the vaild definitions, some don’t. But how can we know for sure?

Well, that’s why we have DSM-5. Or “Diagnostic and statistical manual of mental disorders — Fifth Edition”. This manual is used by psychologists and psychiatrists to identify if a person has depression. Also, the manual provides criteria which helps the specialists to diagnose the depression.

Now, things get interesting. Although we know it and we call it as “depression”, in the field of mental health the specialists use the term “Major Depressive Disorder”. And the bad part about DSM-5 is that it actually doesn’t provide a definition of depression (or MDD). That’s because when diagnosing someone with MDD, specialists need to see which criteria the pacient is meeting. For example, a pacient might have insomnia, but you don’t actually need to have insomnia to develop depression.

So where can we find a definition of depression?

Cubes with individual letters that form the word depression.
Photo by Anna Tarazevich from Pexels

Unfortunately, we have to look at studies. Many studies. That’s because the specialists in the field of psychology don’t agree very often. And that might be a good thing. Because there are many ways to improve what we know in the upcoming years.

So, back to the definition. Looking after more studies is the best thing to find a general definition about depression. But from my experience, 2 or 3 are enough for that.

A study by Fava, M., & Kendler, K. S. (2000) defines depression as “a medical condition that includes abnormalities of with MDD and the level of evidence suggesting that at affect and mood, neurovegetative functions (such as least some of the association is indeed causal: gender, appetite and sleep disturbances), cognition (such as stressful life events, adverse childhood experiences, inappropriate guilt and feelings of worthlessness), and and certain personality traits. Across many studies, varypsychomotor activity (such as agitation or retardation)”.

Another study by Otte, Christian, et al. (2016) defines depression as “a debilitating disease that is characterized by at least one discrete depressive episode lasting at least 2 weeks and involving clear-cut changes in mood, interests and pleasure, changes in cognition and vegetative symptoms”.

Other studies provides just a simple definition, if we can call it a definition, of depression, like the study by luboka, Oloruntoba J., et al. (2018) where the authors define depression like “in addition to mood symptoms, individuals with MDD experience impairments in physical, occupational, and social functioning”.

Criteria of depression from DSM-5

If the definitions didn’t make you understand the scientific view of depression, don’t worry. You will understand after you will read the criteria.

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. 

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). 6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Conclusion

So, there you have it. The criteria for depression. I know it is a lot of information to process, but I know you’ll manage. I hope you have a better understanding of what is a definition of depression (which you can actually write yourself based on the criteria and will be probably correct) and what is the criteria for depression.

Just remember, having 5 or more of the mentioned symptoms is a sign that you or someone you love might have depression. If that, you should seek mental health care as soon as possible for yourself or for the person you love.

And one last thing, do not include symptoms that are clearly attributable to another medical condition. Especially the physiological factors.

Take care of yourself and the people you love!

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