Depression is an illness associated with several symptoms validated by the WHO, the HAS in France and the DSM-5, the reference manual for mental disorders.
Depression is a common illness but not always easy to identify. How to recognize real depression from temporary depression or a bout of fatigue? Depression stands out “habitual mood swings and temporary emotional reactions to everyday problems” notes the WHO which are more similar to those of depression. “Real” depression is marked by symptoms that come on and last. “The person with this disorder has a low mood (feelings of sadness, irritability, emptiness) or a loss of pleasure or interest in activities, for most of the day, almost every day, during at least two weeks” continues the Organization. “These almost daily symptoms disrupt professional and social life and cause significant distress”indicates the HAS.
The DSM is the diagnostic and statistical reference manual for mental disorders, established by the American Psychiatric Association. In its latest version (corresponding to the DSM-5), the depressive episode is based on at least 5 of the following symptoms, present for at least 2 weeks:
- Depressed mood present almost all day, almost every day, reported by the subject (feels empty or sad or hopeless) or observed by others (crying or on the verge of tears). Possibly irritability in children or adolescents.
- Marked decrease in pleasure in all or almost all activities most of the day, almost every day (reported by the subject or observed by others).
- Significant weight loss or gain in the absence of a diet (e.g. change in body weight in 1 month exceeding 5%) or decrease or increase in appetite almost every day. In children, take into account the absence of the expected weight increase.
- Insomnia or hypersomnia almost every day.
- Psychomotor agitation or slowing down almost every day (noted by others, not limited to a subjective feeling of restlessness or inner slowing).
- Fatigue or loss of energy almost every day.
- Feeling of worthlessness or excessive or inappropriate guilt (which may be delusional) almost every day (not just self-blame or feeling guilty about being sick).
- Decreased ability to think or concentrate or indecisiveness most days (reported by self or observed by others).
- Recurrent thoughts of death (not just a fear of dying), recurrent suicidal thoughts without a specific plan, or attempted suicide or a specific plan to commit suicide.
These symptoms result in clinically significant distress or impairment in social, occupational, or other important areas of functioning. They are not attributable to the physiological effect of a substance or another medical condition.
Many people experience episodes of depression linked to triggering factors such as bad weather, the death of a loved one or baby blues. However, the sadness and dejection following bereavement are not always depressive, even if they last several weeks. Likewise, temporary feelings of melancholy and loss of enthusiasm do not necessarily constitute depression, but rather a simple phase of “depression” which will disappear spontaneously. It is actually depression and not “depression” which is a real pathology because it lasts.
