Doesn’t everybody get depressed? The difference between mood changes and a mood disorder

sad, depressed, mood disorder, depressionIn popular culture, the words “sad” and “depressed” are used synonymously, but they are not the same.   Sadness is an emotional response to an event and should pass relatively quickly, but depression is actually a medical condition, known as a mood disorder, involving a collection of specific symptoms.  If feelings of sadness begin to interfere with your life and last for weeks on end, they may have developed into depression. Sadness is a normal change in mood, but depression is a condition which requires evaluation by a clinician and should improve with medical treatment.

It is estimated that 16% of people in the U.S. will experience an episode of depression sometime in their life. Every year, 1 in 16 people have a depressive episode, but only half of these people receive treatment.  Many people know they feel badly, but don’t want to “overreact” to feelings they are having or medicate feelings that are normal and should subside on their own. 

Depression is characterized by:

  • Feeling sad most of the day, everyday
  • Trouble sleeping, either too much or too little
  • Problems with appetite
  • Frequent thoughts about death, suicide, or not wanting to be alive
  • Lack of interest in normal activities
  • Irritability
  • Feelings of guilt or worthlessness
  • Low energy
  • Difficulty with focus or concentration
  • Feeling slowed down or on being on edge

If you have had 5 or more of the symptoms above and they have lasted for 2 weeks or more, you may have depression. There are lots of very effective treatments available, including talk therapy, medications, and mind-body centered treatments. With effective treatment, it is realistic for people with depression to reach full remission and no longer have symptoms of depression. To make sure that you receive the appropriate treatment and gain access to useful resources, it is important to be open with your clinician about your specific symptoms.

The cause of depression is not yet well understood, but likely involves biological, genetic, and psychosocial factors. A family history of depression can put you at increased risk for depression, as can poor social support and differences in coping style and temperament. Stressful life events may lead to depression, but are rarely the sole cause of it.  Not everyone responds to stressful life events with symptoms of depression, but if someone is at increased risk because of other factors, they may be more likely to become depressed after a stressful event.

It is important to recognize that there can be many additional factors that contribute to depression, including medical illness, substance abuse, sleep deprivation, and other psychiatric conditions. If these are the causes of your depression, then treatment of these underlying problems is essential to improve your mood. Any thorough evaluation for depression must therefore also involve a medical evaluation to ensure that there are no other factors contributing. Sometimes treating a medical condition, improving sleep, or avoiding use of substances (like alcohol, marijuana, cocaine, opiates, or other drugs of abuse) can improve someone’s mood without any other treatment.

No one needs to live with depression.  If you or someone you know has symptoms of depression, consider talking to your primary care doctor or scheduling an appointment in behavioral health for an evaluation by a clinician who can get you started on the proper treatment.

Learn more about depression:
National Institute of Mental Health
National Alliance on Mental Illness
Healthwise Knowledgebase

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About Dr. Wendy Cohen

Dr. Wendy Cohen is a board-certified psychiatrist who practices in the behavioral health department at Kenmore. She joined Harvard Vanguard in 2007. Dr. Cohen completed residency at the Harvard Longwood Psychiatry Residency Training Program, and Fellowships at the Boston Psychoanalytic Society and Institute and the Adam's House Psychotherapy Fellowship at Faulkner Hospital. She has clinical interests in anxiety, depression, women’s health, substance abuse, psychotherapy, and patient education. She has a private psychotherapy practice in Brookline.
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