There are two diagnostic “standard works” used today to identify depressions. The first is the so-called ICD-10 of the World Health Organization (ICD stands for International Classification of Diseases) and the second is the DSM-IV of the American Psychiatric Association (DSM stands for Diagnostic and Statistical Manual of Mental Disorders).
These medical reference books define precisely what the symptoms of depression are. They include, for example, the following:
- Lack of interest or pleasure in one’s own activities:
During a depression it often happens that the affected persons can no longer feel pleasure or enthusiasm for things they greatly enjoyed before the depression set in. These may be hobbies, the person’s profession or other things.
- Sadness and despondency:
Loss of interest and the ability to feel pleasure are often accompanied by a feeling of despondency, emptiness and despair. Seriously depressive people often report, for example, that they feel unable to cry although they would greatly like to.
- Reduced appetite or a need to eat excessively:
During a depression the appetite may change in either direction. It sometimes happens that depressive people lose several pounds in weight as they no longer enjoy their food and nothing tastes good to them any more. But the opposite may equally well be the case. Some depressive patients report an increase in appetite and they put on weight during a depressive phase.
- A poor opinion of oneself, for example feelings of guilt, a sense of failure or the conviction that one has disappointed one’s family.
It is typical of depression that the afflicted persons have a low sense of self esteem and put the blame on themselves for all kinds of things. In this situation rational explanations play no part. In particularly serious cases the self-accusations can become so strong that the person thinks he/she is a failure and is convinced that he/she has made other people – for example his/her partner or family deeply unhappy.
- Difficulties in concentrating, for example on reading the newspaper or watching television:
Concentrating on a particular topic for a longer period of time, for example on a text, a professional task or work in the household can be very difficult during a depression. In addition, depressive people are often not able to take decisions and feel that even the smallest decisions are too much for them.
- Difficulties in going to sleep or staying asleep or with oversleeping:
Both can occur during a depression – those affected either sleep much more than usual or they find it difficult to get enough sleep. This can mean that they wake up several hours earlier than usual and then cannot fall asleep again. In these waking hours in the morning the feelings of hopelessness and despair are mostly particularly intense.
- Tiredness or the feeling of having no energy:
This tiredness or lack of energy is often the result of difficulties in sleeping which frequently go hand in hand with a depression. Because of the exhaustion the affected persons find it difficult to go about their daily business. In particularly severe cases it can happen that depressive people lack the energy to get out of bed.
- Speech and movement so sluggish that other people notice; or restlessness and the urge to move around hectically:
The situation is similar here to the changes in sleeping patterns and appetite during a depression. On the one hand movements and speech may be distinctly slower, but the reverse can also be the case so that depression triggers off a kind of restlessness.
- Thinking about one’s own death and the wish to harm oneself:
Suicidal thoughts often occur during serious depressions. Many severely depressed people feel that they would like to put an end to their lives.
There are various ways of arriving at a diagnosis on the basis of these symptoms. What matters is the number of symptoms and the length of time during which they occur. The most common methods in psychological research are based on the so-called DSM-IV. This internationally recognized American manual on psychological disorders states:
If someone suffers continuously from at least five of these symptoms for at least two weeks and at least one of the symptoms is a loss of interest and a depressed mental state (sadness or despondency), one can speak of a major depression.
With the help of these criteria – symptoms and length of time – it is possible to distinguish depression from “normal” reactions of sadness. The diagnosis can, however, only be made by a doctor or psychologist after a thorough examination. If you are not quite sure which symptoms you might be suffering from, this free self-test can help you to make an initial assessment. to depression screener
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