Understanding Situational and Clinical Depression and How to Improve Your Mood

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Millions of people worldwide experience Sadness or Depression at some point. Depression is a mental illness, not an emotion.

The Anxiety and Depression Association of America (ADAA) notes that Depression is one of the most common mental health illnesses in the United States.

Feeling sad is integral to Depression, but they are not the same. Knowing and understanding the differences can help people recognize when to seek treatment.

Sadness

Sadness is a normal human emotion that everyone will experience at stressful or unhappy times.

Several life events can leave people feeling sad or unhappy. For example, the loss or absence of a loved one, divorce, loss of job or income, financial trouble, or issues at home can all negatively affect mood.

Failing an exam, not getting a job, or experiencing other disappointing events can trigger sadness.

However, a person experiencing sadness can usually find relief from crying, venting, or talking out frustrations. More often than not, sadness has links to a specific trigger.

Sadness usually passes with time. However, if it does not pass or the person cannot resume normal function, this could be a sign of Depression.

Feeling down, sad, or upset is normal. However, feeling this way for several days or weeks can be more of a disorder.

In that case, your Depression may have become chronic, requiring proper treatment, and you need to make an appointment with your Doctor or a Mental Health Professional.

If you’re reluctant to meet with a Health Care Professional, try talking with a trusted friend, family member, loved one, or faith leader to help you talk it out and find the root reason for your Depression.

Depression

Depression is a mental disorder that overpoweringly affects a person’s life. It can occur in people of any gender or age and alters behaviors and attitudes.

In 2015, around 16.1 million people aged 18 years or above in the U.S. had experienced at least one major depressive episode in the last year, accounting for 6.7 percent of all adults in the country.

Symptoms include:

• Feelings of discouragement.
• Sadness.
• Hopelessness.
• A lack of motivation.
• A loss of interest in activities that the individual once found enjoyable.

In severe cases, the person may think about or attempt suicide. They may no longer feel like spending time with family or friends, stop pursuing their hobbies, or cannot attend work or school.

If these feelings of doubt last longer than two weeks, a healthcare professional may diagnose the person with Major Depressive Disorder (MDD).

Symptoms of MDD include:

• A daily depressed mood that lasts for most of the day, nearly every day, with noticeable signs of hopelessness and sadness.
• A loss of interest in usual activities for an extended amount of time.
• Significant and unintentional weight loss or gain.
• Insomnia, sleeplessness, or increased amounts of sleep affect regular schedules.
• Tiredness and low energy.
• Feelings of worthlessness or excessive guilt daily.
• Inability to concentrate or make decisions.
• Recurrent thoughts of death, suicidal thoughts, or suicide attempts or plans.

A doctor would consider a person who experiences any five symptoms for longer than two weeks to have a medical problem rather than a prolonged experience of sadness.

For a diagnosis of MDD, the Doctor should link the symptoms only to Depression and not to another medical diagnosis, such as substance abuse or an underlying condition.

Unlike sadness, Depression can leave a person struggling to get through their day. However, sadness is just one element of Depression.

Watch for these Physical and Behavioral Symptoms.

1. Decreased energy or chronic fatigue.
2. Difficulty concentrating or making decisions.
3. Experience aches, pains, or cramps.
4. Experience gastrointestinal problems.
5. Changes in appetite or weight.
6. Difficulty sleeping, restlessness, or oversleeping.

And watch for these Emotional Symptoms.

1. Loss of interest or no longer finding pleasure in activities or hobbies.
2. Persistent feelings of sadness, anxiety, or emptiness.
3. The feeling of hopelessness, pessimism, guilt, worthless, or helplessness.
4. Feelings of anger, irritability, or restlessness.
5. Thoughts of death or suicide.

Situational Depression

Situational and Clinical Depression are similar, but they are not the same. Recognizing the differences between these types of Depression is the first step toward getting help.

Medically Situational Depression is an “adjustment disorder with a depressed mood.” It often resolves with time, and discussing the problem can ease recovery.

Situational Depression is a short-term form of Depression resulting from a traumatic change in a person’s life. An adjustment disorder with a depressed mood is another name for this emotional state.

Triggers can include:

• A divorce.
• Loss of a job.
• The death of a loved one.
• Financial hardship.
• Caring for an ill relative.
• Other significant life changes, such as retirement.

Situational Depression stems from the difficulty in dealing with dramatic life changes. Recovery is possible once an individual can come to terms with a new situation. This may require support and treatment.

For instance, following the death of a parent, it may take a while before a person can accept that their parent is no longer alive.

They may feel unable to move on with their life until they reach acceptance. Some people may need to attend a grief support group or speak with a therapist.

Some critical differences between situational and clinical Depression will determine the type of treatment a person needs and the severity of their condition.

No type of Depression is more “real” than another. Both can present significant challenges and threats to their well-being.

However, knowing which type of Depression is at the root of their persistent, negative mood can support their recovery.

Symptoms of situational Depression can include:

• Listlessness.
• Feelings of hopelessness and sadness.
• Sleeping difficulties.
• Frequent episodes of crying.
• Unfocused anxiety and worry.
• A loss of concentration.
• Withdrawal from everyday activities, as well as from family and friends.
• Suicidal thoughts.

Agitated Depression

Agitated Depression is a type of Depression that involves symptoms like restlessness and anger. People who experience this type of Depression usually don’t feel lethargic or slowed down.

It can be seen in people with bipolar disorder. But, psychomotor agitation can also be seen in major depressive disorder. This condition makes a person appear restless.

Agitated Depression can cause symptoms like insomnia and a feeling of emptiness. You may also feel severely restless. And you may have a strong, uncomfortable sense that seems inescapable.

Symptoms of agitated Depression include:

• Extreme irritability, like snapping at friends and family or being annoyed at small things.
• Anger.
• Agitation.
• Fidgeting.
• They are racing thoughts and constant talking.
• Restlessness.
• Pacing.
• Hand-wringing.
• Nail-biting.
• Outbursts of complaining or shouting.
• They were pulling at clothes or hair.
• They pick at the skin.

Some people with Major Depressive Disorder will experience agitation. However, the agitation is more severe and persistent in those with agitated Depression.

This condition can lead to conflicting feelings of intense restlessness and Depression. People may also experience feelings of agitation or irritability along with sadness or emptiness.

People with agitated Depression may be more likely to be in danger of self-injury and suicidal thoughts and attempts.

Common triggers or causes of agitated Depression include:

• Traumatic events.
• Long-term stress.
• Hormone imbalances.
• Hypothyroidism.
• Bipolar disorder.
• Anxiety disorders.

In some cases, depression medications can cause agitated Depression. In addition, agitation or excitability may be side effects of the medication prescribed.

Tell your doctor immediately if you experience increased anxiety or irritability after starting a new medication for Depression. Then, your Doctor can help you find another remedy.

Seasonal Affective Disorder (SAD)

According to the American Psychiatric Association, Seasonal Affective Disorder (SAD) is officially classified as a major depressive disorder with seasonal patterns.

SAD is triggered by seasonal change, usually when fall starts. This seasonal Depression worsens in the late fall or early winter before ending in the sunnier spring days.

You can also get a mild version of SAD, known as “the winter blues.”

It’s normal to feel a little down during colder months. For example, you may be stuck inside, and it gets dark early. But it goes beyond this; it’s a form of Depression.

Unlike the winter blues, SAD affects your daily life, including how you feel and think. Fortunately, treatment can help you get through this challenging time.

Some people get a rare form of SAD called “Summer Depression.”

It starts in the late spring or early summer and extends into the fall. It’s less common than Seasonal Affective Disorder, which tends to come during winter.

About 5% of adults in the U.S. experience SAD. It starts in young adulthood (usually between 18 and 30). SAD affects women more than men, and researchers aren’t sure why.

About 10% to 20% of people in America may get a milder form of the winter blues.

You’re also at higher risk if you:

• Have another mood disorder, such as major depressive disorder or bipolar disorder.
• Have relatives with SAD or other forms of Depression or mental health conditions, such as Major Depression or schizophrenia.
• Live at latitudes far north or far south of the equator. There’s less sunlight during the winter at these latitudes.
• Live in cloudy regions.

Researchers don’t know precisely what causes seasonal Depression. However, lack of sunlight may trigger the condition if you’re prone to getting it. The theories suggest:

• Biological clock change: When there’s less sunlight, your biological clock shifts. This internal clock regulates your mood, sleep, and hormones. When it shifts, you’re out of step with the “daily” schedule you’ve been used to and can’t adjust to changes in daylight length.
• Brain chemical imbalance: Brain chemicals called neurotransmitters send communications between nerves. These chemicals include serotonin, which contributes to feelings of happiness. If you’re at risk of SAD, you may already have less serotonin activity. Since sunlight helps regulate serotonin, a lack of sunlight in the winter can worsen the situation. Serotonin levels can fall further, leading to Depression.
• Vitamin D deficiency: Your serotonin level also gets a boost from vitamin D. Since sunlight helps produce vitamin D, less sun in the winter can lead to a vitamin D deficiency. That change can affect your serotonin level and your mood.
• Melatonin boost: Melatonin is a chemical that affects your sleep patterns and mood. The lack of sunlight may stimulate an overproduction of melatonin in some people. As a result, you may feel sluggish and sleepy during the winter.
• Negative thoughts: People with SAD often have stress, anxiety, and negative reviews about the winter. Researchers aren’t sure if these negative thoughts are a cause or effect of seasonal Depression.

How Depression is Classified

The term “Depression” has become common in mainstream society. But Depression is a more nuanced subject than widespread usage may suggest. For one, not all cases of Depression are the same. There are varying classifications of Depression, and each can affect your life differently.

Depression may be classified as:

• Mild
• Moderate
• Severe or “Major”

The exact classification is based on many factors. These include the symptoms you experience, their severity, and how often they occur.

Certain types of Depression can also cause a temporary spike in the severity of symptoms.

What does Mild Depression feel like?

Mild Depression involves more than just feeling blue temporarily. Your symptoms can go on for days and are noticeable enough to interfere with your usual activities.

Mild Depression may cause:

• Irritability or anger.
• Hopelessness.
• Feelings of guilt and despair.
• Self-loathing.
• A loss of interest in activities you once enjoyed.
• Difficulties concentrating at work.
• A lack of motivation.
• A sudden disinterest in socializing.
• Aches and pains with seemingly no direct cause.
• Daytime sleepiness and fatigue.
• Insomnia.
• Appetite changes.
• Weight changes.
• Reckless behavior, such as abuse of alcohol and drugs or gambling.

If your symptoms persist for most of the day, on an average of four days a week for two years, you would most likely be diagnosed with persistent depressive disorder. This condition is also referred to as dysthymia.

Though mild Depression is noticeable, it’s the most difficult to diagnose. However, dismissing the symptoms and avoiding discussing them with your Doctor is easy.

Despite the challenges in diagnosis, mild Depression is the easiest to treat. Specific lifestyle changes can go a long way in boosting serotonin levels in the brain, which can help fight depressive symptoms.

Beneficial lifestyle changes include:

• Exercising daily.
• Adhering to a sleep schedule.
• Eating a balanced diet rich in fruits and vegetables.
• Practicing yoga or meditation.
• Activities that reduce stress include journaling, reading, or listening to music.

Other treatments for mild Depression include alternative remedies, such as St. John’s Wort and melatonin supplements.

However, supplements can interfere with certain medications. Be sure to ask your doctor before taking any supplements for Depression.

A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be used in some cases.

However, these tend to be more effective in people with more severe forms of Depression. In addition, recurrent Depression tends to respond better to lifestyle changes and conditions of talk therapy, such as psychotherapy, than medication.

While medical treatment may not be needed, mild Depression won’t necessarily go away. When left alone, mild Depression can progress to more severe forms.

What does Moderate Depression feel like?

Regarding symptomatic severity, moderate Depression is the next level from mild cases. Moderate and mild Depression share similar symptoms. Adyou’really, moderate Depression may cause:

• Problems with self-esteem.
• Reduced productivity.
• Feelings of worthlessness.
• Increased sensitivities.
• Excessive worrying.

The most significant difference is that the symptoms of moderate Depression are severe enough to cause problems at home and work. You may also find significant difficulties in your social life.

Moderate Depression is more straightforward to diagnose than mild cases because the symptoms significantly impact your daily life.

The key to a diagnosis is to talk to your doctor about the symptoms you’re experiencing.

SSRIs, such as sertraline (Zoloft) or paroxetine (Paxil), may be prescribed. These medications can take up to six weeks to take full effect.

Cognitive behavioral therapy (CBT) is also used in some cases of moderate Depression.

What does Severe (Major) Depression feel like?

Severe (major) Depression is classified as mild to moderate Depression, but the symptoms are severe and noticeable, even to your loved ones.

Episodes of major Depression last an average of six months or longer. Sometimes severe Depression can go away after a while, but it can also be recurrent for some people.

Diagnosis is especially crucial in severe Depression and may even be time-sensitive.

Significant forms of Depression may also cause:

• Delusions.
• Feelings of stupor.
• Hallucinations.
• Suicidal thoughts or behaviors.

Severe Depression requires medical treatment as soon as possible. Your Doctor will likely recommend an SSRI and some form of talk therapy.

If you’re experiencing suicidal thoughts or behaviors, you should seek immediate medical attention. Call your local emergency services or the National Suicide Prevention Lifeline at 800-273-8255 immediately.

Zung Depression Scale

The Zung Depression Scale is a self-assessment used to identify the presence of depressive disorders in adults 18 years and older. It does not diagnose Depression — only a physician or mental health professional can do that.

• For the best results, try to complete the assessment in one sitting.
• Select the multiple-choice option based on how much you have been bothered by that symptom during the past several days.
• Take the assessment regularly to watch for changes in your symptoms.
• This instrument is designed for screening purposes only and is not to be used as a diagnostic tool.

Depression Anxiety Stress Scale

The Depression Anxiety Stress Scale (DASS) is a self-reported instrument designed to measure the three related negative emotional states of Depression, anxiety, and tension/stress.

The DASS was constructed not merely as another set of scales to measure conventionally defined emotional states but to define further, understand, and measure the ubiquitous and clinically significant emotional states usually described as Depression, anxiety, and stress.

The Depression scale assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia.

The Anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect.

The Stress scale is sensitive to levels of chronic non-specific arousal. For example, it assesses difficulty relaxing, nervous arousal, easily upset/agitated, irritable/over-reactive, and impatient.

Center for Epidemiologic Studies Depression Scale

The Center for Epidemiologic Studies Depression Scale (CES-D) is a brief self-report questionnaire developed to measure the severity of depressive symptoms in the general population.

The CES-D consists of 20 questions that rate based on how often, over the past week, you experienced symptoms associated with Depression, such as restless sleep, poor appetite, and feeling lonely.

Although initially designed for general population surveys, CES-D is now a screening instrument in primary care clinics and research.

Major Depression Inventory (MDI)

The Major Depression Inventory (MDI) is a self-report mood assessment developed by the World Health Organization. The instrument was constructed by a team led by Professor Per Bech, a psychiatrist based at Frederiksborg General Hospital in Denmark.

The MDI differs from other self-report inventories because it can generate an ICD-10 or DSM-IV diagnosis of Clinical Depression and estimate symptom severity.

Helpful and Informative Resources

Do you know why misery loves company? Because you know you are not alone. And the thing is, you’re not alone.

Depression comes from dwelling on the past, rehashing and reliving the negative things you wish had been different. Anxiety comes from living in the future and thinking about all the negative things that may occur.

You can make yourself feel better by stopping yourself when these thoughts creep into your mind. Instead, try to stay focused on the present moment.

I have found The Power of Now: A Guide to Spiritual Enlightenment by Eckhart Tolle very helpful.

It examines how people interact with themselves and others, self-reflection, and living in the present moment. You can find the Audiobook on YouTube.

Another valuable source of inspiration is Dr. Wayne Dyer’s book Change Your Thoughts—Change Your Life, based on living according to the wisdom in the way of the Tao Te Ching by Lao-tzu.

What is the Tao Te Ching?

Five hundred years before the birth of Jesus, in ancient China, Lao-tzu, a prophet who was also the keeper of the imperial archives in the ancient capital of Luoyang, dictated 81 verses regarded by many as the ultimate commentary on the nature of existence.

These verses offer balanced, moral, and spiritual advice and guidance on living for the good. You can find the Audiobook on YouTube.

The Mayo Clinic website on General Depression is an excellent source of information.

Another good resource is the U.S. Department of Health & Human Services SAMHSA, Substance Abuse and Mental Health Services Administration.