SITUATIONAL DEPRESSION VS CLINICAL DEPRESSION

I treat a lot of depression at my office in Scottsdale Arizona. Distinguishing between the differing kinds of depression is necessary during the initial evaluation. Situational depression is much different than clinical depression. There are at least 8 or 9 types of depression that have been identified. Situational depression is not synonymous with grief nor bereavement, which are different kinds of depressive disorders. In recent times, it seems that we are seeing all types of depression manifest. Getting enough sleep, exercise, and a good diet are critical. These tense circumstances can trigger all of the types of depression.

DEPRESSION – DIFFERENCES

How do we determine the types of depression and the difference between situational depression (SD from here forward), and clinical depression (CD from here forward). This is a very important question because the cause of our depressive state will determine the therapy. Both situational and clinical depression share a common bundle of symptoms. Feeling the blues, loss of appetite or increased appetite, change in sex drive, trouble sleeping, lack of energy, apathy, problems concentrating, feelings of guilt, physical pain, agitation, feelings of hopelessness. Distinguishing symptoms that are more closely associated with CD are suicidal thoughts, symptoms occurring for no apparent reason, symptoms that are not an appropriate response to the stress level; and a family history of depression. These are indicators that the depressive disorder may be clinical depression.

DIAGNOSING IS KEY TO TREATMENT

Generally, we will consider the severity and number of symptoms of depressive episode in determining the cause. This can be a bit tricky because both disorders can entail a bundle of severe symptoms which will vary from person to person depending on the trauma or stress in their lives. As a general rule clinical depression is much more severe and prolonged, clinical depression causes more impairment in functioning and doesn’t tend to go away once the stressors is removed. Depression accompanied with psychotic features is also a sign of major depression, or possibly schizoaffective disorder. A thorough psychiatric evaluation will often reveal the causes of the psychosis.

Clinical Depression Triggers

Sometimes the major stressors in life will trigger clinical depression. Other times there are no apparent triggers in someone’s life that would provoke a depressive episode; it seemingly comes out of nowhere. We may look at the symptoms to see if they exist long after the stressful events have ceased. Chemical imbalances are typically not associated with situational depression. We have discovered that the more stressors or traumas that one has had, the more vulnerable one is to developing CD; especially in those who are genetically predisposed to clinical depression.

Situational Depression Triggers

Major stressors in life will bring on situational depression such as a divorce, death of a loved one, loss of a job, the economy, or any factors that will negatively affect your life. These can be very debilitating and usually trigger this type of depression. When these triggers are present a practitioner must look at the length of time of the symptoms, the number and type of symptoms; and the family history of the individual. The length of time for situational depression symptoms will usually coincide with the duration of the stressful events.

CLINICAL DEPRESSION SYMPTOMS

The inability to enjoy almost any aspect of life is a sign of CD. A family history of depression is an indicator of CD since we are quite sure that depression is a genetic illness. Suicidal thoughts are a telltale sign of clinical depression. Sometimes a patient responding positively to an antidepressant will confirm that the disorder is one of clinical depression. The medication is treating an imbalance of chemicals which are the underlying causes of clinical versus situational depression. Most often CD will last for long periods of time but can subside within 6 months to 1 year left untreated. These symptoms may be the unset of CD, the sooner you begin therapy the greater the chances are of precluding a severe CD episode.

SITUATIONAL DEPRESSION SYMPTOMS

The symptoms are almost identical to clinical depression, but always accompanied by traumatic events or stressful situations. The episodes are short lived and continue in the presence of the causative events. Once the traumatic events are gone, so goes the symptoms. Situational depression can be very debilitating and should be treated, especially when it interferes with everyday tasks, relationships, and ordinary functioning. Often the best treatment for SD is exercise, removing the stressors in your life, changing your worldview, and diet; just to mention a few. When SD persists for a period of time which may be as few as 2 weeks, and the symptoms don’t appear to be subsiding, seek help. We have medications augmented with psycho-therapy and counseling to treat situational depression.

GRIEF OR BEREAVEMENT

Grief, which is termed uncomplicated bereavement in the DSM-5 or Diagnostic and Statistical Manual-5; are the symptoms an individual may experience with the loss of a loved one or friend. Those that have grief may present symptoms similar to those of major depressive disorder.These include feelings of sadness, insomnia, loss of appetite and weight loss. Those that are going through grief is a normal response and shouldn’t be avoided or suppressed. These individuals may seek out medical attention for their symptoms of insomnia and lack of appetite; however, there are some distinguishing characteristics between those that are grieving and those with major depressive disorder. If these are symptoms of clinical depression, treatment is necessary.

In summary, if these symptoms persist beyond the alleviation of the stressors or don’t get better, if you have a family history of depression, or you are having suicidal thoughts; please seek help immediately. The antidepressant medications today have high efficacy rates, even with the first one tried and most of the time they are well tolerated. The goal is to eradicate all of the patients’ symptoms into complete remission. I know that it can be achieved because I have seen it many times. There is much hope for you too. If you are seeking a qualified psychiatrist in Scottsdale, please call my office. Depression treatment is a large part of my practice and is very successful. More on clinical vs. situational depression.