Feeling Depressed vs Having Depression How To Tell The Difference by Dr. Tracey Marks

  Hi, I'm Dr. Tracey Marks, a psychiatrist. Today, I'm talking about how to tell the difference between feeling depressed and having major depression as an illness. This is a very relevant topic in this current time, as we deal with this pandemic and all of the negativities that come with it. I don't think we've begun to see the mental impact that this is gonna have on us long term.

 Drug manufacturers are having a hard time keeping up with the demand for antidepressants because more people are being prescribed antidepressants to help with the situation. And that makes sense, look what we've got, long term isolation and disconnectedness, loss of life, economic ruin. Any of these things occurring by themselves can set you back emotionally, but all of them simultaneously can fill you with apathy, making you not wanna go on. 

Does this mean you have depression? Not necessarily. Depression is an emotional state. Major depressive disorder is an illness. As humans, we're reactive. but not every negativereaction is an illness. There's another mental disorder called adjustment reaction with depressed mood. Some people call it situational depression. It's a milder form of the depressive illness that's triggered by atrauma or a stressor. This disorder is definedas having marked distress that's out of proportion to the severity orintensity of the stressor, and significant impairmentin social, occupational, or other important areas of functioning. 

Notice in the first part of the description, it says out of proportion to the severity and intensity of the stressor. There's some subjectivity here to determine what's out of proportion. We are expected to have reactions to things, but what would be an expected reaction to receiving daily news of deaths, job loss, illness, protests, and being unable to connect with the people that you like and love? Under these circumstances, what would proportional distress even look like? I think the answer to that is in the second part of this criteria for an adjustment disorder, which is that you have distressing emotions that cause certain behaviors that lead to impairment. 

Degree of impairment is generally how we determine these verity of an illness and what kind of treatment you should pursue, if any. So, what do we mean by impairment? With impairment, we lookat the degree of problems that it's causing in your day-to-day life in three main realms, social, occupational,and personal functioning.

 Social functioning would include how you relate to people with your communication and your connectedness. Occupational functioning includes your school ability as well, and your ability to maintaina job, to support yourself, and get along with peoplein your work setting. And then, your personal functioning would be how well you'retaking care of yourself. So, here's how you can think about how seriously your emotions are affecting you based on your level of functioning in these areas. And I'm grouping these into superior functioning, mild impairment, moderateto serious impairment, and profound impairment.

 This is based on the Global Assessment of Functioning Scale that we used to use as part of the diagnostic process. We still think of it in these terms, but we don't use the scale anymore, and I'll have a link to the scale in the description. Superior functioning would be that life's problems never seem to get out of hand for you. And you're even sought out by others because of your many positive qualities. Mild dysfunction would be things like having mild anxiety related to a stressor, like an exam, or worrying about finances after losing your job. Or you could have symptoms that are expected reactions to a stressor, like being unable to concentrate after you've had an argument with someone. 

Moderate dysfunction would behaving some trouble sleeping or trouble meeting your personal, work or school responsibilities. Because of thinking problems or having poor motivation. You may have occasional panic attacks.