When someone is measured by a depression questionnaire in the hospital and the results show a high score, the checklist says “major depression”, so they immediately think they have a very serious depression.
In fact, the meaning of “major depression” and “very serious depression” are not the same.
A similar situation occurs when someone looks up a depression questionnaire on the Internet and realizes how many points he or she has scored, and then breaks out in a cold sweat, thinking that he or she has depression.
Therefore, it is very necessary to differentiate between the symptoms of depression and depression.
Common online depression questionnaires measure depressive symptoms, and a high score only indicates a higher score for symptoms of depression.
Currently, the symptoms of depression are divided into four main categories.
I. Symptoms of depression in terms of emotions
First of all, there is the emotional aspect. Depression actually corresponds to a group of emotions that include, in addition to sadness, feelings of self-guilt, failure and punishment.
People who are depressed tend to have a low opinion of themselves and tend to deny their own value, thus creating a sense of failure.
Sometimes some patients may not be able to express their emotions, thinking that they have “nothing wrong with their lives,” but their low mood can be inferred from a tendency to tear up, or a succession of sighs.
Feelings of self-guilt may sometimes be detached from reality, such as the belief that “I have sinned greatly and have wronged my family,” or even the belief that “my presence may affect the appearance of the city”.
Irritability is also a common emotional symptom of depression, and is more pronounced in children and adolescents.
II. Symptoms of depression in cognitive terms
Secondly, the symptoms of depression are also manifested in cognitive aspects, such as suicide-related thoughts, worries about health, slowing down of thinking, making decisions becomes difficult and feeling of hopelessness.
Suicide is a very serious problem and is the leading cause of death in our population aged 15-34 years. In addition, suicide rates are higher in our older population than in the younger population. When someone commits suicide, people tend to ask what exactly they experienced before the suicide. The truth is that no matter how extreme an event an individual experiences, it doesn’t mean that the person experiencing the event will necessarily commit suicide; one of the common causes of suicide is depression.
While it is true that health is something that deserves to be on each of our minds, excessive worrying about health can have an impact on life.
Cognitive symptoms of depression may also include difficulties with memory and attention. They have selective attention and greater memory capacity for content that triggers negative emotions.
Lack of hope is also a characteristic of depression, and this hopelessness points not only to the here and now, but also to the future.
In psychology, there is a term called “tunnel vision”. In other words, they seem to be looking at the world and predicting the future in a direction where there is no light.
Not seeing hope is not an objective indicator; someone who is trapped by depression and sees no hope may be seen by onlookers as a very successful person, someone who is considered by all to be good, or even someone to be envied.
III. Symptoms of depression in terms of behavior
Third, depression also has behavioral manifestations. These manifestations are often observable by outsiders and may be a decrease in work or study efficiency. Sometimes the individual is unable to accomplish what he or she was able to do before, and sometimes he or she is able to accomplish what he or she was able to do but needs to put in more time and effort.
Decreased interest is also a behavioral manifestation of depression. For example, a person who has enjoyed playing table tennis for decades may feel that table tennis is no longer important to him after depression.
Social withdrawal is also common, corresponding to the example of table tennis, where a depressed individual may not only stop actively inviting friends, but may even be indifferent to their calls.
IV. Symptoms of depression in the somatic area
Fourth, depressive symptoms can also manifest physically.
Sleep disturbances are often the first symptom that people with depression complain about to their doctors. Most people will complain about how little sleep they get, but some people may be sleeping too much.
Changes in appetite and accompanying changes in weight are also two interrelated physical symptoms of depression. It is often assumed that depressed individuals will experience a loss of appetite and significant weight loss. However, for some individuals, the symptoms may be the opposite: appetite becomes better and there is a corresponding marked increase in weight. The author hypothesizes that this may be due to the popularity of dieting, whereby dieters tend to eat more when they are depressed, rather than the typical “too sad to eat” situation.
Loss of energy is also a physical symptom of depression, and depressed individuals often feel “tired”. There is a difference between this tiredness and tiredness after a long day at work: whereas tiredness can be relieved by rest, the tiredness of depression is more difficult to relieve. For some individuals with severe depression, it can be difficult to even accomplish things like getting dressed or washing up. The time when some people with major depression are at highest risk for suicide is not when their symptoms are at their worst, because at the height of their symptoms they may not have the energy to accomplish suicide as a plan. It is precisely when they are beginning to recover that the risk of suicide is highest.
Decreased libido is also one of the somatic symptoms of depression. In addition, the physical manifestation of depressive symptoms may also be pain, which may be localized or generalized.
There are really no absolutist indicators as to which category the above symptoms should be classified into. For example, feelings of self-guilt, although in this article they are attributed to the category of emotions, thinking plays a decisive role in the formation of such feelings.
If measured using a commonly used depression scale, the truth is that many people would not score 0 on every entry. In other words, quite a few people have more or less symptoms of depression. However, even if the symptoms are obvious and the score is relatively high, the diagnostic criteria for depression (MAJOR DEPRESSIVE DISORDER) may not be met.
The diagnosis of depression can only be made by a psychiatrist, and questionnaires are not a substitute for diagnosis.
The diagnosis of depression has very strict criteria. In addition to the diagnostic symptoms, the duration of the symptoms, the degree of distress of the individual, the impact on functioning, and some exclusionary criteria also need to be considered.