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Blue Mood or Depressive Disorder?

Feeling depressed is a common reaction to situations which overwhelm or sadden us. But true depression (clinical depression), or a depressive disorder, is different from having occasional blue moods or unhappy feelings. Depressive disorders are illnesses, often with biological causes, that are diagnosed by fixed criteria and defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

According to the National Institute of Mental Health (NIMH), approximately 18.8 million American adults, or about 9.5% of the U.S. population age 18 and older, have a depressive disorder. In addition, depression is the most common cause of disability worldwide, says the World Health Organization.

Major Depressive Disorder, sometimes known as Unipolar Depression, most commonly begins between the ages of 15-30 and recurs throughout life; however, children and people of any age may develop this type of depression. Also, women are twice as likely to be affected by major depressive disorder than men.

Symptoms of Major Depressive Disorder include:

  • sadness
  • loss of interest or pleasure in normal activities
  • changes in appetite or weight
  • sleep disturbances (insomnia or oversleeping)
  • decreased energy level
  • difficulty concentrating
  • feelings of hopelessness
  • thoughts of suicide

A person is considered to have major depressive disorder if five or more of the above symptoms are present every day or nearly every day during a two-week period.

Dysthymic Disorder is a less severe form of major depressive disorder. Dysthymic disorder is manifested by depressed moods that are not as severe as those in major depression. A diagnosis of dysthymic disorder is made by noting the presence of a depressed mood for at least two years plus at least two of the above symptoms.

Bipolar Disorder, formerly known as Manic Depressive Disorder, involves the presence of depressive episodes along with periods of manic episodes, which are characterized by abnormally elevated moods, irritability, an overly-inflated sense of self-esteem, and distractibility. People experiencing an episode of mania are generally talkative, have a decreased need for sleep, and may engage in impulsive, reckless or risk-taking behaviors. A less severe form of bipolar disorder is known as Cyclothymic Disorder.

The causes of depression are varied. While many physical and psychological factors may play a role in the development of depression, no one factor has been identified as its sole cause. Chemical imbalances are thought to be the major culprit in major depressive disorders, however, and antidepressant drug therapy is generally aimed at restoring the balance of these brain chemicals. An inherited component has been identified in many kinds of depressive disorders but only the tendency to develop depression may be inherited; not the depressive disorder itself.

There may also be physical conditions or illnesses that may cause or exacerbate depression. Sometimes the symptoms of a physical condition, such as hypothyroidism (abnormally low levels of hormones produced by the thyroid gland) can even mimic those of depression; in these cases, treatment of the illness alleviates the depressive symptoms. Hormonal changes, such as those associated with the menstrual cycle, pregnancy, or menopause, may also trigger depression in susceptible individuals.

Lifestyle stress is also a trigger for depression. While not all stressed individuals will develop depression, environmental or occupational stressors likely compound the tendency to develop depression in those already predisposed to this condition. Extreme stresses, such as the death of a loved one, are the most common stresses associated with depression. However, any stressful change in life pattern, such as increased work demands, being fired, geographic move, divorce, or children leaving home, may also contribute to depression.

Before any treatment for depression is begun, a thorough medical and psychological examination is necessary. It is important to rule out physical illnesses as causes of the depression, and physical condition must be taken into account when prescribing certain drug treatments for depression.
A combination of psychotherapy and antidepressant medication is the most effective means of treating major depressive disorders.

About the Author

Michele Soloway has dealt with bipolar disorder from a very young age. Her grandmother, mother, brother, herself, and her teenage son all have the disorder. She also lost her sister to suicide because of bipolar disorder. Michele has a blog for bipolar survivors at, and is also a contributing writer to and

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Cutting and other forms of self-mutilation may be hard for many people to understand. People who self-harm are more likely to have an underlying emotional problems, such as Borderline Personality Disorder (BPD). According to a study by German researchers, people with BPD may engage in self-injury because they get a sense of emotional relief from physical pain. BPD is a complex set of... Read More

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