9
Emotional reactions --feels sad, feels empty or lacks feelings
of all kinds, tired ("everything is an effort")... nervous or
restless, angry and grouchy (adolescents), irritable, overreacts
to criticism... bored, apathetic, "nothing is enjoyable," feels
socially abandoned and/or has less interest in relationships,
sex, food, drink, music, current events, etc.
Lack of skills --poor social skills, frequently whiny or boring,
critical, lack of humor... indecisive, poor planning for future and
unable to see "solutions."
Attitudes and motivation --low self-concept, lack of self-
confidence and motivation, pessimistic or hopeless, feels
helpless or like a failure, expects the worst... self-critical, guilt,
self-blaming, "People would hate me if they knew me"...
suicidal thoughts, "I wish I had never been born."
Physical symptoms --difficulty sleeping or sleeping
excessively, awaking early... hyperactivity or sluggishness,
diurnal moods (worse in the morning)... low sex drive, loss of
appetite, weight loss or gain, indigestion, constipation,
headaches, dizziness, pain, and other somatic problems or
complaints.
If you are trying to determine if you are depressed, there are
several things to keep in mind. First, Levitt and Lubin (1975) found 54
symptoms of depression. Obviously, no one has all these signs. These
are problems that tend to be associated with being sad. Yet, a
depressed person may have only one, two or three of these signs.
There are three important types of depression: (1) major depression is
serious enough to interfere with work and social life. Sometimes it is
called endogenous depression because it seems to come from within
and not a reaction to external events. It affects sleep, appetite, energy
level, self-esteem, and thoughts of suicide often occur. (2) Situational
or reactional depression is more common and sometimes more clearly
a reaction to a loss in life. It is a serious "downer" or "blue spell" but
usually not disabling. Psychiatrists call it dysthymia or chronic sadness
if the blue mood lasts for two years or more. After a while, many do
not know why they are down in the dumps. (3) Bipolar disorder or
manic-depression involves cycles of sadness and mania (too happy,
irritable, insomnia, grandiosity, hyperactive and talkative, poor
judgment, fast and unreasonable thoughts). The bipolar types are just
as likely to be men as women, more extroverted, and more likely to
have relatives with depression. Unipolar types, (1) and (2), are twice
as likely to be women. Bipolar and unipolar respond to medication
differently; thus, they appear to be different disorders.
Secondly, the symptoms found and the judgment of how serious
the symptoms are, vary according to who is making the diagnosis and
how it is being made. For instance, the judgment that a particular
person is depressed might be made by a therapist, family doctor,
friend, spouse, psychological tester, or by self-evaluation. There is
often little agreement among these judges; for instance, MD's miss the
diagnosis in 7 of 10 depressed men and 5 of 10 depressed women. On
the other hand, mental health workers over diagnose depression by
15% to 20%. Sometimes even the psychological tests don't agree with
