Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Throughout the course of our lives, we all experience episodes of stress, unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce
or loss of a job, we may feel depressed (some people call this "the blues"). Most of us are able to cope with these and other types of stressful events.
Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks
in a row, we may have what is called "clinical depression." The term clinical depression is usually used to distinguish the illness of depression from less difficult feelings of sadness,
gloom, or the blues.
Clinical depression is not just grief or feeling sad. It is an illness that can challenge your ability to perform even routine daily activities. At its worst, depression may lead you to contemplate, attempt, or commit suicide. Depression represents a burden for both you and your family. Sometimes that burden can seem overwhelming.
There are several different types of clinical depression (mood disorders that include depressive symptoms):
is an episode of change in mood that lasts for weeks or months. It is one of the most
severe types of depression. It usually involves a low or irritable mood and/or
a loss of interest or pleasure in usual activities. It interferes with one's
normal functioning and often includes physical symptoms. A person may
experience only one episode of major depressive disorder, but often there are repeated episodes over an
Dysthymia, often commonly called melancholy, is less
severe than major depression but usually goes on for a longer period, often
several years. There are usually periods of feeling fairly normal between
episodes of low mood. The symptoms usually do not completely disrupt one's
Bipolar disorder involves episodes of depression, usually severe, alternating with episodes of extreme elation called mania. This condition is sometimes called by its older name, manic depression. The depression that is associated with bipolar disorder is often referred to as
bipolar depression. When depression is not associated with bipolar disorder, it is called unipolar depression.
Seasonal depression, which medical professionals call seasonal affective disorder, or SAD, is depression that occurs only at a certain time of the year, usually winter, when the number of daylight hours is lower. It is sometimes called "winter blues." Although it is predictable, it can be very severe.
Psychotic depression refers to the situation when depression and hallucinations or delusions are experienced at the same time (co-occur). This may be the result of depression that becomes so severe that it results in the sufferer losing touch with reality. Individuals
who primarily suffer from a loss of touch with reality (for
example, schizophrenia) are thought to suffer from an imbalance of dopamine activity in the brain and to be at risk of subsequently becoming depressed.
Adjustment disorder is a state of distress that occurs in relation to a stressful life event. It is usually an isolated reaction that resolves when the stress passes. Although it may be accompanied by a depressed mood, it is not considered a depressive disorder.
Some people believe that depression is "normal" in people who are elderly, have other health problems, have setbacks or other tragedies, or have bad life situations. On the contrary, clinical depression is always abnormal and always requires attention from a medical or mental-health professional. The good news is that depression can be diagnosed and treated effectively in most people. The biggest barriers to overcoming depression are recognition of the condition and seeking appropriate treatment.
Depression in a child or teen may occur suddenly or develop gradually. Your child may seem more irritable than sad or may feel bored or hopeless. It is common for others to notice that a depressed child's body movements are slow, restless, or agitated. Your child may be self-critical or feel that others are unfairly critical of him or her.
The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that your child might have depression.