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Symptoms Of Severe Depression

First, let’s get some terminology straight. ‘Severe depression’, ‘major depression’ and ‘clinical depression’, are terms that tend to be used interchangeably to mean the same thing.

What these terms refer to is the condition described technically by psychiatrists as ‘major depressive disorder’. Therefore as we discuss the symptoms of major depressive disorder in this article, bear in mind that we are looking at what may also be called:

• Major Depression Symptoms
• Clinical Depression Symptoms, and
• Symptoms of Severe Depression.

The Symptoms of Severe Depression – The Technical Version

A person is suffering from major depressive disorder or (severe or clinical depression) if for most of the day, nearly every day for at least 2 weeks, they have had at least 5 of the following symptoms, including (1) and/or (2):

1. A low/depressed mood.
2. Significantly less interest in and pleasure from usual activities (this is called “Anhedonia”).
3. Significant change in appetite or weight.
4. Inability to sleep or sleeping more than usual.
5. Fatigue, loss of energy.
6. Feelings of guilt or worthlessness.
7. Lethargy or hyperactivity.
8. Difficulty concentrating or making decisions.
9. Recurring thoughts of suicide or death.

Now, let’s break that down a bit.

Step 1

First, it is important to note that low mood and/or loss of pleasure or interest in usual activities (Anhedonia) must be present.

In effect these are the threshold conditions. Doctors are sometimes recommended to screen for depression by asking questions to establish whether either of these two conditions are present.

Step 2

If you are suffering from low mood and Anhedonia, then the next consideration is whether 3 of the other listed symptoms are present.

If you are suffering from either low mood or Anhedonia, then 4 of the other symptoms need to be present.

Step 3

The next step relates to the duration of symptoms. The relevant symptoms must have been present every day for at least two weeks and must have been felt for most of every day.

Of course you may in fact have been suffering for much longer than two weeks or have had more than one episode where the symptoms have been present for at least two weeks. This is really the norm, of course – we don’t usually go to our doctor two weeks and one day after starting to feel depressed.

Step 4

The final step that I didn’t refer to above, but which it is crucial to consider, is that your symptoms must be a change from your normal state and have a significant impact on your day to day functioning. The symptoms must: “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

If you think about it, this is what is at the heart of an individual’s experience of depression. It is the inability to function normally that takes us out of the ‘feeling down’ camp into a whole new arena.

Symptoms of Severe Depression – The Real Life Version

Whilst it is useful for you to know the technical framework that doctors use to assess depression, the criteria may not necessarily reflect your own descriptions about the way you feel. We can all experience different symptoms or express them in different ways, both to ourselves and others.

Depression – what is it?:

“Diagnosis by counting is a totally absurd, and often very dangerous, proposition. When it works, we arrive at a very rough indicator of what may be wrong with us. Too often, the exercise is wholly misleading.”

For this reason, doctors assessing a patient for depression (assuming that are doing a thorough job) should ask lots of questions about the way the patient feels and look for examples of behavior that may or may not fit into the accepted criteria.

Some of the other ways that you might use to describe the way you feel, but which in substance may still fit within the technical criteria are as follows:

• Feeling flat
• Feeling very down
• Feel like I don’t care about anything
• Having to make a real effort to do anything
• Can’t really feel anything any more
• Don’t care about the things I used to
• Feel very on edge
• Feel very stressed
• Very irritable
• Can’t think straight
• Can’t make up my mind about anything
• Don’t feel like I can go on
• Feel useless
• Feel hopeless
• Don’t see any future
• Don’t see the point of anything
• Can’t get out of bed
• Don’t want to see anybody
• Don’t want to talk to anybody
• Can’t sleep
• Can’t eat
• Can’t stop eating
• Don’t have any energy
• Feel exhausted

Other Diagnoses:

If you feel that something is not quite right with your moods or the way that you feel, you need to be aware that there are various different types of depression and other behavioral or mood disorders. So, if your situation doesn’t reflect the symptoms of severe depression, then you or your doctor should consider whether any of the other possibilities might apply.

These include –

• Dysthymia (milder, prolonged depression)
• Bi-polar disorder (formerly manic depression)
• Adjustment disorder with depressed mood (a depressive reaction to a particular event or stress)
• Schizophrenia

Conclusions:

The symptoms of severe depression will usually be very clear to you if you stop to think about how you feel.

But, one of the major difficulties with depression, of course, is that it takes away our inclination to take action to put things right – we can just feel ‘too depressed’ to do anything about it.

That’s why it is essential that you discuss how you feel with somebody close to you, as they may be able to help you get the attention you need.

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Being Alone & Content To Be Strong Together

Being alone can be painful. It can also be blissful. It all depends on your level of personal development in this area. A joyful state when you’re alone is attainable. And it is a very worthwhile pursuit.

Once you learn how to be alone you will no long be chained to the desperate need to keep a person in your life even though the relationship is bad for you. Whether the person is a lover, a marriage partner, a friend, or even a family member what good is it if the relationship brings you pain and lower self-esteem? If you can’t bare the thought of being alone you will always be in a position of weakness in your relationships. However, once you learn how to be alone and truly enjoy it you’ll be able to negotiate your relationships from a position of strength knowing that you can end it and be okay.

We all experience moments of intense loneliness. We initially experience this when we are left alone for the first time as children. As we develop and grow we learn not to fear being alone. Nevertheless, there times when we face feelings of loneliness. These times can be extremely difficult at first.

Transitions in adulthood can bring on powerful feelings of loneliness. When we break up, get a divorce, or a partner dies we are suddenly alone. Before this event, we grew to rely on their companionship. We knew that during almost every evening, weekend, and holiday we would have someone to share it with. The sad feelings that you experience can be the same when a close friendship ends.

If your break up or divorce was preceded by months of tension, the separation might come as a relief initially. After a few nights and weekends alone, however, the relief can turn into desperation about being alone. It is at this point where profound growth is possible. You can use the pain of the break up and the loneliness to move yourself past the sometimes terrifying feelings of facing the future alone! Once you breakthrough and find your strength, which is present in you right now, you’ll experience a whole new world of personal power and freedom.

In the insightful book “Intimate Connections – The Clinically Proven Method for Making Close Friends and Finding a Loving Partner”, Dr. David Burns talks about the importance of learning how to enjoy being alone. He says that a person ability to have healthy relationship is in direct proportion to their ability to be alone.

If a person is comfortable being alone, they are in a position of power and not neediness in a relationship. People who do not have the ability to be alone will be imprisoned if they find themselves in a toxic relationship. You can break free by learning how to be alone and truly enjoy it.

– Surrender to Your Loneliness.

There is something indescribably sweet about surrendering to your loneliness. On that darkest of nights, when you come face to face with yourself, true self-discovery can occur. The quietness and the realization that you are completely alone in a world full of billions of people can be chilling. But once you embrace it and surrender to your aloofness you will begin to grow right there and then. And your growth can be rapid and profound. With each new experience of being alone you will grow stronger. Eventually you will begin to enjoy your own company without a nagging need to be with another person. Once you reach this point, you’ll have the power to choose whether you want to spend a Saturday night alone, with a friend, or with a love interest. Your ability to choose any of these options without any worries empowers you. Then if you do chose to enter into a relationship, you’ll be able to do it from a position of strength, independence, and confidence.

– How Do You Learn How to Be Alone?

Don’t fight being alone by trying to distract yourself. Don’t distract yourself by scheduling all your free time with friends. Don’t distract yourself with over indulgence of food, alcohol, drugs, television, the Internet, or video games. Just be with your loneliness until you come to terms with it. Face it head on! Deal with the feelings that come up. Stay with the discomfort until you find your way to contentment. If you are frightened, move toward your fears until they dissipate. As it is with most fears, you’ll most likely find that what you feared was only an illusion or a misunderstanding.

– Embrace Being Alone.

Embrace being alone by using these periods to get to know yourself on a deeper level. Perhaps on a deeper level than you have in your entire life. You can’t do this by spending a few hours alone. You need much more time. Several weekends or even an entire week’s vacation would provide a great start toward mastery of being alone.

Once you can spend a Saturday night, a weekend, or an entire vacation alone and truly enjoy it, you’ve mastered yourself. You teach yourself how to enjoy your own company by treating yourself like you would a close friend or lover. You look for ways to enjoy, entertain, and please yourself. And yes, I mean the big “M.” There are benefits to learning this art as well, especially for women. Men don’t need any coaxing in this area.

Whenever I refer to the benefits of learning to be alone, I am not only talking about you but also the benefits that your lovers and friends will enjoy. These relationships will benefit because you will be able to participate in them from a position of strength and giving rather than weakness and neediness. If you can’t bare even the thought of being alone you’ll put unhealthy demands on these relationships. You will also sell yourself short because of your inability to enter and maintain these relationships from a position of strength and confidence.

Use periods of being alone to get to know yourself. What do you like to do on a Saturday night? Take yourself out to a fancy dinner. Make yourself a gourmet dinner at home. Have fun! Enjoy your own company. Enjoy your own humor. Laugh at yourself. Do you get the picture?

If you don’t know what you find humorous when no one else is present, find out! If you don’t know what you enjoy to do by yourself, discover it! Make it an adventure! Make it an adventure of self-discovery!

Your goal is to find peace, contentment, and confidence when you are alone whether you are at home, in crowded public space, or at table in a fine restaurant filled with couples on a Saturday night! Once you are comfortable, content, and happy in each of these situations you have mastered the art of being alone. Once this is achieved and you are able to “choose” whether you want to be in a relationship or with other people, your ability to truly love and give without fear or measure will be greatly enhanced.

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