People use the word “depression” too often to describe short-term periods of feeling down or blue. The reality is that major depression differs from the “down” feelings that everyone has at one time or another. While the everyday blues often pass quickly without treatment, major depression is a life-altering mental health issue that is persistent and may be resistant to treatment. How can you tell the difference?
How Major Depression and the Blues Differ
One way major depression differs from the garden-variety blues most people get is the chronic, ongoing nature of depression. Most people with the blues have some idea of why they feel down. It could be related to family issues or problems at work. Even if they can’ identify it, the down feelings often subside within a few weeks.
However, two out of ten cases of major depression last at least two years. Even when the symptoms of major depression subside, they return in 90% of the cases. A person with major depression might get a brief reprieve from their feelings of sadness and insufficient interest in the world, but they’ll usually experience another episode.
The Symptoms of the Two Conditions May Overlap
Although the symptoms of the blues and major depression are similar on the surface, major depression causes more severe symptoms that are often persistent. When mental health professionals diagnose depression, they look at whether the individual has at least five of the characteristic symptoms of depression. These include:
- Anhedonia, a loss of interest in activities that once brought pleasure
- Feeling sad or tearful
- Insomnia or sleeping excessively
- Significant weight loss or weight gain
- Significant fatigue or insufficient energy
- Guilt or feelings of worthlessness
- Irritation or anger
- Thoughts of death or suicide
- Problems focusing or concentrating
For a doctor to diagnose depression, they check for five or more of these symptoms. Plus, they look to see whether the person feels sad or has a loss of interest in activities almost daily for 2 weeks or longer.
Unfortunately, there’s no blood test that diagnoses major depression. However, doctors sometimes order blood tests to rule out health conditions that could contribute to feelings of depression. These might include an underactive thyroid gland, type 2 diabetes, problems with the adrenal glands, and more. Even some medications can trigger or worsen depression.
How Severe Are the Symptoms?
People with major depression often have more severe symptoms than a person experiencing sadness or the blues. Depression can be devastating. It can also be a serious, ongoing illness that must be treated with professional care to allow the person to resume their life with meaning and joy. It’s not something that will disappear if you wait long enough. Delaying treatment can lead to further decline, self-harm, or suicide.
With major depression, the symptoms are persistent and severe enough to interfere with life and daily activities. The symptoms may come on quickly or gradually. It’s important to know if there was an event that triggered the symptoms, like a death or divorce. Feeling down or depressed may be situational or related to grief, rather than the more complex problem of major depression.
Major Depression is a Great Masquerador
Sometimes, major depression masquerades as dementia and cognitive decline. This is especially common in older people. They may be forgetful, have problems focusing, have difficulty finding words, sleep problems, and have irritability. These are signs of cognitive problems. However, they can also be associated with depression. That’s why people with cognitive problems need a thorough evaluation to rule out causes like depression.
As mentioned, the symptoms of major depression are also consistent with the mood changes that occur in people with an underactive thyroid. Even nutritional deficiencies, especially vitamin B12 deficiency, can manifest like depression.
The Bottom Line
Major depression isn’t just a case of the blues. The symptoms are more severe and persistent. The first step is to get a proper diagnosis from a mental health professional. Your primary care doctor may believe you have depression, but it’s best to ask them for a referral to a psychiatrist or psychological counselor who deals with major depression daily. It’s helpful to talk to someone who has a deeper understanding of the nuances of depression. Be honest and don’t try to hide the fact that you’re feeling down or sad for fear of being viewed as weak by others. Depression isn’t a weakness; it’s a mental health issue that has effective treatments.
- Medscape.com. “Distinguishing Grief, Complicated Grief, and Depression”
- Burke AD, Yaari R, Brand H, et al. Psychological masquerade. Prim Care Companion CNS Disord. 2011;13(6):PCC.11alz01318. doi:10.4088/PCC.11alz01318
- “Major Depression and the Blues: How to Know the Difference“.
- “Depression vs. Blues: Know the Difference – My HealtheVet.” 19 Dec. 2018
- “Depression Among Women | Depression | Reproductive Health …”