What are the differences between feeling sad and experiencing clinical depression?

Doctor's Answer

Feeling sad can be a normal experience. It is normal for an individual to experience a range of emotions and that would include sadness. Many patients who are recovering from depression complain of antidepressants causing them to be blunted emotionally as they do not experience happiness or sadness.

They feel like a robot - emotionless. It is normal for a person to feel sad when something bad happens or when things go wrong. The sadness may last for hours or days. However, he/she would bounce back pretty fast and there are no adverse effects on the person's work, education or relationships with others [1].

Clinical depression is more serious than typical sadness. Depressed mood is consistent with both major depression and persistent depressive disorder. In major depression, an individual must feel depressed most of the day, nearly every day, for at least two weeks, as indicated by either subjective report or observations made by others.

For children and adolescents, they may appear more irritable than sad [2]. A person with a depressed mood may report feeling "sad" or "empty," or may cry frequently. Having a low mood is one of the two core symptoms which is used to diagnose depression.

People with persistent depressive disorder experience a depressed mood more days than not for at least two years. Children may appear more irritable than depressed and they must experience it more days than not for at least one year. It may be chronic and less severe than a full-blown major depression, but could also represent symptoms of a major depression that have persisted for more than two years.

In essence, three-pointers can be used to distinguish normal sadness from clinical depression.

  1. Look at the duration of the sadness.
  2. Look for other accompanying features of major depression and persistent depressive disorder.
  3. Examine if the low moods affect a person's level of functioning.

If a person becomes suicidal or is very negative in his outlook in life, it is important to arrange for a consult with a psychiatrist for further evaluation.

References:

1. Depression. Healthhub.sg. Published 2019. Accessed December 13, 2019.

2. Wilkinson PO. Managing depression in childhood and adolescence. London Journal of Primary Care. 2009;2(1):15-20. doi:10.1080/17571472.2009.11493236

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