Family Ties, Medical Issues, Mental Health, Therapy

Maybe it’s NOT Depression

Depression is a very real and treatable mental health disorder, and one that most of us as therapists see often in our offices. Even when a client or a couple come in for another reason, sometimes as we work together, we find that depression is an underlying contributor. We have a specific set of criteria to screen for clinical depression in our clients. Treating the depression can then allow the other difficulties to begin to resolve.

Sometimes, though, a person may suspect he or she has a case of clinical depression, when in fact it may be something else with depressive symptoms. Let’s first review what symptoms typically make up a diagnosis of clinical depression:

  • Persistent sad, anxious mood, or a feeling of emptiness
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness – these feelings can make you feel like you can never get out of depression, or even that you deserve it
  • Loss of interest or pleasure in hobbies and activities that you used to enjoy
  • Lack of energy, lethargy, and fatigue
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, trouble falling asleep or staying asleep, or oversleeping
  • Loss of and/or unusual weight loss, or overeating and weight gain
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.
  • Thoughts of death or suicide; suicide attempts – if these are present, it is definitely time to reach out for help, immediately.

All of the above can create an impairment in a person’s life, relationships, and work, and one option is to reach out to a counselor or therapist in order to work on feeling better. As a therapist, I want to do a thorough screening to ensure that what we are dealing with is, in fact depression.

In my own screening, I will ask a client who presents with depression a lot of questions to help us get to the bottom of what they are experiencing. I want to know how long the depressed feelings have lasted, if there have been any major life changes, how the person is sleeping, and if there are any other seemingly unrelated symptoms that are bothersome. For example, if a client tells me they have recently experienced the death of a friend, I want to rule out bereavement as a reason for what they are experiencing. If a client tells me she feels depressed and is also going through menopause, or treatment for a thyroid problem, then I will want to work with her and her doctor to ensure that her treatment is appropriate. I also want to know about the person’s family system and how it works, and whether or not something may be occurring which is a contributor. In other words, just feeling down, or sad, is not enough for a diagnosis of clinical depression.

Sadness, helplessness, or lack of motivation or energy, can occur for a number of reasons unrelated to mental health.  Sometimes these are even perfectly normal reactions to life events or physical condition.  If you are feeling depressed and this continues for more than a couple of weeks, or if you are feeling very overwhelmed and down, do see a mental health professional to help you determine what is going on and help you find a path to feeling better.


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