There are weeks when nothing brings joy and everything falls apart. Sometimes it really is just a tough week, but sometimes it is a condition that does not go away on its own. Let's calmly discuss where the line between sadness and depression lies, how it manifests physically, and when outside help is needed.
Sadness and depression are not the same
Sadness is a normal mood change; depression is a depressed mood or loss of interest that persists for most of the day, nearly every day, for at least two weeks. It is not about a bad day—it is about a period that does not change even when something around you changes. Depression affects all areas of life: relationships with loved ones, work, study, and daily activities.
What a depressive episode looks like
A depressive episode rarely consists of a single feeling. According to DSM criteria, over more than two weeks, at least five symptoms are present simultaneously, and among them there must be at least one key symptom—depressed mood or anhedonia, i.e., loss of pleasure from things that previously brought joy. In addition to these two, the list includes others:
- constant fatigue and lack of energy even after minimal effort;
- difficulty concentrating, feelings of guilt or low self-worth;
- sleep disturbances, changes in appetite or weight, thoughts of death;
- agitation or retardation;
- weight change of more than 5%.
The body speaks too
Depression also manifests physically. Typical signs include early awakening—several hours earlier than usual, morning depressive states, pronounced retardation or agitation, loss of appetite and body weight, and decreased libido. Depression worsens overall health and well-being, causes fatigue, general weakness, asthenia, and reduces memory, reaction time, and concentration.
What increases the risk
Depression arises from the interaction of social, psychological, and biological factors. In 2023, approximately 4.1% of adult men and 6.2% of adult women had depression, meaning women are about 1.5 times more likely. Over 10% of pregnant and postpartum women experience depression. Risk increases after difficult events: loss, unemployment, traumatic experience, violence. Depression is closely linked to physical health: low physical activity and harmful alcohol use are risk factors for both depression and cardiovascular, oncological, diabetes, and respiratory diseases, and these diseases themselves can worsen depression. Preventive programs can reduce depression levels.
How diagnosis is made
According to DSM criteria, duration of more than two weeks, number and severity of symptoms, and their impact on social or professional life are assessed. Standardized tools are also used, such as the Beck Depression Inventory and the Hamilton Rating Scale. Separately, the doctor rules out other causes: similar symptoms can be caused by medications, substances, or diseases, including thyroid dysfunction. Depression should be distinguished from negative symptoms of schizophrenia and from symptoms of neurosis, which is often diagnosed in people with depression. Based on the number and severity of symptoms, the episode is classified as mild, moderate, or severe; there can be recurrent episodes and bipolar disorder, where depressive phases alternate with periods of increased activity.
Where to seek help
If you have symptoms of depression, seek help from a doctor or mental health professional. In high-income countries, only about one-third of people with depression receive treatment for mental health, and one reason is social stigma. Psychological methods are the first line of help; they are combined with antidepressants for moderate and severe depression, while for mild depression medications are not needed. Psychological help can be obtained in person or online.
If you feel you may harm yourself in the near future, immediately call 103 or 112. Here help is needed right away, not in a week.
This material is for informational purposes and does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer