Depression health centre

Major depression (clinical depression)

Major depression is also known as clinical depression. People with major depression feel a profound and constant sense of hopelessness and despair.

With major depression, there are symptoms that make it difficult to work, study, sleep, eat, and enjoy friends and activities. Some people have clinical depression only once in their life. Others may have it several times in a lifetime.

What is major or clinical depression?

Most people feel sad or low at some point in life. But clinical depression is marked by a depressed mood for most of the day, particularly in the morning. In addition, you may have other symptoms with major depression. Those symptoms might include:

• Fatigue or loss of energy almost every day
• Feelings of worthlessness or guilt almost every day
• Impaired concentration, indecisiveness
• Insomnia or hypersomnia (excessive sleeping) almost every day
• Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia, this symptom can be indicated by reports from significant others.)
• Psychomotor agitation or retardation (restlessness or being slowed down)
• Recurring thoughts of death or suicide (not just fearing death)
• Significant weight loss or gain (a change of more than 5% of body weight in a month)
• To distinguish your condition as major depression, one of your symptoms must be either depressed mood or loss of interest. Also, the symptoms must be present for most of the day every day or nearly every day for at least two weeks.

Who is at risk of major depression?

About one in 10 people in the UK may suffer an episode of major depression at some point during their lifetime.

Major depression affects adults, teenagers, children, and the elderly alike. Major depression frequently goes undiagnosed and untreated in children and the elderly.

Are women at higher risk of depression?

About twice as many women as men are diagnosed with major depression. It's thought that hormonal changes in women during puberty, menstruation, pregnancy, miscarriage and menopause may increase the risk of major depression.

Among other factors that increase the risk of major or clinical depression are increased responsibilities at home or at work. Juggling children, careers, commitments and caring for an ageing parent may increase the risk of major depression. Bringing up a child alone will also increase the risk.

What are the signs of major depression in men?

Depression in men is significantly under-reported. Men who suffer from clinical depression are less likely to seek help or even talk about their experience.

Signs of depression in men may include irritability, anger, or drug and alcohol abuse. Repressing their feelings can result in violent behaviour directed both inwardly and outwardly. It can also result in an increase in illness, suicide, and murder.

What triggers major depression?

Not everyone has a trigger for clinical depression. Some common triggers or causes, however, include:

• Grief from losing a loved one through death, divorce, or separation
• Interpersonal deficits that lead to social isolation or feelings of being deprived
• Major life changes - moving, graduation, job change, retirement
• Personal conflicts in relationships either with a significant other or a colleague
• Physical, sexual, or emotional abuse

Major depression also seems to occur from one generation to the next in some families. However, major depression can also occur in people who have no family history of depression.