Because of the nature of depression, definition of the illness is not at all straightforward. Firstly, there are several different types of depression that are clinically recognized as distinct conditions. Secondly, the term is often used quite loosely in every-day life. Consequently, it is not at all simple to state an all-encompassing definition of depression which properly reflects the condition.
Depression and every-day sadness
As indicated, some of the confusion around the definition of depression arises from the fact that the term may often be used to describe moods that do not satisfy the diagnostic tests of depression. Thus, people may say that they are depressed generally, or that they are depressed about something in particular, when they are experiencing a quite normal low mood reaction to the circumstances they face in their lives.
In fact, this is not surprising, Aaron T Beck, one of the leading experts in depression of the modern era and the man who developed Cognitive Therapy, states that there is still uncertainty as to whether depression is an exaggerated version of normal mood or whether it is qualitatively different from a normal mood state (Depression: Causes and Treatment, Beck and Alford, 2nd Edition, 2009).
Official depression definitions
The World Health Organization, defines depression as:
” Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration.
It can be long lasting or recurrent, substantially impairing a person’s ability to function at work or school, or cope with daily life. At its most severe, depression can lead to suicide. When mild, depression can be treated without medicines but, when moderate or severe, people may need medication and professional talking treatments”
This definition of depression begins to get to the heart of the matter, although it doesn’t strictly accord with any of the diagnostic criteria for the various types of depression, since these also focus on the length of time that symptoms have been present and the degree to which they impact the individual’s ability to carry out the normal functions and activities of life (see the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) .
Nevertheless, the factors referred to in the WHO’s definition, when taken together and when present for an extended period, are undoubtedly suggestive of more than a simple sadness, or low mood caused by life events.
Beck, in Depression: Causes and Treatment, suggests that depression cannot be defined only by reference to mood. He contends that mood change may only be one element of depression and may not, in any event, always be present. His view is that the following are the key attributes by which depression may be defined:
- Specific alteration in mood, whether sadness, apathy or loneliness;
- A negative self-image involving self-blame;
- Desire for self-punishment, desire to escape, to hide or die;
- Physical or physically expressed changes such as anorexia, loss of libido or insomnia;
- Changes in level of activity, whether there be increased agitation or hyperactivity or withdrawal and inaction.
But what about how sufferers from depression describe the illness? You may find that a fellow-sufferer’s definition may be the best definition of all if it accords with your own experiences. Here are some examples (quotes taken from Brainyquote.com):
Depression is something that makes you lose your sight.
Depression is the inability to construct a future.
Depression is melancholy minus its charms – the animation, the fits.
Depression is rage spread thin.
Personally, I’d define depression by reference to the “living and partly living” refrain from the chorus in TS Elliot’s play Murder in the Cathedral. For me depression is “living and partly living”. When I’m in the depths of a depressive episode I physically exist and act but almost as if there are no emotional motivations behind my actions – living but only partly living.
Perhaps the precise definition of the term depression does not matter much in any event, although it is interesting in itself to consider it.
The important question – whether a particular person is suffering from depression – is a matter of diagnosis by reference to the thoughts, behaviors and feelings of that individual as judged against the generally accepted diagnostic criteria.
Assessment in that way enables a judgment to be made as to whether the person is suffering from a clinically recognized condition that can be treated by well-tried methods.
What is your definition?
No doubt there are differences in the way depression feels for all of us. But, it is definitely some comfort when you discover a description by somebody else that chimes with your own feelings. So, please add your own definition of depression in the comments below, so we can see how many versions there are and how many of us share a similar experience.