We often hear statistics about how much of the population is depressed - or "clinically depressed."  While depression is a term that is widely used, it can mean vastly different things to different people.

Some people tend to "make mountains out of molehills", while others minimize their experiences, seeing everyone else as worse off than themselves. The majority will fall in the middle, and are often left wondering, "Am I just really sad? Is this normal?"

Here's the thing. According to the American Psychiatric Association, which publishes the Diagnostic and Statistical Manual (DSM - we're on version 5 at the moment), there are certain criteria for official diagnosis with Major Depressive Disorder, Persistent Depressive Disorder, Bipolar Disorder, Disruptive Mood Dysregulation Disorder, Depressive Disorder Due to Another Medical Condition, Premenstual Dysphoric Disorder, and so on. The criteria for these, as well as their names themselves, have changed over time. Also notice that these diagnoses have been determined by the *American* Psychiatric Association. That means that these disorders can have different names and criteria in different countries.  In fact there is a whole other system, the International Classification of Diseases (ICD), published by the World Health Organization, that overlaps, yet has some different terminology. 

Insurance companies require that you have a "billable" diagnosis to justify them paying for your treatment, so a psychologist will assess your symptoms to see if you fit into one of these categories (which are based on clinical research). If you do, your insurance is likely to cover your treatment. If you do not, you can still get therapy, but you will need to pay out of pocket. Psychologists are trained to treat "mental illness", but we can also work to promote growth, increase resilience, improve emotional intelligence, and relieve real symptoms that fall outside of the "official" diagnosis criteria.

That said, depression is not just, "I'm so sad I want to die." I will frequently see clients who say, "I'm not depressed. I mean, I've never tried to kill myself or anything." It's true, people do get to this point. But it is not necessarily where depression starts, and it is not the only symptom. 

Other signs of depression:

• Eating more or less than usual - unintended weight loss or gain

• Sleep  disruption - either too much or too little (including having negative thoughts keeping you up all night)

• Difficulty concentrating, having trouble making decisions, or not being able to think clearly

• Inertia - difficulty getting motivated to get things done, not caring

• Moving, speaking, or thinking slowly - something others might notice more than you do

• Feeling guilty, worthless, or undeserving - even the idea that you aren't miserable enough to need treatment could fall under this!

• Not enjoying things that you used to. Saying no to invitations that used to be an immediate yes. Putting down that project and not picking it back up. Not being in the mood for sex. Just not feeling like there's anything that's worth the effort.

• Thoughts of death like "I'm just tired of it all," "No one would notice if I were gone," "It would be easier if I didn't exist," and so on.

• Physical symptoms such as nausea, aches & pains, high blood pressure, bloating, or a weakened immune system

And yes, of course, you will *feel* sad, or have a "depressed mood" most of the time. 

For an official diagnosis, there are time requirements and there must be significant impairment. In other words, your symptoms have to be interfering with your day to day functioning. If they are not, and you are plodding through life feeling miserable but managing to meet your obligations, you are one of the "walking wounded" who may not qualify for insurance reimbursement, but who are certainly not getting the most out of life.

I can help you either way. If you meet the official criteria, or if you just want to experience more enthusiasm and get out of bed on the weekends. In some cases, you may also need to work with a psychiatrist to find a medication that can lift your mood enough to do the mental work you need to feel better long term.

If you are feeling stuck, down, in a funk, or if you believe you are truly depressed, reach out below to set up an introductory online session. 

If you are seriously considering harming yourself, are feeling suicidal, or just need to talk, please call the National Suicide Prevention Lifeline at 800-273-8255 or text HELLO to the Crisis Text Line at 741741.