Situational vs Clinical Depression

There are many types of depressive disorders; however, due to the trying circumstances that many find themselves in today; I thought it might be appropriate to write an article on Situational Depression vs Clinical Depression.

What is the difference between situational depression (SD) and clinical depression (CD)? This answer will determine the therapy. Both SD and CD share a common bundle of symptoms. Feeling down, loss of appetite or increased appetite, change in sex drive, sleeping issues, lack of energy, apathy, problems concentrating, feelings of guilt, physical pain, agitation, feelings of hopelessness. These are all symptoms that both situational and clinical depressive disorders share. Distinguishing symptoms that are more closely associated with CD are suicidal thoughts, symptoms occurring for no apparent cause or well beyond the alleviation of the stressors; and a family history of depression.

Generally we will consider the severity and number of symptoms of depressive episode in determining the cause; however, this can be a bit tricky because both disorders can entail a bundle of severe symptoms which will vary from person to person depending on the trauma or stress in their lives. As a general rule, CD is much more severe and prolonged, causes more impairment in functioning and doesn't tend to go away once the stressor is removed. Also, the more stressors that one has with difficult situations, the more likely the person is of developing a CD.

Situational Depression:Typically major stressors in life will bring on SD such as a divorce, death of a loved one, loss of a job, the economy or any factors that will negatively affect your life - and these can be very debilitating. When these triggers are present a practitioner must look at the length of time that the symptoms have occurred, the number and type of symptoms, and the family history of the individual. The length of time for SD symptoms will usually coincide with the duration of the stressful events. Again this is not an exact science in making the distinction between SD and CD. Situational depression is quite normal and these stressors should bring on feelings of angst, the blues, and other symptoms. Emotionally healthy people grieve over these situations. SD will typically remit once the stressors are no longer present or it will decrease as one learns to cope with the situation. This kind of depression might respond to exercise and diet as well.

Clinical Depression: Sometimes the major stressors in life will trigger Clinical Depression; when this occurs, making the distinction between SD and CD can be a challenge. We may look at the symptoms to see if they exist long after the stressful events have ceased. Again, suicidal thoughts are a telltale sign of CD. Sometimes a patient responding positively to an antidepressant will confirm that the disorder is CD because the medication is treating an imbalance of chemicals which are the underlying cause of CD. Chemical imbalances are typically not associated with SD; however, some genetic studies are “showing” that exposure to long periods of trauma or stress “might” turn certain genes on or off, may cause them to mutate and therefore affect the chemistry of the brain. These studies are in their early stages; however, scientists are making great efforts in the field of genetics and mental illness. We have already discovered that the more stressors/traumas that one has had, the more vulnerable one is to developing CD either presently or in the future; especially in those who are genetically predisposed to CD.

Clinical Depression: CD is most evident when a combination of four or five of the aforementioned symptoms occurs without any apparent traumatic or stressful events present. Additionally, suicidal thoughts are almost hand in handwith CD; however, this doesn't entail that every individual with CD has suicidal ideations. The inability to enjoy almost any aspect of life is another sign of CD. A family history of depression is an indicator of CD since we are quite sure that it is a genetic illness. Most often CD will last for long periods of time but can subside within six months to one year even left untreated. If someone has CD and they respond favorably to antidepressant medication, this might also be a good indication that their depressive disorder is caused by an underlying chemical imbalance instead of a stressful situation. Medication is very important in treating depression because when left untreated, CD can cause brain cell (i.e. neuron) damage over a long period of time. Studies have shown that the antidepressants will protect the neurons from damage from the stress hormones produced at the time someone has a depressive episode. Therefore, antidepressant medications have a long-term beneficial effect, in that, they are protective in preventing neuronal death and or damage. Imagine an actual good long-term effect of a medication. This is definitely not mainstream knowledge or news that you have heard most likely on TV; but this is what the latest research is showing us.

Situational depression is always accompanied by traumatic events or stressful situations and will typically be short lived or continue with the presence of these events. SD can be very debilitating and should be treated, especially when it interferes with everyday tasks, relationships, and daily functioning. Often the best treatment for SD is exercise, removing the stressors in your life, changing your worldview, and diet; just to mention a few. When SD continues for a period of time, which may be as few as two weeks, and the symptoms don’t appear to be subsiding, seek help. If these symptoms are actually triggers leading to CD, the sooner you begin therapy the greater the chances are of precluding a severe CD episode. The longer one goes without treating a depressive episode, the more they have more neuronal cell death and cell damage. Clinical depression can be triggered by traumatic events or stressful situations - or it sometimes manifests when life is going seemingly well. In other words, CD is often the cause of the depressive disorder when several symptoms are present without the stressful events. Suicidal thoughts and a family history of depression are also indicators of CD and one should seek help immediately. So, as you can see, it is sometimes difficult to tease apart the type of depression one has. Therefore, it is necessary to be evaluated by a trained professional that can determine whether or not a medication is indicated in your particular type of depression. Different types of depressive disorders will each require a different treatment plan, this is why it is important to know what kind of depression is grounding the symptoms.

If these symptoms persist beyond the alleviation of the stressors, or don't get better, if you have a family history of depression, or you are having suicidal thoughts – please seek help immediately. The antidepressant medications today have efficacy rates over 70% even with the first one tried and most of the time they are well tolerated. There are also other treatments available such as Vagus Nerve Stimulation and TMS therapy just to mention a few.

This article is for informational purposes only and not for diagnosing or treating any medical condition