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Feeling down is a common human experience.  How do we figure out if someone is depressed to a point that requires action or just feeling down through a time of life that involves change? See the descriptions below and ask for help from your clinician to connect with a Behavioral Health Consultant (BHC) if you think we can help you.

Depression has sides to it that can affect our mood and general outlook on life. If you find yourself feeling down or low for a week, see the definitions below to see what area your depression falls into. This is not a complete list, but it helps you understand the different levels depressive symptoms can fall into so you can begin to understand its effects on your whole health picture.

Persistent depressive disorder

This disorder is identified by the length of ongoing symptoms of depression (two years or more). These symptoms are observable in self and by others. But important to note is this person has not been suicidal at any time—just down.

  • Poor appetite or overeating
  • Insomnia (unable to sleep) or hypersomnia (being extra sleepy)
  • Low energy or easily tired
  • Low self-confidence
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

This can be someone who never seems to really enjoy life or events. They will always be just a little low and are often negative in outlook. This person can also have physical health issues that can be overlooked because they usually do not ask for care and often avoid good self-care. Yet, they may also go to an appointment with physical complaints of tiredness and exhaustion but have no physical illness to explain their condition.


Major depressive disorder

This disorder is identified by a more severe form of depression that lasts a shorter amount of time and has more intense symptoms.

  • Depressed mood for most days
  • Lack of interest in activities that were previously enjoyed
  • Significant weight change—loss or gain
  • Insomnia (unable to sleep) or hypersomnia (being extra sleepy) nearly everyday
  • Tired every day
  • Restlessness (fidgets) or lethargy (not being active) nearly every day
  • Feeling worthless or guilty nearly every day
  • Decreased ability to think or concentrate nearly every day
  • Frequent thoughts of death, suicidal ideation, attempt or plan

This person usually has had periods of normal moods where they have not felt this way. And they will have slipped into this low mood for most days during a two-week period.

This is not usually as a reaction to a major loss or life event, but because of something unknown to the person. This person might not look for care for depression but might notice they just don’t “feel good”. Sometimes an underlying health condition can make these symptoms worse or appear unrelated, but the mind and body can be affected together. It is always wise to seek a medical consult and determine if it has a physical piece with your clinician.


 Premenstrual dysphoric disorder

This disorder is for women who struggle with extreme symptoms during the week before the onset of their menstruation (period). Symptoms decrease and are absent during the other three weeks of the month.  This disorder is fairly intense, constant, and women who suffer note they are not just moody, they do not feel like themselves.

The week before onset:

  • Very moody and tearful
  • Likely to have feelings of rejection
  • Noticeable worry or anger
  • Feelings of hopelessness, negative self-talk
  • More anxiety, tension or feeling restless
  • Decreased interest in usual activities
  • Having a hard time concentrating
  • Feeling lazy, tired
  • Insomnia (unable to sleep) or hypersomnia (being extra sleepy)
  • A sense of being out of control or overwhelmed
  • Physical symptoms such as breast tenderness, bloating or muscle pain

These symptoms show up about a week before onset. They cause significant stress for the patient, family, and close relationships.


Depression due to a medical condition

See major depressive disorder for symptoms. But note that sometimes physical conditions can cause or add to the mental symptoms one can have. It is common to have a medical condition that is chronic and have depression that goes along with the symptoms as they could be related. Talk with your clinician to see if a Behavioral Health Consultant would benefit you.

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