One Name Means Many Things

depressed woman

The word “depression” confuses just about everybody. We all use the word to describe the most minor and brief down feeling. “Sunday afternoon blues”. Yet the same word, depression, can mean the worst medical down mood. The kind that needs actual medical care. And that same word can also mean every shade and type of moodiness in between the least and the worst.

What We Mean

So let us be clear. On this site we mean the real deal. Medical depression. It’s what the big book of American psychiatry, DSM-5, calls “Major Depressive Disorder”.


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But Still There Are Several Other Names

Despite the “official” doctor’s name, medical people and other clinical types still use other names for a real, medical depression, like “clinical depression”. And, to distinguish this clinical depression that is always down and never up from the up and down roller coaster swings of mania and depression in bipolar disorder, this depression is also called unipolar depression. The general idea is that this is a medical condition much as diabetes, heart failure, or a broken arm, and as such it needs real medical treatment.

So Not Just Lonely Saturday Night Blues

So if you’re feeling down on a Saturday night and a hot fudge sundae makes the world great again, that’s not the kind of depression we’re talking about. We do like hot fudge sundaes, though.

Depression is Common

To start with, this type of clinical depression is common. It’s the 4th leading cause of disability worldwide. One out of every 10 people everywhere in the world will have this medical depression at some time during their lives. So the likelihood is that you know someone with this type of depression. Or maybe you have had it.

What It Looks Like

Depressed people are sad. Their energy is low and they have an empty feeling. Often they are anxious or nervous as well. Nothing is fun and life is not good. They might eat too much, or, have no appetite. They might lose weight because they have no appetite or gain weight because they eat a lot, too much, comfort food. Sometimes they can’t sleep. Other times sleep is a good escape and they sleep a lot. Their body and their brain are clearly off kilter.

Spotting Depression

A good friend might be able to tell if you are badly, medically depressed. A close relative who actually cares about you might be able to tell. There are many easy, short computer or paper-and-pencil tests that will say maybe you have a medical depression. An experienced and skilled clinical person can probably see it from across the room. The bottom line is, seeing depression is not a mystery. It’s straightforward.

What Is Depression, Really?

So, what’s really going on in depression?

Medical science does not know. Or, to be fair, medical science has not fully and clearly defined all little bits and pieces of brain and body chemistry that are there when a person is depressed.

What we know, or what we think we know, comes from seeing what medicines help stop depression. The first good medicines for depressed mood were found by accident, and how those first medicines worked led the way to other medicines. It has been a slow step by step from one that works to the next one that works, hopefully the next one a bit better.

Why Not Just Jack Up The Whole Works?

Well, it’s been tried for over a 100 years. It doesn’t work. Give a depressed someone an upper and they should be up. Problem is, it just doesn’t work right. Maybe it works for a few hours but then that’s the end of it. We all know what uppers are, they’re medicines like the amphetamines. But odd as it seems, the amphetamines don’t treat depression. After that first few hours the depressed mood is back, maybe even worse. The upper can be used again but then it takes more medicine, a higher dose, to lessen the depressed mood. Within a few days of this up and down roller coaster, there is no high dose of upper that is high enough to change the depression. But with higher and higher doses of an upper drug the side effects add up and get toxic. Keep it up and it’s a trip to the ER. Yuk!

Slow But Sure, Well, Almost Sure

Another odd thing is that the medicines for depression take weeks to work. Not good. We need a quick depression medicine. Maybe this new use of ketamine? Time will tell.

So, What To Do?

Get help. Get medicine. Get therapy. There are many medicines and therapies that work well. Usually therapy plus medication works best. Sometimes more than one medicine is needed and a second one is added to help the first one work better. As with so many medical conditions, each person is an individual and needs a plan that is made for just them. Medical care, and certainly depression care, is not “one-size-fits-all”. The trial and error to find the right mix will be faster with the right treatment plan.

Helpful links:

National Institutes of Health, National Institute of Mental Health

National Library of Medicine (United States), Medline Plus

The Mayo Clinic

American Psychiatric Association