If you are always in a bad mood, does that mean you have depression? How can you tell?

Someone took a depression questionnaire in the hospital and the result showed a very high score. The examination form said "severe depression" and he immediately thought he had severe depression.

In fact, "major depression" and "very serious depression" do not mean the same thing.

A similar situation is that someone finds a depression questionnaire online, and then finds out that his score is over a certain number of points, so he breaks out in a cold sweat, thinking he has depression.

Therefore, it is very necessary to distinguish between depression and depressive symptoms.

Common depression questionnaires on the Internet measure depressive symptoms, and a high score only means that the score of depressive symptoms is relatively high.

People often think that depression is a bad mood, but in fact, a bad mood is just one of the symptoms of depression. This misunderstanding is difficult to eliminate for a while, because the first record of the word "depression" in Chinese comes from Bai Juyi's "Letter to Yuan Jiu". At that time, Bai Juyi, who was demoted to Sima of Jiangzhou, mentioned "hesitation and depression", which may be mainly to express his emotions.

Illustration: Yang Jingyi

When a word used by a poet is borrowed by medicine, it is inevitable that some misunderstandings may arise.

Currently, symptoms of depression are mainly divided into four categories.

1. Emotional manifestations of depression symptoms

First of all, in terms of emotions, depression actually corresponds to a group of emotions, which include, in addition to sadness, feelings of guilt, failure, and punishment.

Depressed people often have a low opinion of themselves and are prone to denying their own worth, which leads to a sense of failure.

Sometimes some patients may not be good at expressing their emotions and think that "there is nothing wrong with them in life", but their low mood can be inferred from easy tears or continuous sighing.

The sense of guilt of patients with depression may sometimes be out of touch with reality, for example, they may think "I have committed a great sin and feel sorry for my family" or even think "my existence may affect the appearance of the city."

Irritability is also a common symptom of depression, and this feature is more obvious in children and adolescents.

2. Cognitive manifestations of depressive symptoms

Secondly, symptoms of depression also manifest in cognitive aspects, such as suicidal thoughts, concerns about health, slower thinking, difficulty making decisions, and feelings of hopelessness.

Suicide is a very serious issue. It is the leading cause of death among people aged 15-34 in my country. In addition, the suicide rate among the elderly in my country is higher than that among the young. When someone commits suicide, people often ask what happened before the suicide. In fact, no matter how extreme the event an individual experiences, it does not mean that the person who experiences the event will commit suicide. One of the common causes of suicide is depression.

Health is indeed something that each of us should care about, but excessive worry about health may affect our lives.

Cognitive symptoms of depression may also include difficulties with memory and attention . They may have selective attention and enhanced memory for content that evokes negative emotions.

Lack of hope is also a characteristic of depression. This sense of hopelessness not only refers to the present moment, but also to the future.

In psychology, there is a term called "tunnel vision." In other words, they seem to be observing the world and predicting the future in a direction that they cannot see the light.

Not seeing hope is not an objective indicator. A person who is trapped in depression and sees no hope may be seen by others as a very successful person, a person who is considered excellent by everyone, or even an enviable person.

3. Behavioral manifestations of depression symptoms

Third, depression also has behavioral manifestations . These manifestations are often observable by outsiders and may be a decrease in work or study efficiency. Sometimes individuals are unable to complete the study or work they were able to complete before, and sometimes they can complete the study or work, but it requires more time and energy.

Decreased interest is also a behavioral manifestation of depression. For example, a person who used to like playing table tennis and has played for decades may feel that table tennis is no longer important to him after becoming depressed.

Social withdrawal is also common. Corresponding to the table tennis example, a depressed individual may not only no longer actively invite teammates to play, but may even be indifferent to the teammates' calls.

4. Physical manifestations of depressive symptoms

Fourth, depressive symptoms can also manifest themselves physically.

Sleep disturbance is often the first symptom that people with depression complain about to their doctors. Most people will complain that they are sleeping too little, but some people may be sleeping too much.

Changes in appetite and accompanying changes in weight are also two interrelated physical symptoms of depression. People often think that depressed individuals will have a loss of appetite and a significant weight loss. However, for some individuals, the symptoms may be the opposite: appetite becomes better and weight increases accordingly. The author speculates that the reason may be the current popular dieting. When dieters are in a bad mood, they tend to eat more, rather than the typical "too sad to eat" situation.

Loss of energy is also a physical symptom of depression. Depressed individuals often feel "tired." This tiredness is different from fatigue after a day's work: fatigue can be relieved by rest, while the tiredness of depression is more difficult to relieve. For some severely depressed individuals, even completing tasks such as dressing and washing may be difficult. The highest risk of suicide for some patients with severe depression is not when their symptoms are the most severe, because when their symptoms are the most severe, they may not have the energy to complete their suicide plan. It is precisely when they begin to recover that the risk of suicide is highest.

Loss of libido is also one of the physical symptoms of depression. In addition, the physical manifestation of depression symptoms may also be pain , which may occur locally or throughout the body.

There is no absolute indicator of which category the above symptoms should be classified into. For example, although guilt is classified as an emotion in this article, thinking plays a decisive role in the formation of this feeling.

If we use a commonly used depression scale to measure, in fact many people will not score 0 on every item. In other words, many people have some symptoms of depression. However, even if the symptoms are obvious and the score is relatively high, it may not meet the diagnostic criteria for major depressive disorder.

The diagnosis of depression can only be made by a psychiatrist, and questionnaires cannot replace diagnosis.

The diagnosis of depression has very strict criteria. In addition to meeting the diagnostic symptom requirements, it is also necessary to consider the duration of the symptoms, the individual's degree of pain, the impact on function, and some exclusion criteria.

Author: Wang Kui

PhD in Psychology

Associate Researcher, Institute of Psychology, Chinese Academy of Sciences

Second-level psychological counselor