WHAT IS THE DIFFERENCE BETWEEN FEELING BLUE AND BEING DEPRESSED?

March 23rd, 2009

Almost everyone at one point or another experiences normal depression, a brief period of joyless, dejected, sad feelings that can accompany the usual day-to-day vicissitudes of life. In that sense, feeling blue or down in the dumps can be a normal reaction to disappointing life events if it is short-lived and transitory, lasting perhaps as little as an hour or at most a day or two. Once the adverse events are resolved or the person has had the chance to adapt to changed circumstances, the feeling of being down or blue usually evaporates on its own. And in the meantime, the person continues to function.

Major depression is something else. It does not just blow away in the course of a week or ten days. It persists for at least two weeks, according to the DSM-IV criteria, and sometimes for years. On the average, a major depression lasts three to eight months. Because ft lasts longer and is more serious than temporary feelings of lethargy, gloominess, or sadness, it impairs functioning in a real way.

Since the word “depression” is sometimes used to mean anything from a passing mood to a clinical illness, the first thing any doctor must do when a pattern comes into the office and complains of feeling blue or depressed is to conduct a detailed psychiatric diagnostic evaluation, obtain a recent physical exam, and get a personal and family history. A patient who facto sufficient symptoms to make a DSM-IV diagnosis of one of the depressive disorders may simply be experiencing a temporary down – a normal depression. Or the patient may be experiencing a subclinical depression with only one to two deprive symptoms, in the latter case, many psychiatrists, and particularly psychotherapists, term the subclinical depression a personality disorder since it does not meet the full DSM-IV criteria for any of the main categories of depression.

Prozac should not be used for the transitory down or unhappy feelings that everyone at times experiences. These are part of our normal range of emotions.

On the other hand, if the depression lasts for more than a few weeks, and is accompanied by a sufficient number of DSM-IV symptoms, a diagnosis of major depression, dysthymic or bipolar depression is made and action in the form of medication needs to be taken by a trained expert. This is usually a psychiatrist specifically trained in giving medications (psychopharmacologist).