Degree of severity
There are three diffent kinds of depression. These are:
What is mild depression?
Despite its name, mild depression is a distressing illness, whose symptoms are as follows:
- You feel generally sad and don't have the energy to do things that you usually do. You may be able to pull yourself together but not for particularly long periods.
- You don't enjoy things as much as you used to.
- You are distinctly tired, and sleeping doesn't help. You may misinterpret your tiredness and think that you have a physical illness.
- You may have non-specific physical symptoms. This means that you may be in pain "here and there", feel dizzy, have a tight chest, etc.
If you have had physical symptoms for a long time and cannot explain them, you may be suffering from mild depression. You should therefore go to your family physician.
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What is moderate depression?
The symptoms of moderate depression are similar to those of mild depression, but are worse and are present most of the time. You can pull yourself together for short periods only:
- You are sad
- You lack energy
- You show less of an interest in the world around you.
Your thoughts centre on:
- Feelings of guilt
- Low self-esteem
The people around you find it hard to understand why you feel guilty. You are also less happy with people or things in general.
You have little interest in your family or work. Your ability to concentrate is significantly impaired. You stop watching movies and your favourite TV programs, reading newspapers or books. You find it hard to concentrate.
Tiny everyday decisions may feel insurmountable. It can be hard to decide what you should buy for dinner. You have no desire to go out on the town or entertain guests.
If you suffer from moderate depression, you will normally suffer from mood changes during the day. This means that you may be miserable in the morning but better towards the evening.
Your sleep is disturbed. You don't feel rested. You may find it easy to fall asleep, but wake up after a few hours and can't drift off again. Many people find lying awake during the early hours very stressful. Here you are all alone with your sad thoughts.
You may find your appetite reduces during a bout of moderate depression. It's not unusual to lose 5-10% of your normal weight.
You generally lose your sex drive - you may need closeness and contact but find it difficult. Your lack of sex drive may trigger more feelings of guilt.
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What is severe depression?
If you suffer from severe depression you could have all the symptoms listed under mild and moderate depression, but in an even more prominent form. It is almost impossible to pull yourself together at all.
If you are suffering from severe depression, your sadness will be an "endless blackness" rather than the "endless greyness" experienced during moderate depression.
Some people cry a lot when depressed, while others simply can't cry.
Tiredness
Tiredness and a lack of energy are so dominant during severe depression that you may not be able to get up, have a bath or do anything at all.
Tiredness means that you isolate yourself. For example, you don't have the energy to:
- Answer the phone
- Invite people around
- Deal with other people, not even your nearest and dearest
Feelings of guilt
Isolation helps trigger feelings of guilt. Your low self-esteem is intensified and your lack of sex drive can result in guilt feelings and low self-esteem.
In some cases guilt feelings can be so strong that you think that you don't deserve to live. You may think:
- "Nobody benefits from living with such a sad person"
- "I'm more trouble than I'm worth"
- "It would be best all round if I were dead"
Your thoughts may centre on death and suicide, though you won't necessarily act on these thoughts.
You may have non-specific aches and pains, which are often exacerbated by severe depression. However, your GP cannot find any physical cause for them.
Your ability to concentrate is affected by severe depression, with the result that you may feel empty of thoughts or find it difficult to gather your thoughts. You cannot hang onto a single thought.
Your memory is also affected, and it may be hard to remember the simplest of things. You may find it hard to remember:
- To take your medication
- To go to agreed consultations with your GP, psychiatrist or psychologist
Your sleep is so affected that you only get a few hours' sleep at a time. This is distressing as you often wish you could "go to sleep and forget about it all". You want to sleep through everything and wake up only once your depression has lifted. But you also feel that you are never rested.
Your appetite may completely disappear. Others need to remind you to eat and drink. You don't have the energy to prepare meals and feel that your food doesn't taste good.
Your sex drive may disappear completely. You find physical contact impossible or unpleasant.
A severe bout of depression may mean that you become psychotic, although, fortunately, this is not common. However, this is a serious and sometimes dangerous condition. You may feel that you are the guilty party in accidents and catastrophes around the world. You may also feel persecuted. Perhaps you hear voices that ridicule or threaten you. You can become so distressed that you would rather die.
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