Feeling down: when does a mood become a disorder?
More severe depressive disorders are accompanied by the individual experiencing gravid depressive symptoms (such as suicidal preoccupations), by distinct impairment (such that it prevents them from going to work) and lasting more than two weeks.
Although severity is an important thing to consider in depression, we prefer to distinguish by depression type, not just severity. Depressive disorders can be divided into two types – melancholic and non-melancholic conditions.
The latter is a diverse group that could reflect the contribution of severe life events, such as being humiliated by a partner or a personality style that predisposes someone to depression.
Such personality styles include being an anxious worrier, sensitive to judgement by others, being a perfectionist, having intrinsically low self-esteem, being profoundly shy or having a low sense of self-worth since childhood.
In contrast, melancholic depression is better positioned as a disease, having rather specific clinical features, a strong genetic contribution, biological underpinnings and responding only partially to counselling or psychotherapy but well to antidepressant drugs.
During melancholic depressive states, the individual lacks energy, experiences little pleasure in life, is physically slowed down, and tends to feel much worse in the morning.
One does wonder when you cross that line into depression. I am a sort of melancholy personality bu it is hardly depression. And when I was fighting chronic pain there was depressive bouts with the migraines, When the pain was high. With status migraines. Dangerous plummeting moods. Gone when the migraine was gone. Then this sort of invisible line is crossed. Then there are these passive suicidal thoughts all the time, they just occur all the time really. Wouldn't it be nice to just not wake up in the morning. Or if these chest pains were actually a heart attack. And occasionally active suicidal thoughts. A few actual failed attempts. And I am clearly depressed by any ones accounting of it.
The question I ask; was it spawned from the pain? Or did it come along for the ride to make it so much worse. Moot really. Since it is along for the ride. b8d5ecf66280a113980162082f3f459522481f5f4973b5eee7