Definition Of Depression

[FayetheAspie]

I have a question about what counts as a depressive episode. If someone gets sad and cries 2 or 3 times a day for a few days or so in a row is it still depression if they are still able to find things to enjoy at times during those days? Don't you have to like be inconsolable and stay in bed all the time for it to be an actual depressive episode?

 

[Judge]

Difficult to answer in any generalized manner, given there are different- even more intricate forms of depression. Similar to autism, it's not a condition that can be so easily defined in any "cookie-cutter" fashion. Perhaps this can better answer such a question:

Types of Depression

I was formally diagnosed with chronic major depression back in 1982. Though I suspect this is something I have lived with since I was 15 years old.

For me it always ebbs and flows...and most of the time I'm quite aware of either. When it flows I may keep busy, but I seldom get any enjoyment of out things I otherwise love to do. Causing me on occasion to live literally in no more than 24 hour increments, not looking beyond my own horizon in my own best interest.

It can also be triggered by circumstances or people around me who may not realize how they can inadvertently bring me down into a depressed state with too much negativity in too short a time period.

Perhaps the most practical thing I try to do over things I truly have control over is to avoid making big personal decisions when my depression flows. Though in the real world it's easier said than done, especially if you have a job requiring big decisions daily. For better and for worse I tend to mask my depression apart from my autism when possible.

All I can say from my own perspective is that an "episode" may not necessarily reflect a serious- or permanent condition depending on a number of things to consider apart from its duration, and whether it repeats itself whether cyclical or not.

 

[Boogs]

Difficult to answer in any generalized manner, given there are different- even more intricate forms of depression.

Seconded. It's a spectrum (of course!) and it's at least partly about how much it effects normal daily function as to how it's diagnosed. On top of which as @Judge says, there are different types that can't be directly compared.

Some people can live with low level depression all their lives, but still be able to function on a day to day basis.
You can have an depressive episode for a short period, but it may well be founded on life situation rather than any mental or organic condition, and you wouldn't be likely to be diagnosed as depressed unless it persisted and/or kept returning, and, had a significant negative impact on daily function.

In other words, a diagnosis should come as part of requiring some sort of intervention. If there's no need for intervention (including talk therapy) then no need for a diagnosis.

Caveat - that's not medical rules or procedure to my knowledge but what I gleaned from my own experiences and my fathers knowledge as a psychiatrist. Pinch of salt as always!

 

[Jonn]

I have a question about what counts as a depressive episode. If someone gets sad and cries 2 or 3 times a day for a few days or so in a row is it still depression if they are still able to find things to enjoy at times during those days? Don't you have to like be inconsolable and stay in bed all the time for it to be an actual depressive episode?

I have heard it expressed that way.

Using personal experiences, being an expert in due to my 10 years of suicidal tendencies in my 20's:

At the time I describe depression as being in a deep, dark pit that I couldn't escape from.
It was a feeling that was omnipresent, in the background, if not front of mind.

Suicide was a way out of the misery and constantly considered.
I had various plans and attempted suicide a number of times.
I bough a motorcycle hoping it would help me along.

Spoiler

Spoiler:
I didn't do it.

Since those days, I have never been depressed, despite the continued gang-stalking.
Mountains of sadness, but no desire to leave this mortal coil prematurely.

 

[Misty Avich]

Usually for me a depression episode is triggered, like when being reminded how crap I am at having friends or that I'm definitely the only person in my family with ASD or that someone who experienced all the risk factors of having an ASD turns out normal. Probably anything linked to being reminded of ASD really can trigger a depressive episode. I mope about and think "it's not fair I'm like this and they ain't". It probably would help if I just accepted the fact that I'm on the spectrum but I can't. I just can't.

But even when autism is pushed to the back of my mind and I'm focusing on other things, I still do things what a person with depression would do, such as spending a lot of time in bed and finding it hard to motivate myself even at work.

 

[AprilR]

I have never been unable to leave the bed, though i have been suicidally depressed before. I think everyone experiences depression differently. For me it is an emptiness i feel, that i am useless and life is worthless. Thoughts like" why bother doing x, No one cares about you you are better off dead. " I don't have the will to live some days. I just do things i should do, going through the motions of what i should do and sometimes it helps

 

[FayetheAspie]

Thanks for all your descriptions. There tends to be a reason and usually is more like I'm just a little down and have frequent crying that I generally hold in except when by myself. Small joys can still be found during such times so probably don't count as depression. It rarely ever last more than 4 or 5 days anyway. I have been more depressed before but it takes something really major like loss of someone or something I care about to trigger it.

 

[Judge]

Since those days, I have never been depressed, despite the continued gang-stalking.

Sounds like we have more in common than you may think. In both my childhood and early adult years, I had numerous yet unwanted exposure with various groups of such people.

Though I think the worst was when I was a warehouseman/truck driver, having to frequent parts of town where simply wearing the wrong "colors" could get me beaten or killed.

As a kid in 60s Virginia it didn't help being Catholic and categorized as "unwanted" (and worse) much like people of color by some pretty strange people who seemed to like placing burning crosses in some peoples' front yards. Nothing like seeing some kids innocently on their way to catechism while being jeered at and called "Papists". Small wonder I cut my ties with religion a few years later.

And having to live occasionally on the other side of the country put me into close proximity at times with "one-percenters" who tended to loiter near my school. The sort of people you absolutely do not want to look in the eyes, even as a child. Confusing for me at times given my parents emphasized the need to always look people in the eyes.

Ironically I too wanted that motorcycle. Only to fit into a social group that turned out to be terribly toxic. Apart from my parents being outraged at the idea of two wheels without pedals. Never got one, yet even at my age I still think about it. FOMO...

Though in my own case while such scenarios would bring me down at times, my condition remains pathological. Like my Autism and OCD, my kind of depression is for the duration and always has been. I just deal with it the best I can, and try to stay abreast of when it ebbs or flows.

 

[Aspychata]

l hit a true depressed mode in my life. l was stalked for 4 years of my life by a man who l didn't know. This situation led to a bunch of complexities, and l hit true depression. It was like being in a bubble where l found only enough energy to get to work and to come home. l did eventually jump on a antidepressant which gave me the right chemical cocktail to resume living again, and l stopped the pills after about a year. I only wish to say to you, if you feel like you have zero energy to get thru your day or you are contemplating perhaps ending life, please seek therapy, or go to Emergency dept , where you can be observed and then referred to a medical professional to help you pull thru.

 

[Kayla55]

Don't be delusional: my underlying theme is when I'm gone hopefully the least I left behind was few improvements for people with autism to work in happy environ, and awareness that it won't kill people to include us, we actually very helpful and caring in our own ways.

One of my observations if you not watching your diagnosis is that it seems like other people are deliberately holding you back, that always brick wall as to why I can't have my own business. Hopelessness causes depression border onto manic, or at least how I felt.

 

[Jonn]

"I get knocked down,
But I get up again,
You're never going to keep me down..."

Spoiler

 

[SusanLR]

Depression for me has been like a low hum that is now a part of living since the loss of my parents.
They were the only people I've known in life that I felt really cared for me just as I am.
I've lived with a man that is verbally abusive ever since.
At my age and with disabilities, I don't think it viable to look for another or leave.
At least I have a place I can afford my share to live in and he has plenty of money.

I have just found my routine and even though I don't really want to get out of bed each day I just do it and get on with what I am able to do.
It is situational depression.

 

[Jonn]

Depression for me has been like a low hum that is now a part of living since the loss of my parents.
They were the only people I've known in life that I felt really cared for me just as I am.

I have always been a lone wolf, in nature.
I may not have been able to cope well with everything in life, but I did stumble along in my own independent way.
That made me rather self-reliant overall, without the need for a lot of social interaction.
If I couldn't handle something, I did with out.
And it was easier not to have any significant person in my life.

I was well on my way towards fading away comfortably without any notable ppl in my life, until I met a particular person about 6 years ago.
They were responsible for unlocking the trauma-related repressed/suppressed emotions.

Talk about a two edged sword.
Discovering oxytocin through significant friendships/relations again was a pleasure and a curse.
The pleasure of knowing and exploring interpersonal relationships creating person growth, and rediscovering the agony of loss.

But these days, with decades more of life experiences, the black dog has been replaced with the grey wolf.

 

[Boogs]

It is situational depression.

That resonates. But I wonder if it counts as depression (medically) simply to be depressed? Especially if it's got practical foundation rather than pathological?

 

[Judge]

That resonates. But I wonder if it counts as depression (medically) simply to be depressed? Especially if it's got practical foundation rather than pathological?

Interesting question.

Though it wouldn't surprise me if the medical community would consider such a question to be academic. That it's not about a "practical foundation" or precursor of depression, but rather the pathological result that ensues on a purely individual basis.

Otherwise society would be compelled to reconsider how many necessary, yet potentially toxic occupations and circumstances to be dealt with should be avoided. Simply because their very nature promoted a possibility of depression?

Not to mention society giving up on how to handle convicted criminals of all types, let alone their jailers. What's more objectively depressing than incarceration of any kind? Resulting in an inevitable breakdown of civilization on a broad scale. Where so many would go on workers compensation indefinitely because their job truly depresses them.

In other words, not a medical response to your question, but rather a societal one. Where doctors might agree, but policymakers would not. Hippocrates would not be amused.

 

[Boogs]

I meant pathological cause, i.e. resulting from dysfunction of some nature, rather than a result of environment.
I don't think it's academic - for example while on side they'd consider would be impact on social function regardless of cause, the other side would be the range and options for treatment (I'd imagine). But I honestly don't know how depression is diagnosed with regard to that side of it. But there are practical aspects.

As for society feeling compelled not to exploit those people who do the tasks that result in ill health (never mind punishment of criminals) - there'd be no society as we know it if they gave a rats arse about those people, imho. Hence the current deeply biased distribution of resources and conditions people live in. All of us who live in the wealthier nations benefit from mass exploitation, slavery, abuse of all sorts, to live the unsustainable lifestyles we mostly have.

 

[Judge]

But there are practical aspects.

They may exist by your definition, but if medicine chooses or is directed not to act on them, they would still seem academic as a subjective policy decision.

Policy in a society is not always objectively dictated by practicality. Tragic at times, but it happens nevertheless.

 

[Boogs]

They may exist by your definition, but if medicine chooses or is directed not to act on them, they would still seem academic as a subjective policy decision.

A practical aspect is a practical aspect regardless of who takes it up or not. If it has value as an action or method then surely it's practical? When you say "your definition' I'm not sure what you mean? My definition of what?

Policy in a society is not always objectively dictated by practicality.

I think we may be talking cross-purposes, I was talking about diagnosis not policy.

Maybe you're using a different meaning of 'academic' to me?
"Of or relating to studies that rely on reading and involve abstract thought rather than being primarily practical or technical."

 

[Judge]

A practical aspect is a practical aspect regardless of who takes it up or not. If it has value as an action or method then surely it's practical? When you say "your definition' I'm not sure what you mean? My definition of what?


I think we may be talking cross-purposes, I was talking about diagnosis not policy.

I'm just taking it a few steps further. Citing that even the best, most competent medical diagnosis cannot necessarily transcend situations involving institutions like the law and the courts.

That in circumstances involving criminal law, the prowess of the medical community fades...depending on those very same circumstances. Situations similar to insanity hearings and pleas, where the law- and policy takes precedent over medical findings and decisions.

Imagine long term convicts correctly connecting their long term depression to incarceration through the intervention of a competent psychiatrist. However I don't see the courts commuting a conviction just to appease medical professionals either. Where even the best, practical diagnosis based on pathological reasoning is likely to hit a brick wall. Though with our bureaucracy I don't see that as a real possibility either.

Basically just pointing out that doctors must yield to the court when applicable. No matter how good their diagnosis may be.

 

[Boogs]

I'm just taking it a few steps further. Citing that even the best, most competent medical diagnosis cannot necessarily transcend situations involving institutions like the law and the courts.

I imagine the laws and courts are just a framework within which the medical practices of that country have to operate, indeed couldn't operate without, and by their very nature are political entities.
But why would it want to transcend it?

Basically just pointing out that doctors must yield to the court when applicable. No matter how good their diagnosis may be.

But that's the case for everything, since it's the legal system that underpins the society. Also, how good a diagnosis is depends on definition

Imagine long term convicts correctly connecting their long term depression to incarceration through the intervention of a competent psychiatrist.

I think you're losing me a bit, I can't put that in context. Where does this suggestion come from? Maybe I've missed something in the thread.