Situational depression or clinical depression?
Situational and clinical depression are similar but not the same. Recognizing the differences between these types of depression is the first step toward getting help.
Situational depression is known medically as "adjustment disorder with depressed mood." It often resolves in time, and talking about the problem can ease the recovery process.
Clinical depression, known medically as "major depressive disorder," can develop if the individual does not recover. This is a more severe mental health condition.
What are the differences?
A disappointing event or devastating news can lead to short-term symptoms of depression.
Some key differences between situational and clinical depression will determine the type of treatment the person needs and the severity of the condition.
No type of depression is more "real" than another. Both can present significant challenges and threats to wellbeing.
However, knowing which type of depression is at the root of a persistent negative mood can support recovery.
This is a short-term form of depression that occurs as the result of a traumatic event or change in a person's life.
Adjustment disorder with depressed mood is another name for this emotional state.
Triggers can include:
- loss of a job
- the death of a close friend
- a serious accident
- other major life changes, such as retirement
Situational depression stems from a struggle to come to terms with dramatic life changes. Recovery is possible once an individual comes to terms with a new situation.
For instance, following the death of a parent, it may take a while before a person can accept that a family member is no longer alive. Until acceptance, they may feel unable to move on with their life.
Symptoms can include:
- feelings of hopelessness and sadness
- sleeping difficulties
- frequent episodes of crying
- unfocused anxiety and worry
- loss of concentration
- withdrawal from normal activities as well as from family and friends
- suicidal thoughts
Most people who experience situational depression begin to have symptoms within 90 days of the triggering event.
A doctor or psychiatrist can diagnose clinical depression.
Clinical depression is more severe than situational depression.
It is also known as major depression or major depressive disorder. It is severe enough to interfere with daily function.
The Diagnostic and Statistic Manual of Mental Disorders, 5th Edition (DSM-V) classifies clinical depression as a mood disorder.
Disturbances in levels of certain chemicals — known as neurotransmitters — may be to blame.
However, other factors are likely to play a role, for example:
- genetic factors may influence an individual's response to an experience or event
- major life events can trigger negative emotions, such as anger, disappointment, or frustration
- alcohol and drug dependence also have links to depression
Depression can also alter a person's thought processes and bodily functions.
For a formal diagnosis of clinical depression, a person must meet the criteria outlined in the DSM.
A person must show five or more symptoms from a specific list of criteria, over a 2-week period, for most of nearly every day.
The symptoms should be severe enough that they substantially reduce the person's ability to perform regular duties and routines.
At least one of the symptoms must be a depressed mood or a loss of interest or pleasure.
Other signs and symptoms include:
- depressed mood or constant irritability
- significantly reduced interest or feeling no pleasure in activities
- significant weight loss or weight gain
- a decrease or increase in appetite
- insomnia or an increased desire to sleep
- restlessness or slowed behavior
- tiredness or loss of energy
- feelings of worthlessness or inappropriate guilt
- trouble making decisions or concentrating
- recurrent thoughts of death or suicide or a suicide attempt
Some people with clinical depression experience delusions, hallucinations, and other psychotic disturbances.
These do not generally occur in people with situational depression.
Exercise and hobbies may help treat situational depression.
Situational depression is a natural response to a traumatic event.
The condition usually resolves:
- as time passes after the stressful situation or event
- as the situation improves
- when the person recovers from the life event
In most cases, situational depression is only short-term. Mild cases of situational depression often resolve without active treatment. However, some strategies can help a person reduce the effects of situational depression.
A few helpful lifestyle changes include:
- getting regular exercise
- eating a well-balanced diet
- keeping to regular sleeping habits
- talking to loved ones
- joining a formal support group
- taking up a hobby or leisure activity
People who find it difficult to recover from a traumatic experience might wish to seek consultation with a psychotherapist.
If the issue revolves around family dynamics or difficulties, family therapy is another option.
People with severe situational depression might receive a prescription for medications including antidepressants or anti-anxiety drugs.
Treatment for clinical depression
Clinical depression can last for a long time. It may require more long-term management and an in-depth treatment plan.
A doctor may recommend a combination of psychotherapy or psychological counseling and medication to treat clinical depression.
A primary care physician can prescribe medicine or make a referral to a mental health professional if they feel that the individual requires this level of care.
In severe cases, especially if a person tries to self-harm, they may need to stay in the hospital or attend an outpatient treatment program until symptoms improve.
Adopting a healthy lifestyle can also support recovery.
According to the National Alliance on Mental Illness, 16 million people in the United States had at least one major depressive episode in 2015.
Situational depression occurs after life-altering events, but clinical or major depression has a range of causes and is a longer-term condition. With a healthful lifestyle and the right treatment plan, both forms of depression are manageable.
Support groups and help or depression hotlines, such as the Samaritans, can offer a listening ear and give useful advice and information. You can call them at any time on (212) 673-3000.
At what point does feeling sadness or grief about a life event become clinical depression?
A person should be concerned when the depressed mood is beginning to have a serious negative impact on important areas of functioning- such as work or school or are significantly impairing to the person.
Many people experiencing an adjustment disorder may feel sad,but generally will notice some improvements a few days after the significant life event. This is generally not the case with major depressive disorderTimothy J. Legg, PhD, CRNP Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.