previous post, cont …

In my attempt to look into depression definitions from different approaches, I’m coming across with some diverse ideas. In this post I focus on the medical view.

In the most recent diagnostic and statistical manual of mental disorders (DSM IV), two types of depression are presented: depressive disorder and bipolar or manic depressive disorder. DMS IV postulate the following clinical criteria based on which depression is clinically diagnosed: depressive mood, lack of interest and pleasure in life, changes in sleep and/or eating patterns, fatigue, sense of worthlessness, excessive or inappropriate guilt and death thoughts and recurrent suicidal ideation or attempt (McKenzie, 2000). Another definition of severe or clinical depression, based on DSM IV symptomatology, is the following:

  • Persistently sad and/or anxious
  • Feelings of hopelessness and/or pessimism
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Decreased energy and fatigue
  • Thoughts of death or suicide
  • Restlessness and irritability
  • Difficulty concentrating, remembering, and making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches digestive disorders, and chronic pain


Clinical depression would be diagnosed if symptoms persist for at least two weeks. Diagnostic criteria for mental disorders are essentially descriptions of symptoms that fall into one of four following categories. In major depressive disorder for example, affective or mood symptoms include depressed mood and feelings of worthlessness or guilt. Behavioural symptoms include social withdrawal and agitation. Cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions. Finally, somatic or physical symptoms include insomnia or hypersomnia. Depression can also be understood as ‘reactive’ when it appears as a response to a stressful life event; such as a crisis, an accident or a loss. On the other hand unexplained periods of depression are labeled ‘endogenous’, based on the assumption that the depressive trigger lies within the person’s mind or psyche. There is an increasing disuse of these two distinctions in the light of a more interpersonal way of understanding depression (Solomon, 2001). It appears that modern arguments over the nature and definition of depression fall under the tensions between personal triggers and interpersonal processes.

some more research into ‘definitions’ of depression to be continued ..