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Just the Blues or Clinical Depression: Making the Distinction to Get the Help You Need

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Depression is a serious medical condition involving your mood, thoughts, and body. It may affect how you feel about things, how you think about things, and how well you eat and sleep. Most people normally experience feelings of sadness, loss, or grief at different times throughout their lives. But depression is generally characterized by more intense feelings, such as hopelessness and worthlessness, and is persistent and recurring in nature.

By making the distinction between the blues and clinical depression, you can take the appropriate actions that may help improve your mood and quality of life. If you have depression, you will need professional medical treatment, since depression is not something that you can shake off on your own. On the other hand, if you have the blues, there may be a few things you can try to help improve your mood—but only after you are sure your symptoms are not a result of depression.

Symptoms of Depression

According to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV), if five or more of the following symptoms persist for more than two weeks, or if they interfere with work or family life, you may be suffering from one of several different forms of clinical depression.

  • Persistent sadness, anxiousness, or feeling of emptiness
  • Loss of interest or pleasure in activities, including sex
  • Loss of appetite and/or weight loss or overeating and weight gain
  • Sleeping too much or too little, early-morning awakening
  • Decreased energy, fatigue, feeling like you are slowed down
  • Restlessness, irritability, or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
  • Difficulty concentrating, remembering, or making decisions
  • Thoughts of death or suicide, or suicide attempts

Contact your doctor for a complete evaluation, which will involve a physical checkup, a family health history, and a psychological evaluation.

Not everyone with depression experiences each of these symptoms. The intensity of the symptoms also varies from person to person.

If you are concerned that you may have depression, contact your healthcare provider or doctor regardless of which symptoms you have noticed. If you have thoughts of death or suicide, seek help immediately .

The Need for Treatment

Depression can be devastating and affect all areas of a person’s life, including personal relationships and the ability to work, do recreational activities, or go to school. Because of the false belief that you should be able to get over depression symptoms, some people with depression may not realize that they have a treatable disorder. Or they may be embarrassed or ashamed to seek treatment. However, receiving treatment for depression will not only improve your quality of life, but it may save your life as well. Untreated or inadequately treated depression may lead to suicide.

Types of Treatment
  • Psychotherapy or counseling
  • Prescription medications
  • Combination of psychotherapy and medications

A variety of effective treatments are available to help people with depression. The main categories are antidepressant medications and psychotherapies (or counseling). Treatment is based on the form of depression and is individualized for each person. Some forms of depression may be treated with psychotherapy alone. Others require antidepressant drugs or a combination of drugs and counseling. Medications bring symptom relief and help correct any underlying deficiency of brain chemicals. Counseling can help you learn more effective ways to deal with depression and the factors that originally caused or triggered it.

The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose. Although the warning is for all antidepressants, of most concern are the SSRI class such as:

  • Sertraline
  • Citalopram
  • Fluoxetine
  • Escitalopram
  • Paroxetine

Antidepressants need to build up in your system before they work. This can take a couple of weeks. Your doctor will keep track of how you respond to the dosage prescribed. Do not stop taking antidepressants without talking to your doctor to avoid withdrawal symptoms.

For more information about antidepressants, visit the FDA's website .

Ways to Get Help
  • If you need immediate help or if you are having thoughts of death or suicide, call the National Hopeline Network at 1-800-SUICIDE (1-800-784-2433).
  • Talk to your healthcare provider or doctor about your symptoms and treatment options.
  • Contact a hospital near your home to determine if they have or can recommend a mood/affective disorder clinic. If not, ask for their referrals to doctors in the community who specialize in the treatment of depression.
  • If you, or someone you know, has been diagnosed with depression and treatment has not been effective within three months, get a second consultation. Preferably, this should be from a physician who specializes in the treatment of this illness.
Steps to Take for Managing the Blues

After you have checked with your doctor to be sure you do not have depression, you may want to try a few of the following suggestions for managing your blues:

  • Adjust your expectations. Set realistic goals you can achieve, breaking large tasks into smaller tasks to make them more manageable.
  • Be patient with yourself. You may not be able to accomplish everything you usually do. Ask your friends and family for help when needed.
  • Postpone important decisions until you are feeling more optimistic.
  • Participate in activities that make you feel better, such as spending time with friends, making time for hobbies, traveling, and meditating.
  • Increase your social and/or spiritual support.
  • Manage stress .
  • Exercise regularly .
  • Eat a healthy diet .
  • Consider attending a support group or talking with a counselor to help you come up with other strategies to improve your mood and functioning.


Depression and Bipolar Support Alliance

National Institutes of Mental Health


Canadian Mental Health Association

Mental Health Canada


Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: Updated August 12, 2010. Accessed March 28, 2014.

Depression. American Psychiatric Association website. Available at: Accessed March 28, 2014.

Depression. EBSCO DynaMed website. Available at: Updated March 14, 2014. Accessed March 28, 2014.

Depression. National Institutes of Mental Health website. Available at: Accessed March 28, 2014.

Depression help guide. Help Guide website. Available at: Accessed March 28, 2014.

Last reviewed April 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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