Situational Depression vs. Clinical Depression

man standing near window depressed

Depression affects roughly 10% of U.S. adults at some point in their lives. There are several different types of clinical depression or depressive disorders that can be diagnosed and treated, as well as a short-term, more transitory type called “situational depression.”

There is an important distinction to be made between clinical depression and situational depression. Clinical depression can be chronic and can recur for years, while situational depression is usually a shorter bout of deep sadness that is tied to a particular event–a major life change, illness or trauma, the death of a loved one, a divorce or the loss of a job.

Here are some basics to help you further distinguish between situational depression and other types of depression.

Situational Depression Basics

According to mental health experts, situational depression is considered an adjustment disorder, while clinical depression is considered a mood disorder. This doesn’t mean that situational depression should be ignored.

Situational depression, also known as “adjustment disorder with depressed mood,” can happen to anyone at any age and occurs when someone has a hard time coping with a major change or event.

Situational depression often goes away in time, especially if the affected individual is able to talk about the issue. As the person begins to adjust to the situation, their deep sadness may gradually lift, leading to recovery. However, if recovery does not occur within a few weeks, the more severe condition of clinical depression may develop, which can be more difficult to resolve.

Diagnosing and Treating Situational Depression

A mental health professional will diagnose situational depression when symptoms of depression occur within three months of a triggering or stress-inducing event, are more severe than expected and/or interfere with normal functioning. A physical exam with a primary care physician can rule out underlying physical illness as a cause, and a psychological evaluation should rule out more serious conditions such as post-traumatic stress disorder (PTSD) or clinical depression.

Signs and symptoms of situational depression can overlap with those of clinical depression, but typically resolve sooner. If symptoms seem particularly pronounced or long-lasting, treatment can help.

Common signs of situational depression include:

  • Sadness, tearfulness
  • Feeling nervous, tired or hopeless
  • Physical symptoms such as headaches, stomachaches or heart palpitations
  • Behavioral signs such as arguing and fighting more or skipping school/work
  • Changes in sleeping or eating habits
  • Using alcohol or drugs

“I actually started to think, ‘Maybe I really am depressed,’” Oprah Winfrey told Vogue magazine, when she experienced deep sadness after one of her movies failed at the box office. “Because it’s more than, ‘I feel bad about this.’ I felt like I was behind a veil.”

A person who experiences situational depression can usually overcome it through counseling that helps improve attitude and perspective, daily behaviors and interpersonal functioning, notes Chris Iliades, MD, but it is important not to leave it untreated for too long. Medication can also help if the symptoms are severe, according to Dr. Iliades.

“If emotional and behavioral symptoms reduce normal functioning in social or occupational arenas, situational depression should be treated,” agrees Kathleen Franco, MD, professor of medicine and associate dean of admissions and student affairs at Cleveland Clinic Lerner College of Medicine in Ohio, in an article for Everyday Health.

Clinical Depression Basics

Clinical depression, also known as “major depression,” “major depressive disorder (MDD),” or “unipolar depression,” is characterized by more severe, persistent or chronic symptoms that manifest regardless of whether a person has experienced a traumatic event or major change. Episodes of clinical or major depression can occur just once in a lifetime, but are more likely to recur.

“If you are chronically down, it is a lifelong fight to keep from sinking,” says Elizabeth Wurtzel, author of the best-selling memoir Prozac Nation: Young and Depressed in America and other books, who was diagnosed with atypical depression.

The different types of clinical depression include persistent depressive disorder (a depressed mood that lasts for at least two years); postpartum depression (severe depression experienced by one in seven women after childbirth); seasonal affective disorder, or SAD (severe depression triggered by reduced sunlight during winter months); and psychotic depression (severe depression triggered by a co-occurring psychosis).

Diagnosing and Treating Clinical Depression

A surprising thing about depression is that sadness is only one aspect of it, and some individuals diagnosed with clinical depression don’t feel sad at all. They may, for example, experience persistent fatigue and irritability or physical aches and pains without feeling sad.

“Sad hurts, but it is a healthy feeling; it is a necessary thing to feel,” says J.K. Rowling, author of the best-selling Harry Potter series of novels and others, who suffers from clinical depression. “Depression is very different.”

Not everyone who is depressed experiences every symptom of the illness. Some people experience just a few symptoms, while others experience all or most of them. Further, the severity and frequency of symptoms vary among individuals. According to the National Institute of Mental Health, gender can influence which symptoms an individual with depression experiences. For example, women typically have symptoms of sadness, worthlessness and guilt, while men typically have symptoms of insomnia and fatigue, irritability and loss of interest in activities.

Symptoms can also vary depending on the stage of the illness. For a diagnosis of clinical or major depression, five or more symptoms of the illness must have been present during the same two-week period and represent a change from previous functioning, with at least one of the symptoms being either depressed mood, or loss of interest or pleasure.

Common signs of clinical depression include:

  • Persistent sadness, emptiness or depressed mood
  • Loss of interest or pleasure in hobbies and activities
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Decreased energy, fatigue, being “slowed-down”
  • Difficulty concentrating, remembering, making decisions
  • Insomnia or oversleeping/trouble waking up in morning
  • Appetite and/or weight changes
  • Restlessness, irritability, anxiety
  • Persistent physical symptoms such as headaches, stomachaches or heart palpitations
  • Thoughts of death or suicide, suicide attempts

These symptoms can overlap with symptoms of physical illness, other mental health disorders and substance abuse, so a full medical and psychological examination is usually conducted to make sure symptoms aren’t caused by another medical or mental health condition.

Strategies for Getting Better

Whether the diagnosis is situational depression or clinical depression (or another condition), seek depression treatment and ongoing support. Studies show that 60% to 80% of all cases of depression can be treated effectively with structured forms of psychotherapy and antidepressant medication.

For those with situational depression, ruminating over the negative things that have happened in your life without seeking help may make matters worse.

“Rumination makes you much more likely to develop depression,” says David Sack, MD, chief medical officer of Promises Behavioral Health. Dr. Sack notes that treatment can help you break the cycle of depressive thoughts by getting you into healthier and more optimistic thought patterns.

Don’t just notice the things that go bad, he advises. Make a point of noticing the things that go well. Dr. Sack also recommends mindfulness meditation and yoga to complement counseling or psychotherapy. These are proven techniques for keeping thoughts in the moment and breaking negative cycles of thought, especially those tied to upsetting events or situations.

Other complementary strategies that can help lift people out of depression include getting regular exercise, eating a balanced diet, maintaining good sleeping habits, adopting a new hobby or fun activity, and talking to friends and loved ones.

 

Sources:

“Depression: What You Need To Know” – U.S. Department of Health and Human Services, National Institutes of Health (NIMH)
https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml

“What Is Situational Depression? Oprah Opens Up About Extreme Sadness.” –  MSN
http://www.msn.com/en-us/health/healthtrending/what-is-situational-depression-oprah-opens-up-about-extreme-sadness/ar-AAqcDu1?li=AA5LBhu&ocid=spartanntp

“Situational Depression vs. Clinical Depression” – Medical News Today
http://www.medicalnewstoday.com/articles/314698.php

“When Life Gets You Down: Coping With Situational Depression” – Everyday Health
https://www.everydayhealth.com/depression/coping-with-situational-depression.aspx

“Depression Research Update: October 2016” – Psychiatric Times
http://www.psychiatrictimes.com/major-depressive-disorder/depression-research-update-october-2016

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