The word depression means different things to different people. For some, it entails feelings of sadness and melancholia; for others, a sense of dejection and hopelessness. In the most severe cases, depression can cause delusions and thoughts of suicide, making day-to-day life unbearable. But what exactly is the difference between mild feelings of depression (subclinical depression) and full-blown clinical depression (major depressive disorder)? And is cognitive behavioural therapy, a form of psychotherapy used in treating clinical depression (among other disorders), an effective tool in helping to alleviate subclinical depression as well?
Signs and Symptoms of Major Depressive Disorder (MDD)
The Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM5) summarizes the symptoms of major depressive disorder as “the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function.” There are nine symptoms associated with MDD; a clinical diagnosis requires that five or more of them are present during the same 2-week period, represent a change from previous functioning, and that at least one is either depressed mood or loss of interest or pleasure. The nine symptoms of MDD, summarized, are as follows:
- Depressed mood most of the day, nearly every day.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
- Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Am I Really Depressed?
Most people who read this list will identify with at least one of the nine symptoms. This is normal: feelings associated with depression are a part of the human condition and will be experienced by healthy adults, to some degree, from time to time. What separates these feelings from clinical levels of depression is that, in clinical depression, the symptoms experienced cause significant distress or impairment in social, occupational, or other important areas of functioning.
Does this mean that you shouldn't pursue treatment if my feelings of depression don't warrant a diagnosis? Not necessarily. Pain is pain, regardless of a clinical diagnosis. If you are struggling with feelings of depression, there are treatments available that address cases ranging in severity from subclinical to life-threatening.
Cognitive Behavioral Therapy as a Treatment for Depression
Cognitive Behavioral Therapy (CBT) is one of the most common forms of psychotherapy used today. It involves working one-on-one with a mental health professional and is designed to help raise awareness of inaccurate or negative thinking so that new situations can be viewed with more clarity and responded to more effectively. According to research conducted by the Clinical Psychology Review, CBT has been found to have a high efficacy when treating depressive disorders, as well as a number of other mental conditions. CBT was also found to be "somewhat superior to antidepressants in the treatment of adult depression."
What about subclinical depression? According to the Mayo Clinic, "Cognitive behavioral therapy can be a very helpful tool in treating mental disorders or illnesses, such as anxiety or depression. But not everyone who benefits from cognitive behavioral therapy has a mental health condition. It can be an effective tool to help anyone learn how to better manage stressful life situations." The research supports this: a study published in the British Journal of Psychiatry found cognitive behavioural therapy to be effective in the treatment of subclinical depression and may also reduce the incidence of major depression.
The Easiest Way to Try CBT Yet
At TranQool, we connect people with trained mental health professionals who provide CBT over the Internet, making it therapy more convenient and affordable than ever before.
Butler, A., Chapman, J., Forman, E., & Beck, A. (n.d.). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 17-31.
Cognitive behavioral therapy. (n.d.). Retrieved December 31, 2015, from http://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/basics/definition/prc-20013594
Cuijpers, P., Koole, S., Dijke, A., Roca, M., Li, J., & Reynolds, C. (2014). Psychotherapy for subclinical depression: Meta-analysis. The British Journal of Psychiatry, 268-274.
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
Disclaimer: this article is for informational purposes only and is not intended to replace the advice of a mental health professional. If you are experiencing symptoms of mental illness, seek help from a professional immediately.