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What is Depression? Major Depressive Disorder

Written by Valentina Dragomir, Psychotherapist | Fact Checked | See our editorial process

Everyone feels sad sometimes. While sadness is a natural and normal emotion, depression is more than that. If you wonder what depression is, it is a mental illness that has specific symptoms and can have a serious impact on the functioning of the affected person.

Today I want to help you learn about what depression is, and how to differentiate between depression and sadness. This will help you better assess if you or a loved one have depression or they feel sad because of something, to help make the proper steps for recovery.

What is depression?

Depression is an affective disorder (or mood disorder) that can occur because of different reasons (e.g. trauma, bullying, loss and grief, genetic predisposition, environmental and/or biochemical causes). It can also occur for no apparent reason, even when we think everything is ok. Depression affects our perception and the way we think about life, ourselves, the world, and the future.

When you have depression you wonder why you live, what is your purpose and you feel worthless. When you have depression you feel empty inside, unable to enjoy life and what you love. You can have everything you need in your life and much more, and still have depression.

In depression you can have negative thoughts about yourself, the others, the world, life, whatever surrounds you. You can feel that whatever you do will fail and that nothing makes sense anyway.

Does this still sound like being sad? To better understand what is depression, we must define the differences between depression and sadness.

What is sadness?

Sadness is an emotion often labeled as negative. Sadness is the opposite of happiness and appears when we go through difficult events in life: loss in general (loss of a loved one, of a relationship or object, resources, status, health, job or business), when injustice is done to us, when we are hurt or disappointed by someone, when we fail at something.

Sadness or emotions in general don’t last long. Emotions can last up to 90 seconds.

Read more about sadness

What are the differences between depression and sadness?

It is a common confusion to say that you are depressed when you feel sad. No wonder this happens. The confusion comes from the fact that the main symptom in depression is sadness (in depression, sadness is profound and persistent). Another reason for this confusion is that the word “depression” is used often to describe the emotion “sadness”.

We usually know why we feel sadness and how we can feel better. For example, we can say something like this: “I feel sad because my friend is sick and we will not go to the concert.” When we have depression we may not realize why we feel this way and we cannot get out of this state. Depression is like a huge weight that immobilizes us in bed, takes our energy and leaves us empty inside … day by day, for a long time. This is clinical depression, or major depression disorder (MDD).

Sadness is an emotion that does not last long. Depression is a mood disorder that can last very long without treatment and can have severe impact in one’s life.

In my practice I met so many people who thought they had depression, although on a close examination they did not have the symptoms of depression (hence being confused).

I also met people who thought they were just sad and could handle the situation, while they had severe depression. These are people who carry their depression for a long time until they reach a limit.

Depression is an invisible illness

What I find to be very sad is that many families or friends of the person suffering from depression do not understand what is depression.Therefore they fail to offer understanding and support.

Some people with depression don’t even share their true feelings with their loved ones. They hide the fact that they feel bad, they are isolated in the house and they prefer to spend their time alone not doing something.

This sometimes happens because loved ones may tend to offer solutions without listening, or without asking what they can do for the sufferer.

Family members can even say things such as “snap out of it / get over it”. “you are just lazy”. “it is in your mind, you have no depression”. “you are a burden / shame / disappointment for the family”. These affirmations can worsen the mood of the person with depression.

We cannot ask the person who has depression to just snap out of it. Overcoming depression is not an act of will, it is not dependent on time or motivation.

If we do this it’s like asking a person who has the flu to get out of this illness by putting more effort in or being more motivated. Mental health is just as important as physical health, and these disorders require specialized treatment.

What are the symptoms of depression?

According to DSM 5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition), to be diagnosed with depression you must have at least 5 of the following symptoms, present for a period of at least 2 weeks and have an impact on individual functioning:

  • Depressive mood most of the day, almost every day.
  • Diminished interest and pleasure in all or almost all activities, most of the day, almost every day.
  • Significant weight loss or weight gain without a particular diet, or increase / decrease in appetite almost daily.
  • Insomnia or hypersomnia almost every day.
  • Psychomotor agitation or slowness almost every day, observable by others.
  • Fatigue or lack of energy almost every day.
  • Feeling of worthlessness or excessive guilt (which can be delusional) almost every day.
  • Decreased ability to concentrate and think, indecisiveness, almost every day.
  • Recurrent thoughts of death (not just fear of death), recurrent suicidal thoughts without a specific plan, or suicide attempt, or a plan to commit suicide.

If you are in crisis and you have suicidal thoughts, contact the relevant authority in your country.

In Romania this authority is

Info icon
The Romanian Suicide Prevention Alliance. / Phone 0800-801-200 /

Of course, in diagnosing depression it is not enough to look at the list of symptoms in DSM 5 and we are ready to make a diagnosis. Also, not everyone can make such a diagnosis. The process is much more complex.

Other aspects of the history of the individual are taken into account, such as events or other mental disorders, medical problems, drug treatments, use or abuse of substances or drugs. Therefore, for a correct diagnosis of depression, it is advised to seek consultation with a specialist in mental health (psychiatrist and / or psychologist, psychotherapist).

What are the causes that trigger depression?

Depression is a mood disorder that often does not have a single cause. Although a singular event may trigger the onset of this disorder, there are situations in which it is triggered by a combination of factors. Among the main factors we can list:

  • Life events or situations: death of a loved one, loss of job or unemployment, natural disasters, traumas, abuse, financial problems, loneliness and lack of social life, conflicts.
  • Diseases or illnesses, disability or medical interventions: serious medical and mental illness, chronic pain, disability, can lead to depression.
  • Drug Use, substance abuse and drug abuse: Many people with depression are substance abusers. Alcohol and drug use can lead to and result from depression. There are several types of drugs known to trigger depression.
  • Genetic causes: People who have family members with depression or other mental disorders are at increased risk of suffering from depression.
  • Biochemical causes: Imbalance of neurotransmitters in the brain (serotonin, dopamine, or norepinephrine) can lead to depression.
  • Hormonal causes: Hormonal problems and changes in both women and men can trigger depression.

What does the statistical data say about depression?

The World Health Organization presents us with these statistics on depression (data from 2017):

  • Depression is a very common affective disorder.
  • Globally, more than 300 million people of all ages have this mental health disorder. In 2015, there were an estimated 322 million people suffering from depression, an increase of 18.4% since 2005.
  • WHO statistics show that 5% of Romania’s population suffers from depression. 5% of the current population means almost 1 million Romanians suffering from this mental disorder.
  • Depression is the leading cause of disability worldwide.
  • More women are affected by depression than men.
  • In the worst cases, depression can lead to suicide.
  • There are effective methods of treatment for depression.

In a report for a Romanian news network, Mrs. psychologist and psychotherapist Ileana Botezat-Antonescu said that it is very difficult to name an exact number of people suffering from depression in Romania. There are many people who suffer from depression and do not get treated. We can also include the people who live in the rural area and where there are no psychiatric doctors nor psychotherapists to offer them specialized treatment.

A study from Romania led by the Institute of Management and Medical Statistics shows that out of 2000 people participating in the study, less than half have asked for specialized help in the first year since the onset of depression (Agerpres).

How is depression treated?

As we saw above, we learned about what depression is and the differences between depression and sadness.

Depression is a mood disorder common for many people both in Romania and around the world. Therefore we should not be ashamed that we feel this way, but we should seek specialized help because it exists.

Just as we are not ashamed that we have tonsillitis or appendicitis, we should not be ashamed of having depression. Psychological health is just as important as physical health.

Many people suffering from depression think that their mood will not improve. But the news is very good. Although depression is a disorder that could have severe consequences, it is also one of the most treatable psychological conditions. Depression is so common that almost everyone goes through it at some point in life.

The modern treatment consists of combining medication (although not in all cases of depression) and psychotherapy.

Psychotherapy can help

  • First of all to understand what is depression and reduce the negative or limiting beliefs and myths about this this mood disorder
  • Discover and understand how certain problems or events have led to depression and how or what a person can do to manage these events or situations
  • Understanding how certain behaviors, thoughts, or other personal factors contribute to the depressive state and how or what the sufferer can do to change these aspects and improve their emotional state
  • Learning techniques, skills, coping strategies or learning how to manage emotions, thoughts, situations, relationships or events or other factors that have a negative impact on the person’s life
  • Gaining control and pleasure in life

Psychotherapy is not a miraculous treatment. One or two sessions are not enough to treat depression. Therapy is most successful when the client is actively involved in therapy sessions. The therapeutic process requires time and perseverance to get the best results.

It happens that after a few sessions the symptoms of depression subside and the client drops out of therapy. Thus, the symptoms may return in a short time because the wounds that caused this disorder have not been healed or the triggering causes have not been successfully managed.

Also, if you happen to feel that the therapist you are seeing is not the right one for you, you can always address this in therapy with him/her. You can also find a different therapist to help you with depression. Just because you didn’t find one yet it doesn’t mean that therapy is inefficient.

Always talk about it if something does not work for you, do your homework and ask questions if you don’t understand something.

How is depression treated with medication?

Medication targets the chemistry of the brain. It reduces the symptoms or just some of the symptoms. Sometimes it may come with some side effects that may (or may not) be overlooked in favor of better health. Psychiatric medication helps by putting us back to a stable level of functioning in order to resume our daily tasks, continue going to school or work, and especially to seek psychotherapy.

It is scientifically proven that psychotherapy – regardless of orientation – is just as effective in treating depression as medication. Some causes of depression cannot be cured with drugs. Medication is limited to restoring the chemical balance of the brain that can maintain the symptoms of depression.

Openness to medical treatment of depression is important because sometimes either the drugs do not have a good effect for us, so we need to try a different antidepressant. But this does not mean that there is no treatment for depression or that the treatment does not have the effect.

There are many types of antidepressants and you can find the one that is right for you.

What to do if you have depression?

If you have depression take steps that help you overcome it. There are many things that you can do even if your mind may have a negative outlook. Don’t believe all your thoughts. There is effective treatment out there and you can get it. Here are some resources to help you get started:

Seek individual therapy and look for a psychotherapist that is right for you

He/she may also recommend a visit to a psychiatrist for medications as part of your treatment. Psychotherapy and medication do not exclude each other, but are complementary, helping sufferers recover effectively and faster.

See a psychiatrist for medical treatment

It is important that the medication is administered as prescribed by the doctor. If unpleasant side effects occur, changing the medication may be a solution, but this should never be done without consulting your doctor!

Also, stopping the treatment should be made only under the doctor’s supervision.

Often, the psychiatrist may also recommend psychotherapy.

Join a depression therapy and support group

Depression therapy groups are a real help. You can get in contact with other people who have the same difficulty as you. Also socializing is especially important for people who have depression.

If you are in crisis and you have suicidal thoughts, contact the relevant authority in your country.

In Romania this authority is

Info icon
The Romanian Suicide Prevention Alliance. / Phone 0800-801-200 /


Here is a summary of the most important points of this article:

  • Depression is a mood disorder that often gets confused with the emotion sadness, one of the six basic emotions.
  • There are many differences between depression and sadness. Depression can last a long time if it goes untreated and can have serious consequences, while sadness is an emotion that does not affect people severely.
  • Depression is a common mental health disorder that can be caused by external or internal factors and has specific symptoms.
  • Depression can be treated by psychotherapy, medication when needed and lifestyle changes.
  • There is help for depression. Always seek support from people in your life or from a specialized mental health practitioner.

PsihoSensus Therapy uses only reputable resources, scientific articles and research, medical journals and magazines, books and other relevant and reliable documents written by known researchers and specialists in the field, for writing articles. Read our editorial and publishing policy and how we write our articles.

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