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

    image for clinical depression article Periodic moodiness and feeling down are a normal part of life. It can result from a specific event, seasonal changes, or stress. However, 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. It may be hard to tell the difference between them, 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.

    Symptoms of Depression

    According to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-5), if 5 or more of the following symptoms persist for 2 weeks or longer 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
    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 doctor regardless of which symptoms you have noticed. If you have thoughts of death or suicide, seek help immediately.

    Types of Treatment

    Beating the Blues

    If you are feeling down, you may need to make an extra effort to find ways around it. In most cases, beating the blues can be done without treatment. Consider writing down triggers, stresses, or other factors associated with your mood and how you overcome it. This may reveal a pattern and may prove useful the next time you feel down. Suggestions include:
    • Getting into the light. Winter months, especially in a northern climate, reduce light exposure which can affect your mood. You can make changes by going outside when the sun shines and turning on more lamps. If you have problems coping with the colder, darker days of winter, talk to your doctor about seasonal affective disorder.
    • Adjusting your expectations. Set realistic goals you can achieve, breaking large tasks into smaller tasks to make them more manageable.
    • Being patient with yourself. You may not be able to accomplish everything you usually do. Ask your friends and family for help when needed.
    • Postponing important decisions until you are feeling more optimistic.
    • Making time for friends, hobbies, traveling, and meditating even when you do not feel like it. Talking to or hanging out with your friends will help improve your mood.
    • Increasing your social and/or spiritual support.
    • Finding time for regular exercise. Exercise helps clear your mind and improve your overall mood. Aim for 30 minutes of exercise per day on most days of the week. To combine exercise with being outside, find a winter sport to participate in.
    • Improving sleep patterns. Go to bed and wake up on a regular schedule that you can stick with (this includes your days off). Getting the proper amount of rest will make you feel better.
    • Eating a healthful diet that starts with breakfast every day. Limit the amounts of caffeine and sugar from snacks and drinks. Switch to water to maintain hydration.


    Depression affects 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. There may be feelings of embarrassment or shame involved in seeking 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.
    A variety of effective treatments are available to help people with depression. Treatment may include:
    • Psychotherapy or counseling to help you learn more effective ways to deal with depression and the factors that originally caused or triggered it. Therapy can be individual, in a group, or with your family. Support groups are also helpful.
    • Prescription medications for symptom relief and to help correct any underlying deficiency of brain chemicals.
    • Combination of psychotherapy and medications
    The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms, suicidal thoughts, and suicide. 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.
    Be patient and honest with your doctor. It may take some time to find the right combination of medications or a therapist you feel comfortable with.

    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 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 doctor who specializes in the treatment of this illness.


    Depression and Bipolar Support Alliance http://www.dbsalliance.org

    National Institutes of Mental Health http://www.nimh.nih.gov


    Canadian Psychiatric Association http://www.cpa-apc.org

    Mental Health Canada http://www.mentalhealthcanada.com


    Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated December 23, 2014. Accessed January 29, 2016.

    Depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 29, 2016.

    Depression. National Institutes of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed January 29, 2016.

    The blues and depression: What you can do to overcome them. Kansas State University website. Available at: http://www.k-state.edu/counseling/topics/life/blues.html. Accessed January 29, 2016.

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