Whats clinical depression

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

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No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

Overview - Clinical depression - NHS

Depression is more than simply feeling unhappy or fed up for a few days.

Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression is not a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, anxiety or low mood during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression.

When to see a doctor

It's important to seek help from a GP if you think you may be depressed.

Many people wait a long time before seeking help for depression, but it's best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.

What causes depression?

Sometimes there's a trigger for depression. Life-changing events, such as bereavement, losing your job or giving birth, can bring it on.

People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Read more about the causes of depression

Treating depression

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medicine. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as "watchful waiting". They may also suggest lifestyle measures such as exercise and self-help groups.

Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that is not improving, or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medicine.

Living with depression

Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily.

Reading a self-help book or joining a support group are also worthwhile. They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.


Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled – including family members

Our guide to care and support explains your options and where you can get support.

Video: clinical depression - Lawrence's story

In this video, Lawrence talks about his experience of clinical depression.

Media last reviewed: 1 June 2021
Media review due: 1 June 2024

causes, types, stages, symptoms, signs, diagnosis, treatment in women and men







Depression is a common mental disorder, the main features of which are a persistent decrease in mood, problems with memory and concentration, and minimal physical activity.

The causes of such a painful condition for a person in most cases are neuropsychic shock or chronic stress. Depression can be accompanied by severe illness, sudden changes in life.

Treatment is based on the use of psychotherapeutic techniques. In some cases, it is supplemented by taking medications.


Depending on the form, the disease is associated with external or internal factors. The causes of psychogenic reactive depression can be severe experiences, an acute psychotraumatic situation. Often, a violation develops after the loss of a loved one, loss of a job, divorce, relocation, injury.

Positively colored events, for example, finally gained wealth or popularity, can also cause upset. In this case, mental deviations are explained by the realization of a dream with the subsequent loss of the meaning of life, provided there are no other goals.

Neurotic depression is a consequence of chronic stress. In this state, it is usually not possible to establish a specific cause of experiences. A person finds it difficult to name any specific psycho-traumatic circumstance, sees his life as a whole as a series of losses and disappointments.

Depression in men often develops with regular use of alcoholic beverages, psychoactive substances.

Other risk factors for affective disorder in patients of either sex are:

  • very high or extremely low financial status;
  • impressionability, suspiciousness, poor resistance to stress;
  • low self-esteem, a tendency to self-flagellation;
  • pessimistic outlook on life;
  • high psycho-emotional stress in professional activities;
  • difficult childhood, psychotraumatic situations suffered at a young age;
  • divorce of parents or loss of one of them, upbringing in an incomplete family, orphanage;
  • the presence of mental or neurotic disorders, addictions among relatives;
  • loneliness, lack of support in the family and social environment;
  • economic and political instability in the country;
  • physiologically determined changes in the hormonal background - the process of puberty, the postpartum period, menopause.

Endogenous depressions develop as a result of neurochemical abnormalities due to genetic mutation or aging of the body. This group of disorders includes involutional melancholia and senile depression. This form of pathology also occurs in manic-depressive psychosis, characterized by a change in the phases of mania, depression and mental stability.

The likelihood of depression in women is higher in the postpartum and menopause periods, when there is a change in the level of sex hormones, which is stressful for the body. In a young mother, neuropsychic disorders can occur with complicated childbirth, problems with breastfeeding or the health of the baby, and the appearance of excess weight.

Diseases of various organs can also be accompanied by depression. They are divided into the following groups:

  1. Pathologies of the cardiovascular system - myocardial infarction, hypertension, circulatory failure, heart rhythm disturbances.
  2. Brain damage due to stroke, neuroinfection or head trauma.
  3. Endocrine disorders - diabetes mellitus, hyper- or hypofunction of the thyroid gland.
  4. Violation of the digestive system - cirrhosis of the liver, colitis.
  5. Rheumatic diseases with prolonged pain syndrome - rheumatism, systemic lesions of the connective tissue, arthritis.
  6. Oncological processes, especially malignant neoplasms.


Depending on the severity and nature of manifestations, depression is of the following types:

  • major or clinical;
  • postpartum;
  • atypical;
  • recurrent;
  • small;
  • dysthymia.

Latent or "masked" depression is characterized by the absence of signs of neuropsychiatric disorders and symptoms characteristic of somatic diseases. The following options are distinguished:

  • cardiology;
  • abdominal;
  • dermal.

Caused by an acute psycho-traumatic situation, reactive psychogenic depression proceeds in several stages:

  1. Denial. The psyche makes an attempt to isolate itself from the ongoing negative events, the patient stubbornly does not believe in what happened.
  2. Anger. Anger arises from a sense of injustice, and the search for the guilty begins.
  3. Trade. A person tries to negotiate in order to avoid consequences. This indicates active attempts to find a way out of the situation.
  4. Depression. There is a feeling of loss of control over what is happening, a feeling of powerlessness and the impossibility of correcting anything. This is accompanied by a depressed mood, apathy, laziness, sadness, pessimistic judgments.
  5. Acceptance. After a real assessment of the situation and the prospects that have opened up, a person resigns himself to his fate and mentally prepares for the consequences.


The main manifestations of the disease are united under the name "depressive triad" and include:

  • a persistent decrease in mood, despair, melancholy, a sense of hopelessness for several weeks and even months;
  • slowing down of thinking, problems with memorizing and analyzing information, fixation on one's own experiences;
  • decreased motor activity, slowness, lethargy, prolonged stay in the same position.

The patient ceases to enjoy activities that previously brought positive emotions, becomes withdrawn and taciturn, can spend most of the day lying in bed or sitting, hunched over, bowing his head and resting his elbows on his knees. Feelings of guilt appear, self-esteem falls, suicidal thoughts arise. Fatigue is characteristic, the solution of simple everyday tasks requires great effort.

In some cases, depression may present with the following symptoms:

  • nocturnal insomnia, often associated with drowsiness during the day;
  • decreased appetite and weight loss;
  • increased heart rate;
  • constipation;
  • dilated pupils;
  • loss of sexual desire;
  • menstrual disorders;
  • intense pain in different parts of the body without objective reasons;
  • aggressive behavior, attacks and accusations against other people;
  • dryness and flabbiness of the skin, the appearance of wrinkles;
  • increased hair loss, brittle nails.

With endogenous depression, the intensity of symptoms peaks in the morning, gradually weakening during the day, and the manifestations of psychogenic affective disorders increase in the evening. A feature of postnatal depression is a decrease in the mother's interest in the child, irritation from the need to take care of him.

Clinical depression is severe, including all of the triad and many additional symptoms. The small form is characterized by only a couple of signs of the disease that persist for two or more weeks. The atypical variant proceeds with increased appetite, drowsiness, emotional arousal, and anxiety.

Recurrent depression is characterized by a short duration of several days with a monthly recurrence. Seasonal affective disorder is associated with the change of seasons, the symptoms begin and end at about the same time interval. With dysthymia, the mood is steadily reduced for several years, but negative emotions and experiences do not reach the intensity characteristic of clinical depression.


The greatest danger is suicidal thoughts arising from the disease. They can provoke appropriate actions and lead to tragic consequences. With postpartum depression, a woman can harm not only herself, but also the child. In order to alleviate symptoms, the patient may resort to taking alcohol, drugs.


With somatogenic or latent forms of the disease, a person can seek help from a general practitioner, cardiologist, neurologist, gastroenterologist and other doctors. In the case of psychogenic affective disorder, self-referral to a psychologist is possible. It is important that these specialists promptly refer the patient to a psychotherapist who diagnoses depression. It detects the disease by questioning the patient, during which complaints and symptoms are clarified, possible causative factors. Based on the data received, the doctor will tell you how to get out of depression as soon as possible and draw up a treatment plan.

Special tests for depression are carried out to determine the severity of the process. They include standardized tasks designed and tested by experts. Thus, personal needs, character traits, emotional responses, intelligence levels, anxiety and stress are studied. The Beck Depression Scale with a test questionnaire is often used to identify and assess symptoms of the disease.


With a mild course of the disease, it is possible to undergo only a course of psychotherapy without the use of medications. Additionally, massage, hydrotherapy and exercise therapy may be recommended. Moderate and severe affective disorders also require medication.

The essence of drug therapy for depression is to take drugs that affect the production of biologically active substances that cause the transmission of a neurochemical impulse through the neurons of the limbic system of the brain. For this purpose, antidepressants are used. A large clinical form of the disease, as a rule, requires hospitalization. According to indications for severe depression, pills for insomnia and anxiety are also prescribed - sedatives, tranquilizers.

Psychogenic reactive disorders are successfully treated, and soon after the onset of the disease comes the way out of depression. The clinical picture of the somatogenic form of the disease depends on the severity of the organic pathology. Endogenous disorders are not amenable to psychotherapy, but medication can often achieve long-term remission. Neurotic depression is prone to a long, chronic course.

The author of the article:

Ivanova Natalya Vladimirovna


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  • Primary appointment (examination, consultation) with a general practitioner2100