Psychological Depression

Depression is one of the most widespread mental disorders in the world and one of the most dangerous to both physical and mental health. It is often referred to as the number one global public health threat

Depression is so prevalent that it is often compared to the common cold among mental disorders. However, there is a fundamental difference between depression and the common cold

Depression can be fatal. Studies indicate that suicide rates have significantly increased in recent years, even among children and adolescents

Although depression is one of the oldest recorded mental disorders in history, it was long believed—until recently—that it was exclusive to adults and did not affect children. However, depression in children and adolescents has gained increasing attention and was first identified as a clinically significant issue in the early 1970s. Depression is a real disorder in childhood and adolescence and, in many cases, can be the underlying cause of various social and health-related problems. It can also persist into adulthood

Depression is classified as a mood disorder and is considered a psychological issue that can hinder an individual’s social role, adjustment, and development. It has emotional, cognitive, and physical aspects. The emotional disturbance in depression can manifest as an inability to love, self-hatred, and suicidal thoughts

Depression is a concept that can describe a mood state and does not necessarily indicate a medical condition, a symptom, or a set of overlapping symptoms. The phenomena associated with depressive disorder are a mix of physiological disturbances and other psychological symptoms. These physiological and psychological disturbances, along with certain unconscious habitual behaviors, can lead a patient to experience recurrent sadness

Depression and its causes are often linked to an imbalance in brain chemistry. It may result from a decrease in positive reinforcement and an increase in reinforcement of distressing events or arise from psychological conflict between the self and the superego. Albert Ellis believes that depression is an emotional disorder caused by cognitive distortions and illogical thinking, which shape an individual's emotional responses. Depressed individuals often generalize partial experiences negatively toward themselves. For example, a minor criticism may make them feel like a complete failure, or a small setback in achieving a goal may lead them to believe they are incapable of success

One cognitive model explains depression as the tendency of depressed individuals to perceive their surroundings as uncontrollable. Some people see the world in extremes—either black or white—without recognizing that even negative situations may have positive aspects. This rigid thinking is associated with non-adaptive traits such as intolerance, authoritarianism, tension, and anxiety. When analyzing emotional disorders such as anger and depression, extremism plays a significant role in triggering these conditions. Ellis also noted that in many cases of anxiety, depression, and aggression, behavior results from misinterpreting an event due to a lack of certain information

Genetic factors also play a role in depression. A neurotransmitter imbalance, especially a deficiency in serotonin, is a key factor in depressive symptoms. Medications that increase serotonin levels are among the most commonly used treatments for depression worldwide

Most cases of depression are preceded by a recent loss, such as academic failure, divorce, job loss, or a failed romantic relationship. However, some factors help individuals avoid depression, including strong relationships with a partner, fewer family and financial burdens, and engagement in meaningful work. Studies by Abdel-Khalek, Bird, and others suggest that early childhood loss is more common among depressed individuals than among non-depressed individuals. Horowitz argues that depression and feelings of suffering are key symptoms that emerge after deprivation or loss. Therefore, depression is often the cumulative result of various modern challenges, including social, academic, health, economic, and emotional issues

Definition of Depression

Depression has multiple definitions. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), depression is diagnosed when a person experiences at least five of the following symptoms within two weeks

A noticeable change in psychological, physical, cognitive, and emotional functions

At least one of the symptoms must be either a depressed mood or loss of interest/pleasure

Significant weight loss or gain

Sleep disturbances (insomnia or excessive sleep)

Psychomotor agitation or retardation

Fatigue or loss of energy

Feelings of worthlessness or excessive guilt

Difficulty concentrating or making decisions

Recurrent thoughts of death or suicide

These symptoms must significantly impact the individual's ability to function in daily life

Clinical Symptoms of Depression

Depression symptoms were first classified in psychological literature in the early 1970s. The DSM-3 later modified symptom patterns, and these have remained largely consistent in later editions, including the DSM-5 (2013). Similar symptoms are also described in the ICD-10 (International Classification of Diseases, 1999 and the Oxford Handbook of Psychiatry (2013)

For a clinical diagnosis of depression, the individual must experience at least five symptoms for at least two weeks, with one of them being either a depressed mood or loss of interest/pleasure

Key symptoms include

A depressed mood most of the day, almost every day

A significant loss of interest in daily activities

Noticeable weight loss or gain

Sleep disturbances (insomnia or excessive sleep)

Fatigue or loss of energy

Feelings of worthlessness or excessive guilt

Difficulty concentrating or making decisions

Recurring thoughts of death or suicide

Additional Symptoms

Anxiety

Delusions

Decreased libido

Types of Depression

There are multiple classifications of depression. Researchers categorize it based on severity, while psychiatric professionals classify it based on clinical presentation

According to the DSM-5, depression is categorized as

Disruptive Mood Dysregulation Disorder

Major Depressive Disorder (MDD)

Persistent Depressive Disorder (Dysthymia)

Premenstrual Dysphoric Disorder

Substance/Medication-Induced Depressive Disorder

Depressive Disorder Due to Another Medical Condition

Other Specified Depressive Disorder

Unspecified Depressive Disorder

According to Mohamed Ghanem (2004), depression is classified into

Major Depression: A clinical condition lasting more than two weeks with severe symptoms

Severe Depression: Includes psychotic features such as hallucinations or delusions

Mild Depression (Dysthymia): A chronic but less intense form lasting for years

Bipolar Disorder: Characterized by mood swings between depressive and manic episodes

Consequences of Untreated Depression

If left untreated, depression can lead to severe consequences, including

Academic failure due to lack of focus and motivation

Truancy and running away from home as a sign of distress

Substance abuse, often starting as experimentation

Low self-esteem and feelings of worthlessness

Eating disorders, such as anorexia or binge eating

Internet addiction, as a form of escapism

Self-harm, such as cutting or burning

Aggressive behavior, leading to conflicts

Violence, as a reaction to distress

Suicidal thoughts and attempts, which require serious attention

Depression in adolescents should always be taken seriously, as they are at a higher risk of attempting suicide. Proper intervention and support are crucial

Arabic References

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Foreign Reference

American Psychiatric Association (2015). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV-TR). Washington, DC: American Psychiatric Publishing

Burns, D., M. (1980). Feeling Good the New Mood Therapy. New York: U.S.A. Harper Collins Publishers

Beck, Aeron; Rush, John; Shaw, Brian & Emery, Gary (1979). " Cognitive Therapy of Depression". New York: The Gilford Press

Beck. A., T., & Dozois, D., J., (2011). Cognitive Therapy: Current Status and Future Directions. Vol. (62). 397-409 

Bird, H.; Gould, M.; Yager, T. & Staghezza, B. (1989). Risk Factors for maladjustment in Puerto Rican children. Journal of the American Academy of Child and Adolescent Psychiatry. Vol. 28, No.6, pp. 847-850

Hazell, P.L., Rey. J. M (2009). Depression in children and adolescents. Clinical Evidence. BMJ Publishing Group Ltd 2009

Horowitz, J., L. & Garber, J. (2006). The Prevention of Depressive Symptoms in Children and Adolescents: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology. The American Psychological Association, Vol. 74, No. 3, 401–415

International Classification of Diseases (ICD-10).( 2017). Second Edition Volume 2 - World Health Organization 

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Semple, D. & Smyth, R. (2013). Oxford Handbook of Psychiatry. Third Edition. United Kingdom (UK): Oxford University Press