Clinical depression, sometimes known as unipolar depression or major depression, can be described as a type of depression where the symptoms are persistent and severe enough to warrant clinical intervention by a health professional. This is not the same as feeling fed up, down in the dumps or being moody. When someone is suffering from clinical depression, the individual's daily life is filled with sadness and despair to the point that it interferes with their ability to get on with their normal daily routines. It differs from normal depression in that although a person who feels they are depressed can have feelings of sadness, lethargy and lack interest in things that used to give them pleasure; the symptoms associated with clinical depression are much more severe.

Diagnostic Criteria

To be diagnosed with clinical depression, at least five of the following symptoms of clinical depression must have existed for longer than two weeks and with a tendency to last for between four and six months, which are also accompanied by a depressed mood or anhedonia. Anhedonia can be described as an inability to find pleasure in events that would normally be considered pleasurable, for example, social interactions, eating and sex. The symptoms must also not be related to any obvious cause such as bereavement.

? Overwhelming feelings of sadness and despair, perhaps accompanied by fear, or feeling empty. Someone who feels empty may feel devoid of emotion, numb, unable to feel anything emotionally.

? Feeling less interested or completely uninterested in nearly all daily activities and unable to find any pleasure in carrying out normal daily routines or activities that were previously enjoyed.

? Changes in appetite resulting in either an increase or decrease in weight. This could take the form of eating too much, comfort eating and cravings for carbohydrates or chocolate, or having little or no appetite and unable to face food.

? Disturbed sleep patterns. This might involve an inability to sleep (insomnia) where the person often lies awake at night, or is sleeping too much (hypersomnia) and can't get out of bed in the morning

? Feeling agitated or experiencing psychomotor retardations almost every day. Agitation can manifest itself in many ways including extreme restlessness, pacing up and down a room, wringing hands, masturbating, indulging in purposeless pursuits, or any similar type of behaviour. Psychomotor retardation is where thoughts and physical movement slow right down so everything is happening at a slower pace

? Mental or physical fatigue and a lack of energy, which could mean difficulty in finding the strength or motivation to do anything, even the simplest of tasks

? Overwhelming feelings of guilt and hopelessness, feeling worthless, lonely and isolated possibly accompanied by feelings of anxiety too

? Finding it difficult to concentrate or focus or make decisions, perhaps less able to take things in and possibly suffering from memory lapses such as forgetting appointments etc.

? Recurrent thoughts of death, but not fear of death, and suicide with or without a plan to carry this out, or an attempted suicide

? Feelings of abandonment or fear of being abandoned by loved ones

A person who is depressed may also suffer from other symptoms including:

? Low self esteem and self loathing

? Neglect of appearance and personal hygiene

? Physical aches and pains with no obvious physical cause

? Fear of going mad or ?losing it'

? Emotional outbursts

? Feeling aggressive or irritable

? Alcohol or substance abuse

Some people may suffer from a milder form of depression known as Dysthymia before going on to develop more major depressive episodes. Dysthymia is characterised by lack of enjoyment or pleasure in life that has continued for a period of two years. The difference between this type of depression and clinical depression is in the severity of the symptoms. Sometimes, a person can suffer from Dysthymia with episodes of major depressing occurring alongside, which is known as double depression.

Possible triggers of clinical depression

Although depression can strike any one of us at any time and for no apparent reason, there are certain factors that are known to increase the risk of triggering a depressive episode and these include:

? Stressful situations or events

? Relationship problems

? Long term illness

? Having a negative or pessimistic outlook on life

? Alcohol and substance abuse

? A history of depression in the family

? Chemical imbalances in the brain

Conclusion

People who are suffering from a depressive disorder such as clinical depression may feel isolated and alone. It is important to have the support of family and friends to help them through this difficult time. The depressed person cannot just snap out of it and pressure to do so can make the depression worse. Looking at the positive side of things, clinical depression can be treated so the first step is to speak to a doctor who will be able to make a full assessment of the individual's symptoms and medical history and will be able to offer appropriate treatment options.