Here are some frequently asked questions about clinical depression, along with their answers.

I think I’m depressed, where do I start?

Talk to your primary care or family physician. He or she will be able to review the signs and symptoms of depression with you, as well as rule out a possible physical cause for your symptoms. Following diagnosis, your physician can then begin antidepressant therapy or refer you to a psychiatrist (for medication treatment), as well as a psychotherapist or psychologist for appropriate evaluation and treatment. Another route is to consult with your local mental health association or community mental health center, or check with your insurance company’s online database of mental health professionals. Online therapy may also be an option to consider (but you’ll likely have to pay out of your own pocket for such treatment).

It seems that more people are depressed nowadays than in the past. Is the rate of depression increasing?

Depression is fairly common in the general population — it seems likely that it impacts 1 in 5 people in their lifetime. That having been said, this is a seemingly simple question that requires a very complicated answer. While research documents an increase in the number of cases of depression reported and the number of prescriptions for antidepressants, it is unclear whether this results from either a true increase in depression due to the stresses of modern life or from increased awareness and recognition of depression as a treatable mental illness. In any event, it is clear that major depression is one of the most commonly diagnosed types of mental illness.

What is the difference between grief and depression?

Grief is a natural reaction to the loss of an important relationship. As human beings, our bonds to each other develop early (virtually at birth), are strong, and often influence major decisions in our life. When we lose a significant relationship in our lives, it is natural for us to feel sadness or other depressive symptoms, such as loss of appetite and disturbed sleep. In fact, about 30 percent of people who have lost a significant other will continue to have these symptoms two months after the loss. These symptoms, however, usually lessen within six months.

Although both conditions may include depressed mood, loss of appetite, sleep disturbances, and decreased energy, people with depression usually experience a sense of worthlessness, guilt and/or low self-esteem that is not common in normal grief reactions. For some, a grief reaction can develop into a major depression. For example, about 15 percent of grieving individuals will develop major depression one year after a loss.

The latest version of the diagnostic manual used to diagnose mental disorders suggests that sometimes complicated, chronic grief can be diagnosed as a major depressive episode, if it is severe enough and lasts long enough.

When is being depressed a normal reaction and when is it truly major depression?

All of us have days when we feel “depressed.” Usually, these feelings are temporary, and we can have a great day tomorrow. Even when we have a bad day, we can still find enjoyment in things. These occasional bad days are part of life and not depression. Remember, a diagnosis of depression requires that you have these symptoms every day, or nearly every day, for a period of two weeks.

Sometimes, these feelings may persist for several days or even a week. This is common following the break-up of a relationship or other unpleasant event. Still, while you may have some of the symptoms of depression, it is unlikely that you have major depression unless a number of the symptoms are present and impair daily functioning. Even if you do not have major depression, you may have an adjustment disorder that would benefit from professional help. A trained professional can differentiate between a period of the blues and clinical depression.

How do most people react when they are diagnosed with depression?

For some people, a definitive diagnosis is a relief: “At last I know what I have,” is their reaction, even if it comes months or years after the onset of symptoms. For others, however, the diagnosis comes as a terrible shock. Many people are ashamed of having a mental illness. Both reactions are quite normal.

Even when a definitive diagnosis is made and accepted, there may be additional concerns about the unknowns of the disorder: its course and outcome, worries about work, effects on family, and frustrations about physical and emotional limitations. It is not unusual for these concerns to be expressed as anger, which may further deepen the depression. What is important is to know that depression is treatable and carries a good prognosis. Whatever your reaction, you are not alone, as depression is a common and very treatable problem.

What can I expect regarding other people’s reaction?

A person suffering from fatigue and weakness, two symptoms of depression that can occur without obvious signs of physical disability, may look fine. Family members and friends may unsuspectingly expect more from the depressed person than he/she is capable of doing. Those symptoms may then be seen as character defects. Fatigue, for example, is frequently interpreted as laziness, or lack of initiative; depressed mood is sometimes seen as self-pity. These reactions may lead patients to begin to doubt their own self-worth. It is important to discuss this issue with your therapist and identify ways of handling this. It is important to remember that millions of people are disabled from a chronic injury or disorder and are living life to the fullest if they get proper treatment.