Depressed person

Depression may not be as commonplace as researchers thought. A new study published today suggests that about one in four people who were diagnosed with depression may instead be struggling with normal and expected emotions associated with an important loss or event in the person’s life. For instance, it is not uncommon for someone who has lost their job, marriage, or a loved one, to feel deep, depressive feelings. But researchers now suggest that such feelings, when associated with such a traumatic event, should not usually be diagnosed as depression.

The study appeared in today’s The Archives of General Psychiatry. It was based on a survey administered to 8,098 Americans from 1990 to 1992. The questions were based on diagnostic criteria for mood problems and asked people who reported a period of sadness if they remembered any event that might have caused it, like the death of a loved one or a divorce. Researchers estimated that approximately one in six people suffer from depression at some point in their lives.

Researchers of the study found that extended periods of depression-like symptoms are common in people who have been through other life stresses such as a divorce or a natural disaster and that they do not necessarily constitute illness. They also found that those who had experienced a variety of stressful events frequently had prolonged periods in which they reported many symptoms of depression. Only a fraction, however, had severe symptoms that could be classified as clinical depression, the researchers said.

“Larger and larger numbers of people are reporting symptoms on [depression] checklists, and there’s no way to know whether we’re finding normal sadness responses or real depression,” said Jerome C. Wakefield, a professor of social work at New York University and the study’s lead author.

To avoid unnecessary diagnosis and stigma, the standard definition of depression should be redrawn to specifically exclude cases where a person is experiencing a normal grief reaction to a loss, rather than full-blown depression, the researchers argue.

The study also suggested that drug treatment may often be inappropriate for people who are experiencing painful — but normal — responses to life’s stresses. Supportive psychotherapy, on the other hand, may be useful — and may keep someone who has been through a divorce or has lost a job from going on to develop full-blown depression.