{"id":5732,"date":"2021-10-22T13:40:07","date_gmt":"2021-10-22T05:40:07","guid":{"rendered":"https:\/\/scc.sg\/e\/?page_id=5732"},"modified":"2021-12-07T16:11:03","modified_gmt":"2021-12-07T08:11:03","slug":"depression-what-causes-symptoms-treatment","status":"publish","type":"page","link":"https:\/\/scc.sg\/e\/depression-what-causes-symptoms-treatment\/","title":{"rendered":"Depression"},"content":{"rendered":"<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p style=\"text-align: center;\"><a href=\"#introduction\"><strong>What is Depression?<\/strong><\/a>\u00a0| <a href=\"#signs\"><strong>Common Signs &#038; Symptoms of Depression<\/strong><\/a> | <strong><a href=\"#causes\">Causes &#038; Risk Factors of Depression<\/a><\/strong>| <strong><a href=\"#treatment\">Treatment of Depression<\/a><\/strong> | <strong><a href=\"#faq\">FAQ<\/a><\/strong><\/p>\n<\/div><\/section>\n<div   class='hr hr-short hr-center   avia-builder-el-1  el_after_av_textblock  el_before_av_image '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div>\n<div  class='avia-image-container  av-styling-    avia-builder-el-2  el_after_av_hr  el_before_av_heading  avia-align-center '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\"  ><div class='avia-image-container-inner'><div class='avia-image-overlay-wrap'><img class='avia_image' src='https:\/\/scc.sg\/e\/wp-content\/uploads\/2021\/10\/Depression-1080x430.jpeg' alt='' title='Depression' height=\"430\" width=\"1080\"  itemprop=\"thumbnailUrl\"  \/><\/div><\/div><\/div>\n<div  id=\"introduction\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-3  el_after_av_image  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >What is Depression?<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Depression comprises a set of symptoms such as depressed mood and loss of interest in activities that must <\/span><i><span style=\"font-weight: 400;\">persist<\/span><\/i><span style=\"font-weight: 400;\"> almost every day for at least two weeks (to be diagnosed as having MDD). This is in contrast to the everyday mood fluctuations and negative emotions that arise from everyday life\u2019s experiences. These symptoms often greatly affect one\u2019s daily functioning, interactions with people, and accomplishment of tasks [<a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/depression\">1]<\/a>.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Depression is a mood disorder that includes various subtypes of depressive disorders such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/scc.sg\/e\/?page_id=6181\"><span style=\"font-weight: 400;\">Major depressive disorder (MDD)<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Persistent depressive disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Premenstrual dysphoric disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Postpartum depression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seasonal affective disorder<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It is one of the most common and widely known mental disorders worldwide, affecting more than 264 million people [<a href=\"https:\/\/www.who.int\/health-topics\/depression#tab=tab_1\">2]<\/a>.<\/span><\/p>\n<\/div><\/section>\n<div  id=\"signs\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-5  el_after_av_textblock  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Common Signs <span class='special_amp'>&amp;<\/span> Symptoms of Depression<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>According to the World Health Organisation, a depressive episode is characterised by a loss of pleasure or interest in activities and depressed moods (i.e., feeling sad, irritable, empty), for most of the day, nearly every day, for at least two weeks. During a depressive episode, the person experiences significant difficulty in their daily functioning, affecting their relationships, work and personal life, and\/or other important areas of functioning. A depressive episode can be categorised as mild, moderate, or severe depending on the number and severity of symptoms, as well as the impact on the individual\u2019s functioning [<a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/depression\">4<\/a>\u200b\u200b].<\/p>\n<\/div><\/section>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>Additionally, several other symptoms may also be present:<\/p>\n<ul>\n<li>Poor concentration<\/li>\n<li>Feelings of excessive guilt or self-worthlessness<\/li>\n<li>A sense of hopelessness regarding the future<\/li>\n<li>Thoughts about dying or suicide<\/li>\n<li>Disrupted sleep<\/li>\n<li>Changes in eating patterns or weight<\/li>\n<li>Feeling especially lethargic or low in energy<\/li>\n<\/ul>\n<p>For some, symptoms of a depressive episode may manifest as bodily symptoms such as experiencing pain, fatigue and weakness, that are not due to another medical condition.<\/p>\n<\/div><\/section>\n<div  id=\"causes\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-8  el_after_av_textblock  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Causes <span class='special_amp'>&amp;<\/span> Risk Factors of Depression<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">According to The Diagnostic and Statistical Manual of Mental Disorders (DSM-V), depression is believed to be caused by a combination of genetic, biological, environmental, and psychological factors<\/span><span style=\"font-weight: 400;\">, including [<a href=\"https:\/\/doi.org\/10.1176\/appi.books.9780890425596\">3<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Personal or family history of depression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Adverse childhood experiences, or stressful life events\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain physical illnesses and medications<\/span><\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"treatment\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-10  el_after_av_textblock  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Treatment of Depression<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Treatment for depressive disorders includes both medication and non-pharmacological approaches such as psychotherapy. Most research has shown that combined treatment (medication and psychotherapy) is the most effective course of treatment, compared to standalone pharmacological approaches [<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3918025\/\">5<\/a>].\u00a0\u00a0<\/span><\/p>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-12  el_after_av_textblock  el_before_av_textblock  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Medication<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Pharmacological management generally includes <a href=\"https:\/\/scc.sg\/e\/?page_id=5660\">antidepressants<\/a> such as [<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK361016\/\">6<\/a>]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Selective serotonin reuptake <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><span style=\"font-weight: 400;\"> (SSRIs)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Serotonin-noradrenaline reuptake inhibitors (SNRIs)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tricyclic Antidepressants (TCAs)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Monoamine Oxidase Inhibitors (MAOIs)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">SSRIs and SNRIs are second-generation antidepressants that are more commonly prescribed due to their more manageable side-effects compared to TCAs and MAOIs, the first-generation antidepressants.\u00a0<\/span><\/p>\n<\/div><\/section>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-14  el_after_av_textblock  el_before_av_textblock  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Therapy Treatments<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">Since depressive disorders affect aspects of emotional functioning, therapies which address these issues are especially helpful. The following are some examples of psychotherapies and how it helps people with depression:<\/span><\/p>\n<\/div><\/section>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Cognitive Behavioural Therapy (CBT) <\/b><\/h4>\n<p><span style=\"font-weight: 400;\">CBT looks into the links between thoughts, emotions and behaviour. It aims to alleviate distress by identifying, interrupting and correcting negative thought patterns and learned unhelpful behavioural responses, and equipping patients with more adaptive mindsets and behaviours [<a href=\"https:\/\/www.apa.org\/ptsd-guideline\/patients-and-families\/cognitive-behavioral\">7<\/a>, <a href=\"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/1755738012471029\">8<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Psychodynamic Therapy<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">It examines emotional conflicts in relation to childhood experiences and seeks to improve insight through self-reflection and self-examination [<a href=\"https:\/\/www.apa.org\/news\/press\/releases\/2010\/01\/psychodynamic-therapy\">9<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Emotion-focused Therapy<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">This therapy type focuses on becoming aware, identifying, accepting and understanding to better manage their emotions more flexibly \u2014 by facing negative emotions and transforming them to take on a more positive meaning [<a href=\"https:\/\/www.apa.org\/pubs\/books\/Emotion-Focused-Therapy-Ch-1-Sample.pdf\">10<\/a>].<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Acceptance and Commitment Therapy (ACT)<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">ACT is an action-oriented approach to psychotherapy that stems from traditional behaviour therapy and cognitive behavioural therapy. It aims to improve functioning and quality of life by increasing psychological flexibility, defined as being able to act effectively, to live in line with one\u2019s values, while accepting the presence of distressing or interfering thoughts, emotions and bodily sensations [<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5830477\/\">11<\/a>]. <\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">\n<h4><b>Dialectical Behavioural Therapy (DBT)<\/b><\/h4>\n<p>DBT is designed to facilitate the learning of new skills, the embedding of these skills into the individual\u2019s repertoire, and the generalisation of these skills across contexts. DBT incorporates a range of change-enhancing strategies interwoven with acceptance-focused strategies [<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1476179308000086\">12<\/a>].<\/li>\n<\/ul>\n<\/div><\/section>\n<div  id=\"faq\"  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2    avia-builder-el-17  el_after_av_textblock  el_before_av_toggle_container  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >FAQ<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<div  class=\"togglecontainer   toggle_close_all  avia-builder-el-18  el_after_av_heading  el_before_av_hr \" >\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  >        <p data-fake-id=\"#toggle-id-1\" class=\"toggler \"  itemprop=\"headline\"    role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-1-container\">1. What is the difference between Bereavement and Depression?<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-1-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color \"  itemprop=\"text\"   ><p><span style=\"font-weight: 400;\">Experiencing significant loss especially of a loved one can be extremely devastating. Bereavement and grief in response to that loss may appear to resemble symptoms of a depressive episode, but it does not necessarily lead to an episode of major depressive disorder [<a href=\"https:\/\/dsm.psychiatryonline.org\/doi\/book\/10.1176\/appi.books.9780890425596\">3<\/a>]. To distinguish between the two, the following table may be helpful:<\/span><\/p>\n<table>\n<tbody>\n<tr>\n<td><\/td>\n<td>\n<h5><b>Bereavement<\/b><\/h5>\n<\/td>\n<td>\n<h5><b>Major Depressive Episode<\/b><\/h5>\n<\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Pattern<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Experienced in periodic waves that become less frequent and severe over time, as the individual learns to manage their feelings of yearning and pain.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u200b\u200bExperienced more as an underlying, prolonged season of negative emotions.<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Emotional Focus\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Feelings of emptiness, disorganization, yearning, and grief regarding the deceased\u2019s absence.\u00a0 The individual has the capacity to still enjoy community, hobbies, and pleasant emotions when not thinking about the deceased.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Pervasive depressed mood and the loss of capacity to feel pleasure or allow oneself to enjoy moments.<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Self-esteem<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Typically preserved, but self-loathing usually centres around regret for not having done more, or failing to intervene (e.g., not visiting the deceased more often, failing to communicate their love enough to the deceased).<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Fundamental sense of identity and self-worth is poor; not targeted to one area or trigger. The individual is usually critical toward themselves, and often questions their belonging to the world or their communities.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Sociability<\/span><\/td>\n<td><span style=\"font-weight: 400;\">While this is dependent on individual grieving patterns, bereaved individuals\u2019 perception of community and social relationships remain preserved. Most are able to maintain connections with close family and friends.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Feels a deep sense of displacement and disengagement from community, leading to withdrawal behaviours not just temporarily, but for prolonged periods of time. Depressed individuals also tend to feel the impulse to cut ties even with close friends and family.\u00a0\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Thoughts<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Thoughts mainly focus on the deceased and memories of the deceased.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Self-critical or pessimistic thoughts that are often a result of a culmination of experiences and hurt.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Thoughts of death or suicide<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Thoughts of death and dying stem from a yearning to be reunited with the deceased.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Thoughts of death and dying stem from feelings of helplessness, hopelessness, and worthlessness. In many cases, individuals at a high risk of suicide have self-justified that their deaths will not matter, and will be worth more to those around them than their lives.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Triggers<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u200b\u200bDepressed mood triggered by thoughts or reminders of the deceased.<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Depressed mood does not have a clear trigger.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-weight: 400;\">(Adapted from <\/span><a href=\"https:\/\/www.aafp.org\/afp\/2014\/1115\/p690.html\"><span style=\"font-weight: 400;\">https:\/\/www.aafp.org\/afp\/2014\/1115\/p690.html<\/span><\/a>)<\/p>\n<p><span style=\"font-weight: 400;\">According to DSM-V [<a href=\"https:\/\/dsm.psychiatryonline.org\/doi\/book\/10.1176\/appi.books.9780890425596\">3<\/a>], when bereavement and an episode of depressive disorder do co-occur, one tends to experience greater functional impairments compared to bereavement without major depressive disorder.<\/span><\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  >        <p data-fake-id=\"#toggle-id-2\" class=\"toggler \"  itemprop=\"headline\"    role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-2-container\">2. What is the difference between Sadness and Depression?<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-2-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color \"  itemprop=\"text\"   ><p><span style=\"font-weight: 400;\">Sadness is often perceived to be synonymous with depression. However, while sadness is one of the main symptoms of depression, it is not a necessary nor sufficient condition for one to be clinically diagnosed as having depression. In other words, one may experience sadness even without a diagnosis of depression, and sadness is not necessarily required for one to be clinically diagnosed with depression [<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3181878\/\">13<\/a>].<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The criteria for one to be diagnosed as having a Major Depressive Episode requires meeting at least 5 of these symptoms among 9 including [<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3181878\/\">13<\/a>]:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight variation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insomnia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Psychomotor agitation or retardation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of energy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Feelings of worthlessness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diminished concentration<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Recurrent thoughts of death<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">And must include depressed mood<\/span><b> or<\/b><span style=\"font-weight: 400;\"> lost of interest or pleasure in almost all activities<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">In other words, one may be clinically diagnosed as having MDD even without experiencing feelings of sadness. The following table presents further differentiating symptoms between sadness and depression:\u00a0<\/span><\/p>\n<table>\n<tbody>\n<tr>\n<td><\/td>\n<td>\n<h5><b>Sadness<\/b><\/h5>\n<\/td>\n<td>\n<h5><b>Depression<\/b><\/h5>\n<\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Triggers<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Usually has a clear trigger (e.g., loss of loved one or romantic breakup)<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Usually has no clear cause<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Self-esteem<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Self-esteem generally preserved<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Underlying tones of guilt and\/ or worthlessness that can culminate in suicidal thoughts<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Activities<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Still able to find happiness and enjoyment in engaging in hobbies or things that they like<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Lack interest and\/ or enjoyment in activities that used to be enjoyable (anhedonia)<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Time frame\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Temporal \u2014 Sense of guilt and worthlessness generally not permanent\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Consistently low mood; frequent and long-lasting sense of worthlessness and guilt\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-weight: 400;\">(Adapted from <\/span><a href=\"https:\/\/www.semanticscholar.org\/paper\/Grief%2C-Demoralization%2C-and-Depression%3A-Diagnostic-Strada\/98b811ad5e7605ae60e446769d73fb08a2b3eebe\"><span style=\"font-weight: 400;\">https:\/\/www.semanticscholar.org\/paper\/Grief%2C-Demoralization%2C-and-Depression%3A-Diagnostic-Strada\/98b811ad5e7605ae60e446769d73fb08a2b3eebe<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<\/div>\n<div   class='hr hr-default   avia-builder-el-19  el_after_av_toggle_container  avia-builder-el-last '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","footnotes":""},"class_list":["post-5732","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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