😢 Sadness
A normal reaction to something that has happened. It is short-lived. A person can still enjoy things, and they feel better as time passes.
Clinical Depression » Characteristics of Clinical Depression
What you'll learn this session
Study time: 30 minutes
AQA spec: 3.2.4.3
- The difference between sadness, unipolar depression and bipolar depression
- How the International Classification of Diseases (ICD) is used to diagnose unipolar depression
- The symptoms doctors look for: low mood, low energy, sleep and appetite changes, low self-confidence
- How the number and severity of symptoms decide whether depression is mild, moderate or severe
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Unlock This CourseSadness or depression?
Everyone feels sad sometimes. You fail a test, a friend moves away or a pet dies, and you feel low. That is normal. Clinical depression is different. It is a significant mental health problem that lasts a long time and gets in the way of everyday life.
Key terms:
- Sadness: a normal, short-lived reaction to events. It fades as things improve or time passes.
- Unipolar depression: persistent low mood. "Uni" means one, because the mood stays at the low end.
- Bipolar depression: episodes of depression that alternate with episodes of mania. "Bi" means two, because the mood swings between two extremes.
- Mania: a period of extremely high energy and excitement, when a person is overactive and feels they can do anything.
- International Classification of Diseases (ICD): a list of illnesses, with the symptoms needed for each one, that doctors use to make a diagnosis.
- Symptom: a sign that something is wrong, such as feeling tired all the time.
Three different things
🌧 Unipolar depression
Low mood that is persistent. It does not lift on its own and it affects sleep, energy, eating and confidence. There are no high "manic" episodes.
🎢 Bipolar depression
Episodes of depression alternating with mania. The person swings between very low periods and very high, overactive periods.
Quick way to remember
Sadness = short and linked to an event. Unipolar = low mood that stays. Bipolar = low episodes that swap with manic episodes.
How is unipolar depression diagnosed?
A doctor cannot see depression on a scan, so they look at the symptoms. In the UK, doctors use the ICD to do this. The ICD sets out which symptoms count. The symptoms the specification asks you to know are:
- Low mood: feeling sad, empty or hopeless most of the time.
- Reduced energy levels: feeling tired and worn out even after resting.
- Changes in sleep patterns: sleeping much too little or much too much.
- Changes in appetite levels: eating much less or much more than usual.
- Decrease in self-confidence: feeling worthless or not good enough.
Two things matter when the doctor decides. First, the symptoms must last for a period of time, about two weeks. This is what separates depression from a bad few days. Second, the doctor looks at the number of symptoms and how severe they are.
Mild, moderate or severe?
The ICD does not just say "depressed" or "not depressed". It also grades how serious the depression is. The more symptoms a person has, or the more severe those symptoms are, the more severe the diagnosis.
🙂 Mild
Fewer symptoms, and they are less severe. The person can usually carry on with most daily life, but it takes extra effort.
😐 Moderate
More symptoms, or more severe ones. Daily life such as school or work becomes much harder.
😔 Severe
Many symptoms, or very severe ones. The person finds it very hard to cope with everyday life at all.
Worked example: a case to diagnose
Amir is 15. Over the last month he has felt low almost every day and says nothing is worth doing. He is tired all the time, even after a long sleep. He has stopped eating lunch and says he is "rubbish at everything".
Reasoning: Low mood, reduced energy, a change in appetite and a decrease in self-confidence are all symptoms the ICD uses. They have lasted longer than two weeks, so this is not just sadness. His mood is only low, with no manic episodes, so this points to unipolar depression. He has several symptoms that are affecting daily life, so a doctor would grade it as more than mild.
Common mistakes
Common mistakes
- Saying sadness and depression are the same. Sadness is short-lived and linked to events. Depression is persistent.
- Mixing up unipolar and bipolar. Unipolar has only low mood. Bipolar has depression and mania.
- Forgetting the time rule. Symptoms must last about two weeks.
- Forgetting to say that more or more severe symptoms give a more severe diagnosis (mild, moderate, severe).
If this feels close to home
If you ever feel like this for a long time, talk to a parent, a teacher, a school counsellor or your doctor. Depression is common and it can be treated.
Exam-style question
(a) Give one difference between sadness and unipolar depression. [2 marks]
(b) Identify two symptoms that doctors use when diagnosing unipolar depression with the ICD. [2 marks]
(c) Explain how the ICD decides whether unipolar depression is mild, moderate or severe. [2 marks]
Model answer
(a) Sadness is a normal, short-lived reaction to events (1), whereas unipolar depression is persistent low mood that lasts a long time (1).
(b) Any two from: low mood; reduced energy levels; changes in sleep patterns; changes in appetite levels; decrease in self-confidence (1 each).
(c) The more symptoms a person has, or the more severe the symptoms are (1), the more severe the diagnosis (1).
Exam tip
In part (a) write about both things. "Sadness is short-lived" on its own earns one mark. Say what depression is like as well.