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Minor Depression

Don't brush off minor depression.

In the vernacular, “depression” or “being depressed” can mean a number of things. In the clinical sense, “depression” is tightly defined by diagnostic criteria. Clinical depression typically refers to “major depression” which is characterized by having a history of one or more major depressive episodes without episodes of mania or hypomania. In addition to having depressed mood, the diagnosis of major depression requires having the presence of five or more of the following symptoms for at least two consecutive weeks: 

  • Depressed mood most of the day

  • Loss of interest or pleasure in most or all activities 

  • Insomnia or over-sleeping

  • Significant weight loss or weight gain

  • Abnormal movement speed (such as talking too fast, or moving too slowly)

  • Fatigue or low energy

  • Decreased ability to think or concentrate

  • Thoughts of worthlessness or inappropriate guilt

  • Recurrent thoughts of death or suicide

It’s easy to brush off a depressed mood associated with one or two symptoms. We’re expected to carry on, despite feeling down. In the absence of a deluge of five or more associated symptoms, the mood disturbance with insomnia and weight gain may be thought of as isolated problems, rather than manifestations of depression. We now recognize, however, that depression is a spectrum disease. There are epidemiologic, genetic, and radiologic studies that suggest minor depression and major depression are the continuum of one illness. 

The diagnosis of minor depression is made when depressed mood manifests with two to four of the associated symptoms for at least two weeks. It’s not an uncommon condition but it’s often underdiagnosed.  It is estimated that the lifetime prevalence of minor depressive disorder is 10%. Compared to major depression, mild depression tends to have shorter episodes, less comorbidity, less psychosocial and physical impairment, and fewer recurrences. Nevertheless, mild depression can impact our overall well being and can progress into major depression. Left untreated, patients with minor depression may be at increased risk of having major depressive disorders.

If you suffer from minor depression, it’s important to have a discussion with your doctor. A qualified provider can help distinguish minor depression from other conditions with similar symptoms. Develop a treatment strategy with your doctor or mental health provider. In mild cases, lifestyle changes (such as boosting your body’s natural feel good chemicals through daily exercise, practicing gratitude, connecting with family and friends) can be therapeutic. Learning to identify negative beliefs and develop alternative, more flexible thoughts through cognitive behavioral therapy (CBT) have been shown to be an effective non-pharmacological mode of treatment. Multiple randomized studies indicate that CBT can prevent progression of minor depression to major depression. Of course, sometimes, minor depression can persist despite lifestyle changes and psychotherapy. Minor depression that does not respond to multiple courses of different psychotherapies may require the addition of antidepressants. 

You are not alone. If you think you may suffer from depression, reach out to your doctor and trusted family and friends.  There are always people to help. Don’t suffer alone needlessly. 


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