When does sadness become depression, and depression become a clinical problem? As the biologist Lewis Wolpert asked in his account of his own illness: “Are the same factors involved and are the differences just quantitative, or is there a qualitative change?”
When diagnosing depression, doctors look for classical syndromes: low mood, pessimistic outlook, lack of enjoyment, sleeplessness, reduced energy and lethargy. A clinical problem arises when these elements occur with sufficient severity to disrupt someone’s life to an unacceptable degree.
Most psychiatrists now agree that the division of depressive disorders into reactive or endogenous (responses to external or internal events)…
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