Depressive disorders: an educational overview

Beyond the word depressed

An assessment explores sustained low mood or loss of interest alongside changes in energy, sleep, appetite, concentration, self-evaluation and activity. Describe the pattern, persistence and change from usual functioning. Everyday use of the word depression does not itself establish a depressive episode.

Functional consequences may appear in work, relationships, self-care or the effort required to maintain ordinary activities. A person can still complete tasks while experiencing substantial difficulty. The account should include the lived impact rather than only a symptom list.

Read the longitudinal history

Establish previous episodes and periods of recovery. Ask about earlier changes involving elevated or unusually irritable mood and increased activity, because a depressive presentation must be understood in the broader mood history. Also examine physical illness, medication and substance-related contributors.

Life events and bereavement are part of the context. They neither automatically establish nor automatically exclude a disorder. Use the complete clinical description and the person’s circumstances instead of treating a single symptom or event as decisive.

Questions for a case discussion

What changed first? Which symptoms occur together? What is the effect on functioning? What evidence supports the working interpretation, and what alternative explanation remains plausible? State information that was not assessed.

Assessment includes direct exploration of thoughts of death and self-harm by the clinician. A brief educational article cannot establish an individual’s risk or choose treatment. Consult the full reference and current applicable guidance for clinical decisions.

For your next supervision discussion

Summarize the episode timeline and effects on ordinary activities before discussing a label. Which part of the prior mood history would change the interpretation of the present symptoms?