Depressive disorders are a group of illnesses that have the presence of pathological sadness as a symptom in common. In medicine the sadness symptom is defined as the presence of a more intense feeling of sorrow than expected, and persistently limits the person to be able to perform their usual activities.

Non-pathological sadness Sadness as a symptom of illness
Intensity proportional to the situation Intensity disproportional to the situation
Intensity not maintained with time Intensity maintained with time
Absence of other symptoms of depression Presence of other symptoms of depression
Non-limiting Limiting

 

Based on the most common symptoms, to the response to various existing treatments, and the short-term, medium-term, and long-term prognosis, the depressive disorders are divided into:

Adjustment disorder with depressed mood is characterised by:

  • The patients themselves identify a recent trigger (stressor) as the origin of the symptoms.
  • The trigger (or its direct consequences) is still present.
  • The exposure to intense environmental situations leads, temporarily, to an adequate performance. Said another way, if the person affected by an adjustment disorder is shown an intense stimulation (for example; a funny video of their grandchild), this is due to the new focus of attention and expresses a logical feeling to that situation.

Dysthymic disorder or dysthymia is characterised by:

  • Chronic presence (months or years, not days or weeks) of a feeling of dissatisfaction, a feeling of downheartedness and despondency that causes sadness and a poor daily functioning of the person. Apathy and the loss of initiative predominate over the loss of hope and expectations.
  • The patients describe their feeling of sadness as qualitatively similar to the normal feeling of sadness. What is remarkable for the individual patient that suffers from it, is its persistence or chronicity and apparent absence of specific triggering situations.
  • As occurs with the adjustment disorder, the exposure to intense environmental situations gives rise, temporarily, to an adequate performance.
  • Often, but not always, these patients have a very emotional and/or very dependent baseline personality.

The depressive episode (or major depression) is characterised by:

  • The patients describe their feeling of sadness as qualitatively similar to the normal feeling of sadness, considering it a new experience. What characterises it is the existence of a decrease in the emotional response to situations of, theoretically, marked emotional depth. This fact explains that the patients very often do not focus their complaint on their sadness, but on the feeling of fear and anguish of the emotional block from which they suffer.
  • Unlike what happens in adjustment disorder and in dysthymia, the exposure to intense environmental situations leads to little or no variation in their mood state (that is to say, their mood is not easily changeable by determined environmental situations).

Table comparing the main characteristics of sadness in each one of the three most common depressive disorders

Adjustment disorder Dysthymic disorder Depressive disorder
Sadness focused on the problem or acute stress Chronic feeling of sadness, with dissatisfaction, fury and/or deception Feeling of incompetence, bewilderment, alert and fear of the lack of their emotional responses
Temporary improvement to intense stimulations Temporary improvement to intense stimulations Absence of frank improvement to intense stimulations

According to data published by the World Health Organisation (WHO), in Spain, every year, 5.2 persons per 100 inhabitants have a depressive disorder.

The prevalence of depression varies slightly from one area of the world to another; the lowest rates are observed in the Western Pacific Region (3.6 individuals per 100 inhabitants), and the highest in Africa (5.4 per 100 inhabitants).

Depressive disorders are approximately two times more frequent in females than in males. Likewise, the prevalence varies with age. The higher the age, there is more risk of suffering these types of illnesses. The highest incidence is seen among women greater than 55 years (7.5 per 100 inhabitants). Depressive disorders also affect children and adolescents, although its prevalence is less than among adults.

Substantiated information by:
Joana Guarch DomènechPsychologist — Psychiatry and Psychology DepartmentVíctor NavarroPsychiatrist — Psychiatry and Psychology Department

Published: 3 April 2018
Updated: 3 April 2018

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