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Normal sadness is caused by upsetting or disappointing circumstances, and resolves over time. Clinical depression is influenced far more by inherited body chemistry than circumstances. It is hard for people who have not experienced clinical depression to understand its impact and severity.

Diagnosis of clinical depression

A diagnosis if based on one of the following two elements being present for at least two weeks:

  • depressed mood, or
  • the absence of pleasure or the ability to experience it – anhedonia.

In addition, at least five of the following ten symptoms must also occur:

  • feelings of overwhelming sadness, fear or lack of emotion
  • decreased interest in daily activities
  • changing appetite and marked weight gain or loss
  • disturbed sleep patterns
  • unintentional and purposeless movements
  • fatigue, mental or physical, and loss of energy
  • intense feelings of guilt, anxiety, hopelessness and worthlessness
  • trouble concentrating, making decisions or remembering
  • recurrent thoughts of death or suicide
  • fear of being abandoned by those closest.

Treatment of clinical depression

There are two primary modes of treatment, typically used in conjunction – medication and psychotherapy.


Most antidepressants are believed to work by slowing the removal of certain chemicals from the brain. These chemicals are called neurotransmitters (such as serotonin and norepinephrine). Neurotransmitters are needed for normal brain function and are involved in the control of mood and in other responses and functions, such as eating, sleep, pain, and thinking.

Antidepressants help people with depression by making the natural neurotransmitter chemicals more available to the brain. By restoring the brain’s chemical balance, antidepressants help relieve the symptoms of depression.


Therapy offers people the opportunity to identify the factors that contribute to their depression and to deal effectively with the psychological, behavioural, interpersonal and situational causes.

Skilled therapists aim to:

  • pinpoint the problems that contribute to depression
  • identify and assist with negative or distorted thinking patterns
  • explore learned thoughts and behaviours that contribute
  • help regain a sense of control and pleasure in life.

Suicide risk

Be aware of any signs of suicide risk. If suicidal thoughts are present it is important to encourage the person to seek help from a doctor or psychologist. Warning signs to look for include:

  • statements like “It would have been better if I had died”
  • making threats about committing suicide
  • having a plan for suicide and the means to achieve it are very strong indicators of intent and must be taken very seriously.

All suicidal comments need to be taken seriously and addressed but having a plan and the means to achieve it is a sign that professional help needs to be sought as a matter of urgency. If the situation is critical, call 000.

Further information

Beyond Blue – 1300 22 4636

Lifeline Australia 13 11 14 for 24/7 support

Sane Australia 1800 18 7263