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From Sadness to Major Depression

Emotions are complex reactions that our minds create in order to understand and engage with the world around us. Feeling sad or even lacking motivation or energy may be ways in which our brains help us adapt to the environment and its challenges. The way we relate to other people and their attitude to us also changes depending on our emotional state.

Understanding when sadness and depression are normal and adaptive can be critical in validating our emotions and in fully understanding when and how being depressed is not in our best interest.

Major depression is more than normal sadness or bereavement. Major depression is a syndrome of multiple symptoms that are getting in the way of functioning, personal growth and adaptation to the challenges at hand.

Depression is a very common and debilitating condition. More than one in eight people will have an episode of depression in their lifetime and the majority of the patients who have an episode of depression end up having at least one more episode later in life.1 Depression involves losing motivation and interest in things, a decreased ability to enjoy life, and feeling sad or down. People suffering from depression may also have low energy, problems sleeping, too much or too little appetite, feelings of guilt and thoughts about death or even suicide.2 Depression can drastically affect somebody's ability to function interpersonally, socially, and at work. It affects the lives of the sufferers, their families and caregivers, and their employers and coworkers. From a broader view, it has a negative impact on the functioning of society at large.3

In treating major depression, it is important to avoid a symptom-focused approach. The goal should not be to eliminate sadness, to improve energy levels or to become optimistic. The goal should be to find better ways to cope, to go after our goals and find fulfilling activities and relationships.


  1. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Arch Gen Psychiatry. 2005;62:593-602.

  2. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. By American Psychiatric Association, American Psychiatric Association. Task Force on DSM-IV.

  3. The economic burden of depression in the US: societal and patient perspectives. Paul E Greenberg, Howard G Birnbaum. Expert Opinion on Pharmacotherapy, March 2005, Vol. 6, No. 3, Pages 369-376.

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