Dr. Scott B. Patten, MD, PhD, Associate Professor, Departments of Community Health Sciences and Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB.
Introduction
The term depression can refer either to an emotion, such as sadness, or to a set of depressive disorders. As an emotion, depression is a universal experience, which likely explains why people naturally understand feelings of depression, on an intuitive level, as a reaction to undesirable life events. However, intuition tends not to be clinically useful for depressive disorders, and can even act as a barrier to effective communication and clinical decision-making. Of course, when depression really does represent a non-pathological reaction to a negative life event, empathic and intuitive understanding is completely appropriate, but a mental disorder should not be diagnosed in these circumstances. It is critical to be able to distinguish normal emotional reactions from the potentially dangerous and usually destructive manifestations of depressive disorders. This distinction is particularly important in the elderly, who may experience a variety of losses such as financial security, health and loved ones. Bereavement in relation to such losses may be normal and adaptive, whereas the emergence of a mood disorder--even if triggered by such events--is typically destructive and can be dangerous.
It is often difficult for patients and physicians to understand the distinction between normal or adaptive forms of depression and depressive disorders.
