When is depression considered severe?

  • Depression is a progressive illness.

    There is no demarcation line where one crosses over from being depressed into being severely depressed as depressive symptoms are on a continuum.

    This is a typical explanation of the journey from feeling depressed to becoming severely depressed.

    One morning Joe woke up in a bad mood. He didn’t want to get ready for work because he was feeling very tired. However, he was a good employee so he forced himself to get into the shower, get dressed, eat some breakfast and go to work.

    His day at work was filled with irritability. It was not like Joe to be irritable, but everything seemed to set him off.

    The next night Joe couldn’t get to sleep at all. After lying awake for a few hours he did eventually sleep and had a good night. But next day he still felt tired and irritable. He made it to work, but everything he did took an extra effort.

    Over the next few weeks Joe developed insomnia and hardly slept at all. This made him very irritable indeed. He also lost his appetite and his head began to feel as if it was stuffed with cotton wool. He had a responsible job, but now found that he was unable to think things through clearly and he was frightened that he might get fired.

    Over the next few weeks Joe’s mood became very gloomy indeed. He began thinking about how useless he was and wondered if he would ever be able to do his job properly again. He also felt guilty because he was always snapping at his wife. Nothing seemed to please him.

    Over the next couple of days Joe’s symptoms increased and he was hardly able to make it to work at all. His energy level was at an all time low and he could barely drag himself across the room.

    A few days later, Joe found that he couldn’t stop crying. He had been brought up to believe that ‘big boys don’t cry’ so he felt extremely embarrassed about this and hid himself away in his bedroom most evenings. Whenever anybody talked to him, he got very snappy and told them to leave him alone.

    Now Joe had a new symptom. He could not stop thinking about death. These thoughts kept going round and round in his head and he began thinking how he might kill himself. The problem was he didn’t seem to have enough energy to make a plan.

    After a few days, Joe found that he had no energy to take a shower. He just wanted to stay in bed all day and do nothing. He didn’t even have the energy to brush his teeth. Eventually, his wife called his work to say that he wouldn’t be coming in.

    The crying just would not stop. He didn’t have to be thinking of anything in particular, in fact he couldn’t concentrate long enough to think properly anyway, nevertheless he found tears would be pouring down his cheeks and he had no power to stop them.

    Now Joe was unable to get out of bed at all. He felt like a little animal that was hibernating. He lay all curled up in the fetal position and slept for hours. He spent the whole day sleeping and doing nothing else. Sometimes he slept for 16 hours straight. His wife told him she was very worried about him and would have to call the doctor if he didn’t improve.

    At this point, Joe couldn’t quite understand what was happening to him, but felt sure that no doctor would be able to help him. The crying had stopped but the thoughts of death were intense when he was awake. He found that he didn’t mind the thought of dying, in fact he thought it would be better for everybody if he was out of the way.

    Joe had a distinct feeling that he was at the bottom of a deep, dark well. The sides were made of mud and he realized that there was no way to climb up the walls and get out. When he looked up all he could see was the black night above him. He didn’t have the energy to climb out of the well so resigned himself to being left down there until he died.

    His wife finally called the doctor and he was admitted to the hospital with severe depression.

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