Is depression just another diagnosis?

Are you depressed? Is depression just another diagnosis? Over a decade ago, depression was called the “common cold of psychiatry.” I never ask that question because people will tell me before I ask it. I used a textbook titled “Dr. Smith’s Lectures on Psychopathology” in which I described depression in all its flavors. In fact, I likened it to a fast food combo. 

Besides being a psychiatric fast-food, it’s a wildly popular topic.   Treatment approaches on depression are equally popular.  More than 50% of my clients report depression as their major problem.  And my treatment approaches vary a lot.  Like most therapists, I use cognitive-behavior therapy (CBT) and dialectic behavior therapy (DBT).

Both treatment methods examine how a person’s thoughts and beliefs affect their behaviors.   That is great except a person’s thoughts and beliefs get increasingly unusual.  The combination of CBT and DBT along with medication has been used a lot in controlling the symptoms of schizophrenia and depression.  

And that’s the rub.  Diagnoses for disorders like schizophrenia and depression are commonplace but there’s no real cure.  In many situations, all that can be done is to control their symptoms.That’s it; no cure but you can manage the symptoms and get a normal life.  But it’s more complex.  Depression is not just another diagnosis.  It is both a diagnosis and a measure.  

A diagnosis is a lot like putting people in a pigeonhole.  It provides boundaries on what it is and is not.  So, a person has the diagnosis or does not.  A measure puts people on a spectrum of some disorder.  In that case, it’s an issue of how much of a depression a person has.  Is it a “3” or “4?”  Usually, the higher the number, the more severe the problem.

Depression becomes a way of communicating absence/presence or the severity of a disorder.  It can lead to getting insurance payments or being prescribed different psychiatric medication.  And of course, it is a way of getting sympathy!