Difference between situational and clinical depression?
So I know there is a definition difference between situational and clinical depression. I know they can be diagnosed differently and have slight differences that can be present that "the experts" should pick up on to tell the difference between the two. I guess I am asking because currently all the people I have seen to try to treat my depression seem to be at odds on whether my depression is situational or clinical. I guess my question is, can it be both?
I can give explanation for why I might have been depressed for every time I've felt like I do now in my life. I could make a good case for situational depression if we just focus in on the beginning of any depressive episode in my life and just the depressive episode itself. However, the length of my episodes leans toward clinical depression. Usually my episodes last for at least a year if not longer. Many would tell you that this is subjective because I've never been treated before for depression until now. I got very good at hiding. I quickly learned in elementary school to hide my emotions thanks to bullying. The counselor is sure that bullying is probably the cause of my first serious depressive episode when I was in late elementary. I nearly attempted suicide during that episode, the fact that I had a dog (whom I considered to be my very best friend) that I didn't want to leave behind was the only thing that stopped me. My parents are not even aware that I nearly commited suicide. I do not trust my parents, it was not the best family life. But that's why it's hard to say if it's situational that leads me into these episodes. I seem to just cycle between "I can manage life, but it certainly is shitty" and "dear god, I can't do this anymore." There's lots of bad moments in both stages.
I realise this reveals that my brain is really wired towards the negative in my life. I can easily focus on the piles of shit in my life, but I can also acknowledge the good too. While my family life wasn't always the best, I knew that deep down my parents do actually really care for me, even if they haven't always demonstrate that in the best way. Their anger is often seated in "please don't make the same mistakes I did" even if they don't demonstrate this in the best ways. I certainly know my life isn't the worst it could be. My parents helped me get through undergrad by taking out loans themselves so I came out of college with less than $20,000 of debt when it could have easily been double that without their help. I'm grateful that they helped me. I have made some great friends throughout my life that have been super supportive. I made it to graduate school to study what I've been working towards since I first set myself on that path in high school. I can tell you a lot of great things about my life.
Yet, even if I try to focus on all those positives, I still spiral down. I think on all the great things, and I feel overwhelming guilt that I should stop being a cry baby, buckle down, and get back to work. I know this is how depression can be. I try to just be in the moment and stop focusing on what I have to do and what has happened in the past. This helps a little, but I can only keep that up for a bit before depression just overwhelms me again. I feel at a loss anymore. I've tried all the suggestions that the counselors, doctors, and whoever has offered, but nothing seems to really help anymore. I've kept a gratitude journal for years that I update every day. And yet this black cloud is just there. Maybe it lessens a bit, sometimes it might be so faint it's like it's gone, but it eventually comes back. This time seems worse than ever and I worry it might get worse. I guess in some ways, I'm already starting to accept that it might just always be there. Yet, everyone else keeps telling me if I just do this, that, or other that it will go away. I guess I just hope for someone to acknowledge that maybe I am not just pessimistic and I have realised the reality of my situation, and I am trying my best to make do, but it doesn't always work. I don't even know if this completely makes sense to anyone.
@irime, this is a really good question. Many of the symptoms for these two types of depression can be the same. But there are some differences. Situational depression gennerally appears with or soon after a major life crisis and will leave once the event is over or dealt with. Clinical depression will also occur without a major life change/event/crisis. Suicidal ideation can accompany clinical depression, but not all those with CD experience it. Clinical depression is generally of longer duration. If the depressed person responds well to medications and/or has a family history of depression, this tends to indicate clinical depression rather than situational depression. Of course, the best way to know whether it's situational or clinical is receiving a diagnosis from a medical professional.
Remember that we're here in the Depression community to listen and support.
@BridgetAileen Yeah, I guess that's why I'm asking. My family does not have a past of depression as far as I know. My mom once got depressed, but she said it was situational. Granted it is also difficult to know, because there is a bit of stigma with my family about mental illness. They're the type that just keeps working even if the situation is not very good at all. They would rather say depression is laziness because they are hard working people so there could be a family history, but it is not known. I've been working with a therapist as well as several doctors, as I said in my original post, and they're not sure which one I am. I don't seem to be responding to medication which is why I think the psychiatrist I recently saw was asking if my depression may be caused by my gender dysphoria. This is a likely possibility since the dysphoria can't really be "removed" like a situational event can be passed. However, I only became aware of my dysphoria 3-4 years ago and this bought of depression only came in the past year or so. Amazing how you can't get straight, easy answers with mental illness because there's too many factors.
@irime, so true. We're such complicated creatures, aren't we? I know with my parents' generation, there was a huge stigma associated with mental illnesses and disorders. It was not as bad with mine, and continues to improve. That's not to say that the stigma is gone, but that with better medical care, the research done, the education available, and more people willing to speak up, we've seen stigma begin to decrease generation by generation.
It could be that although your dysphoria was recognized several years before the depression, that it just took the depression a few more years to show up as everything just built up. Kind of like filling a balloon until it bursts. I don't know...just trying to think of possibilities. I'm clinically depressed, but it didn't really manifest as full blown depression until I was in my 20s. Maybe it just took that long for me to be out of balance enough. I don't know. Like you said, it's hard to know exactly with these things.
I hope to see you around. 
