Sub-threshold depression

A person who has between two and five symptoms is diagnosed as having sub-threshold depression. If this has been going on for two years, with more days affected by low mood than not, it is termed persistent sub-threshold depression, or sometimes dysthymia. In most cases, these individuals are able to cope with everyday life.

Depression

Someone with at least one core symptom plus at least four more symptoms is generally diagnosed as having depression. If this appears episodic, with recurrences appearing in winter and remitting in spring each year, it is likely to be regarded as seasonal affective disorder.

An assessment of someone with suspected depression should not hinge solely on ticking symptoms off a checklist. The duration of symptoms, plus past and family history, should be considered to gain as much insight into the patient as possible. The impact of the symptoms – which is likely to be influenced by a wide range of biological, psychological and social factors – should also be taken into account as this will help classify the depression and influence management. 

• Mild

Depression is usually regarded as mild if functional impairment and/or symptoms are relatively minor.

• Moderate

Moderate depression is when more symptoms are present and to a greater degree. The individual is likely to be struggling to maintain their everyday activities. 

• Severe

In severe depression, most symptoms are present, there may be symptoms of psychosis and functioning is markedly impaired.

Reflective exercise

Do you know the contact details for your local specialist mental health crisis team? Make sure the details held in your signposting folder are up to date.