Why is depression considered a psychiatric disorder?

Depression is a psychiatric disorder and is classified as a mood disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard classification system used by mental health professionals.

The official term for clinical depression is major depressive disorder (MDD).

Why is depression a psychiatric disorder?

  1. Affects brain function
    • Depression is associated with imbalances in brain chemicals (neurotransmitters) like serotonin, dopamine, and norepinephrine, which regulate mood, motivation, and emotions.
  1. Defined symptoms
    • Depression meets clear diagnostic criteria, including persistent sadness, loss of interest, fatigue, sleep disturbances, and suicidal thoughts, lasting at least two weeks or longer.
  1. Impairment in daily life
    A couple who are having a fight.
    • It considerably disrupts normal functioning in areas such as work, relationships, and personal well-being.
  1. Biological and psychological causes
  1. Effective medical treatment
    • Since it has biological underpinnings, depression is often treated with antidepressant medications (SSRIs, SNRIs, etc.), psychotherapy (CBT, interpersonal therapy), or both.
  1. Heritability and genetic links
    • Studies show that depression runs in families, with 40-50% heritability in cases of severe depression.
    • Specific genes related to serotonin regulation (such as SLC6A4) have been linked to increased depression risk.
  1. Structural and functional brain changes
    • Brain imaging studies reveal reduced activity in the prefrontal cortex, which is responsible for decision-making and emotional regulation.
    • The amygdala is involved in processing emotions and frequently shows increased activity, leading to heightened negative emotions.
    • The hippocampus (linked to memory and stress regulation) tends to be smaller in people with depression.
  1. Chronic stress and HPA axis dysfunction
    Image of a man lying awake in bed, unable to sleep, with the clock reading 4:24.
    • The hypothalamic-pituitary-adrenal (HPA) axis controls stress responses and is regularly overactive in many depressed individuals.
    • This leads to higher cortisol levels, contributing to symptoms like anxiety, fatigue, and sleep issues.
  1. Comorbidity with other psychiatric disorders
    • Depression frequently coexists with other psychiatric conditions, such as anxiety disorders, bipolar disorder, PTSD, and schizophrenia.
    • This suggests a common neurological or genetic basis for these conditions.
  1. Global recognition by health authorities
    • Organizations like the World Health Organization (WHO) and the American Psychiatric Association (APA) classify depression as a mental disorder based on scientific research and clinical evidence.
    • The WHO ranks it as one of the leading causes of disability worldwide.
  1. Response to psychiatric treatment
    Image of a bottle of medication that's open, with the pills spread over a table.
    • Unlike temporary sadness, clinical depression typically requires medical or therapeutic intervention.
    • Antidepressants (SSRIs, SNRIs, MAOIs), psychotherapy (CBT, DBT, IPT), and even electroconvulsive therapy (ECT) are helpful for many patients.
    • These treatments wouldn’t work if it were merely an emotional state.
  1. Evolutionary and developmental aspects
    • Some theories suggest that depression evolved as a biological response to stress, loss, or trauma, helping individuals to withdraw and conserve energy.
    • Childhood trauma and early life adversity are known risk factors that can impact brain development and emotional regulation.

Final note

Depression is classified as a psychiatric disorder because it involves biological, neurological, genetic, and psychological factors that disrupt normal brain function and emotional regulation.

It is not just temporary sadness but a clinically recognized condition with defined symptoms, clear diagnostic criteria, and a major impact on daily life.

Studies show that depression is linked to neurotransmitter imbalances, structural brain changes, genetic predisposition, and stress response dysfunction.

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