What is subclinical depression?

Many people experience a drop in mood in the form of chronic sadness and associated behavioral, cognitive, and emotional problems that prevent them from leading full lives.

The DSM-5 establishes very clearly what are the diagnostic criteria for major depressive disorder, indicating that the patient must present a minimum of five of the nine symptoms specified in this manual for depression.

But .What happens to those who have symptoms but do not meet that minimum? These people would fall within the idea of subclinical depression , a problem without as many symptoms as major depression but equally disabling and generating discomfort. Let’s delve into this health problem.

Subclinical depression: what is it?
Depression is a psychological problem with different symptoms . Among the most characteristic we find a decline in mood, reduced ability to experience pleasure and decreased self-esteem, all accompanied by corresponding affective, cognitive and behavioral manifestations.

According to the WHO (World Health Organization), depression is the leading cause of disability worldwide. Its mildest variant, subclinical depression, also has important repercussions on the quality of life of those affected .

The term “subclinical” refers to the fact that the person is showing symptoms similar to those of the disorder, but not enough of them to make the diagnosis of the specific syndrome, disorder or disease. Applied to mood disorders, subclinical depression is a condition in which some symptoms of depression occur, but not enough to be able to give the diagnosis. People with subclinical depression may experience brief and recurring episodes of depressive symptomatology .

Subclinical depression is a condition that has important implications for the functioning and well-being of those who present it. Although this condition is milder than in cases of major depression, it is known that people with subclinical depression present a significant deterioration in life and show worse work, academic and social performance. In addition, they are at risk of progressing to major depressive disorder and addiction.

Characteristics of subclinical depression
There are no uniform criteria for defining subclinical depression . In fact, there is no unequivocal terminology regarding this condition, finding in the expert literature all kinds of names for what we here call subclinical depression, such as subsyndromic depression, minor depression and non-specific depressive symptoms. Despite this disparity in terms of its name, in most cases subclinical depression is considered to be one in which the patient has at least two characteristic symptoms of major depressive disorder.

In the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5), subclinical depression is classified within the category “other specific depressive disorder” and “depressive episode with insufficient symptoms”.

Symptoms of this condition
The symptoms of subclinical depression coincide with those of major depressive disorder, the main difference between both health conditions is that in the subclinical there are fewer or milder symptoms .

Depressed mood most of the day
Major weight loss or weight gain
Insomnia or hypersomnia (sleeping too much) almost every day
Psych0m0tor agitation or retardation almost every day
Fatigue or loss of energy
Feeling worthless
Concentration problems
Recurring thoughts of death and suicidal thoughts
To receive the diagnosis of major depressive disorder, it is necessary that a minimum of five of the symptoms that we have just mentioned are present , and that the patient indicates having presented them during the last two weeks. In the case of subclinical depression, these symptoms are reduced to a minimum of two and a maximum of four.

Early detection is key to successful treatment . In cases of subclinical depression, treatment is aimed at making sure that the symptoms do not worsen and degenerate into a case of major depressive disorder. However mild they may be, the symptoms in subclinical depression are still just that, symptoms, which can become very disabling.

Causes of subclinical depression
Depression is a very complex mental condition , which can be influenced by several different factors. Some risk factors can increase the probability that the person will experience symptoms of depression, among which we find genetics, family history, history of abuse and trauma, use of some drugs, significant vital changes, stress, medical illness and substance abuse.

Subclinical depression is depression only milder, with fewer symptoms. Thus, the causes behind suffering from this minor depression would be the same as for major depression, only that they would not have acted with as much force or else the person would have some type of protection factor that would have prevented him from presenting the serious disorder .

Related article: Anxiety Disorders in Children

However, it is important to insist on the idea that having mild symptoms of depression is in itself a risk factor for later developing major depression.

Psychology and Psychotherapy Miguel Ángel
Psychology and Psychotherapy Miguel Ángel
Health Center of Psychology

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As we said, subclinical depression is a case of depression in which sufficient criteria are not met to be diagnosed as such. Many people have depressive symptoms but, because they do not occur in sufficient numbers, they would not receive the diagnosis of major depressive disorder .

Several studies suggest that subclinical depression can have as much impact on a person’s functioning as major depression. Subclinical depression can have the same negative effects on the general health of the patient as major depression, only less severely . In this sense, some experts and researchers on this issue consider that depression would be more of a spectrum, a continuum from fewer to more depressive symptoms.