Depression: Symptoms, Severity and Treatment
In brief
Depression is a mental health disorder in which low mood or loss of interest lasts a long time and disrupts daily life. The Finnish Current Care (Käypä hoito) guideline classes it as mild, moderate or severe by the number of symptoms. It is treatable: psychotherapy, antidepressants or both are chosen by severity. Only a professional can diagnose it.
Severity levels of depression
In the Current Care guideline, severity is set by the number of ICD-10 symptoms. Symptoms must have lasted at least two weeks, and severity can also be judged by how much they impair daily functioning. The classification is a clinician's tool, not a self-test.
- Mild depression: 4-5 symptoms.
- Moderate depression: 6-7 symptoms.
- Severe depression: all three core symptoms are present, plus 8-10 symptoms in total. Psychotic depression also involves delusions or hallucinations.
Symptoms such as prolonged low mood, loss of interest, fatigue, sleep problems and feelings of worthlessness are described in more detail in the glossary. Depression (glossary)
How is depression treated?
Treatment depends on severity and circumstances. Key points of the Current Care guideline:
- Mild and moderate depression: psychotherapy and antidepressants relieve symptoms equally well, and combining them is usually the most effective.
- Severe or psychotic depression: medication should always be used. The effectiveness of psychotherapy as the only treatment is uncertain. In psychotic depression an antipsychotic is added, and electroconvulsive therapy (sähköhoito) is the most effective treatment.
- Evidence-based psychotherapies include cognitive behavioural therapy, interpersonal therapy, psychodynamic therapy and behavioural activation.
- The guideline advises continuing medication for about six months after symptoms have gone. A doctor decides on medication; do not stop it on your own.
When and where to get help
Seek help if low mood or other symptoms last over two weeks and make daily life harder. Getting help early is worthwhile.
- Contact a doctor
A health centre, occupational health or a private doctor can assess your situation and plan treatment. - Check support for psychotherapy
After treatment has lasted at least 3 months, a psychiatrist can write a B-statement (B-lausunto) for Kela rehabilitative psychotherapy. See the Kela application guide. - Choose a therapist
You can search for a therapist by method, location and language.
If you have thoughts of suicide or are in immediate danger, call 112. For a conversation, the MIELI Mental Health Finland crisis line is 09 2525 0111 (in Finnish, around the clock). Crisis help
Source: Depression. Current Care guideline (Finnish Medical Society Duodecim, Finnish Psychiatric Association), kaypahoito.fi.