Depression as a disorder vs. depression as a symptom: what's the difference

When most people hear the word "depression," they picture low mood, exhaustion, a general sense that everything feels grey. That is how the word is used in everyday speech. But for a psychiatrist, it means something entirely different — and that distinction matters enormously.

"Depression" in everyday language vs. psychiatry

In ordinary conversation, "depression" has become a catch-all word for a wide range of difficult experiences: fatigue, anxiety, feeling unwell. Dr. Saulitis describes it as a basket word — people throw all kinds of bad feelings into it and attach a single label.

In psychiatry, depression is a specific mental disorder with a defined clinical picture. It is an endogenous, genetically determined condition, and it requires a fundamentally different approach than situational low mood or burnout. This mismatch, as the doctor puts it, creates "wild confusion": the specialist and the patient are using the same word but talking about entirely different things.

How to understand what you are actually dealing with

The first step is to rule out conditions that can mimic depression or other mental disorders. Before drawing any conclusions, it is important to:

• Examine the body. Blood and urine tests, biochemistry — especially liver enzymes (ALT, AST and related markers). Issues with the thyroid, liver, pancreas and other organs can independently produce psychiatric symptoms.
• Perform an EEG. This is the baseline examination of brain activity.
• If needed — MRI. Only a 3-tesla scanner provides sufficient imaging detail to assess brain function meaningfully.

Only once these results are in hand does it make sense to consult a specialist. Without them, appointments risk becoming a waste of both time and money.

Why this matters for choosing the right help

A symptom and a disorder call for fundamentally different approaches. If the cause of "depression" turns out to be physical, that is what needs to be treated. If the problem is an endogenous psychiatric disorder, talking therapies that work well for situational distress will not be sufficient. Confusing the two is genuinely harmful: a person either fails to receive the help they need, or receives help that is irrelevant to their actual condition.