Most episodes of depression are brief and mild, and are dealt with by the patient's own resources, or by talking with a relative or friend. Of those patients who do present for help, the vast majority are dealt with in primary care. The diagnosis of depressive illness in clinical settings will have some regard to the official classifications set out above. However, clinical training and experience also comes into play. Mild reactions to difficulties experienced in life may not in practice be diagnosed as clinical depression. The clinician should look for features such as biological symptoms of depression, anhedonia, and guilt before entertaining the diagnosis. Depressed mood which seems unduly severe or prolonged in relation to its apparent precipitant, the presence of somatic symptoms, and prominent guilt, pessimism, anhedonia, suicidal thinking, and low self-esteem, all suggest depressive illness.
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