“…As with other conditions where diagnosis is made on the basis of inevitably arbitrary cut-off points on scoring systems (such as anaemia, asthma, and diabetes), we also need to consider the context of symptoms, and understand the complexity of the relationship between psychological, physical, and social problems and their temporal variations. 7 The updated NICE guidelines on depression note that identification of major depression should be based not only on its severity but also on persistence, the presence of other symptoms, and the degree of functional and social impairment. 8 Many people with sub-threshold disorders in current classification systems experience significant degrees of disability, while people with severe depressive symptoms may be able to function with a remarkable degree of normality.…”