“I am Good, just a little blue today” is a phrase we have all probably heard from other or said ourselves. We all feel blue from time to time. It is a perfectly normal emotion and there is no need for shame. The issue is when it becomes a constant in everyday life. While this may seem cut and dry, the difference between a bout of sadness and clinical depression is a common point of confusion. Expressions of sadness are often followed by “I promise I will be better tomorrow.” What happens if tomorrow comes and you are still feeling down?
Clarity begins by considering the definition of depression. Mayo Clinic describes it as such: “Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.” The key part of this definition is “persistent feeling of sadness and loss of interest.” Those not prone to depression may struggle to understand how one can feel down for such a long period of time, but it is actually quiet normal. In fact, 6.9% of Americans live with some form of major clinical depression. With more than 3 million cases a year, clinical depression is no trivial matter.
With such a large number of people affected by a variety of forms of depression, the first question is “why do people get depression?” The honest answer is there is no one cause. Depression can be caused by inherited traits from family members or a combination of, biological, environmental, and psychological factors. The breadth of causes makes it hard to proactively diagnose or prevent depression.
The societal stigma associated with depression also contributes to the difficulty of diagnosis. Many people are ashamed of feeling depression and therefore hide it from friends and family. Mental health professionals at the Mayo Clinic have compiled a list of symptoms to help others see through the attempts to cloak depression:
- Feelings of sadness, tearfulness, emptiness or hopelessness.
- Angry outbursts, irritability or frustration, even over small matters.
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports.
- Sleep disturbances, including insomnia or sleeping too much.
- Tiredness and lack of energy, so even small tasks take extra effort.
- Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people.
- Anxiety, agitation or restlessness.
- Slowed thinking, speaking or body movements.
- Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility.
- Trouble thinking, concentrating, making decisions and remembering things.
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide.
Keep in mind while these are general symptoms and not everyone will exhibit one or more as described. Many find it hard to express how they feel while suffering from depression. Vincent van Gogh once described depression through this metaphor: “One feels as if one were lying bound hand and foot at the bottom of a deep dark well, utterly helpless” (Brain Picks).
When dealing with someone who may have depression, it is important not compare their situation to times you have been sad. Chances are you may have experienced similar things on paper, but in reality the way someone feels and internalizes different experiences are uniquely their own. The best choice is to let them talk about their experience and ask questions to help them process their emotions.
Now that we have a good understanding of depression, it is time to consider courses of treatment:
- Depression can be treated through medicine and psychotherapy and there is a large market of antidepressants available to physicians to prescribe. It is always important to remember that all medicines do not work for everyone and that there is always a potential for side affects.
- Depression can be treated with psychotherapy. A psychotherapist can help patients address their feelings through open discussion and by developing personal strategies to combat depression.
- Depression can be treated through Electroconvulsive Therapy (ECT). This treatment has greatly improved over years and is nothing like the immediate images that are brought to mind. The patient is administered anesthesia and is asleep through the minor electrical pulses. Patients do not have memory of the treatment, and it has proven effective in many cases.
Depression is a complicated mental condition that carries some unfortunate stigmas. Regardless, there is no need to let depression rob you of a happy life because there are effective courses of treatment. If you even believe you may be experiencing depression, seek the support from friends and family to face the issue head on. If you know a someone that you may suspect is experiencing depression, ask them about it and let them know you care. Starting the dialogue is the first, critical step.
One last note. Depression in the most extreme cases can lead to thoughts of suicide. If you or a loved one is experiencing suicidal thoughts, please call the National Suicide Prevention Hotline at (800) 273-8255. The hotline is is open 24/7 or you can visit www.suicidepreventionlifeline.org.