I have found myself having a lot of conversations about depression lately. From clients to friends to colleagues, sadness and disappointment have many people in their grasp these days. I imagine that local, national, and global events are major contributing factors. Whether you call recent U.S. economic challenges the Great Recession or the 2nd Great Depression (hmmm, there’s that word again), unemployment & stagnant wages & cuts to services to our most vulnerable are crippling the nation. Then there’s the Haiti earthquake, the BP Oil Spill, the Japan earthquake, tsunami, and nuclear crisis, and the various wars the U.S. is participating in. Lots of reasons to be bummed, especially if you watch mainstream news on a regular basis.
Sadness is a normal human emotion and while it may not be pleasant to feel, it is an essential part of our experience. I think it is important to be sad about the above laundry list of alarming events… Sadness — like all our other emotions — can be a messenger, if we let it. Sadness alerts us that something important, significant, meaningful is happening. Whether sad at the end of a fun experience or about living far from family or about the loss of a job or loved one, sadness is part of our collective story. In addition, one cannot be happy all the time. In fact, we call it mania when someone’s mood is excessively positive for too long. Think about the cycles of nature… There is birth, growth, death. Plants require both sunshine and rain to grow, so how can we expect only sunshine in our own lives? As the book of Ecclesiastes notes, “To everything there is a season and a time to every purpose under heaven.”
While personal challenges and socio-political factors have a huge impact on a person’s mood, there is a significant difference between general sadness and clinical depression. True clinical depression is deeply painful (both emotionally & physically) and makes it difficult for a person to function normally. The disorder takes over a person’s thoughts, turning them almost exclusively to the negative (or at least making it really hard to think anything positive). There is huge body of research on what is happening in the brain on a neurochemical level in a depressed person, but that’s beyond my purpose here in this article. I’ll focus instead of the different types of depression, their symptoms, and some resources for more information.
There are different types of depression, but when most people use the word they are probably referring to Major Depressive Disorder. From the Diagnostic & Statistical Manual of Mental Disorders, the symptoms of Major Depressive Disorder include:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). Children and adolescents may present with irritable mood.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite.
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
As you read through this list, you may have found yourself thinking, “I’ve felt that way before!” It’s true, many of us have had these signs or symptoms at one point or another for a short time. It is important to note that a person with true major depression will have at least five of these symptoms and experience them nearly every day for at least two weeks. In addition, the above symptoms must be significantly impairing a person’s daily functioning. This means that the person’s behaviors are causing them to have significant difficulties at work (e.g., can’t complete important tasks), school (e.g., sudden drop in grades), or in personal relationships (e.g., emotional withdrawal from or frequent arguments with one’s partner).
Another form of depression is called Dysthymic Disorder (from Greek, quite literally “bad mood”). This is more of a low-grade depression that lasts for an extended period of time. Two or more of the following symptoms must be present for at least two years in adults and one year in children (with no more than two months being symptom-free).
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
Due to the training & experience required to properly diagnose a depressive disorder, I encourage you to refrain from diagnosing yourself based on the information presented here. If you suspect that you or a loved one are experiencing depressive symptoms, please consult with a qualified mental health professional. You can also take this online Depression Screening Test to help you determine whether your feelings & behaviors match up with depressive symptoms. Psych Central hosts this screening test and has an amazing collection of resources on depression and its treatment.
In my next post, I’ll be exploring various treatments for depression, with an emphasis on how mindfulness, meditation, and movement can be used in depression recovery. Be well and stay tuned!