It’s okay to feel sadness. The loss of a loved one, getting fired, the dissolution of a relationship, these are all valid reasons for experiencing sadness, loneliness, and heartache. However, there are some individuals for whom these feelings are continual. Known as depression, this psychiatric condition manifests itself in different ways for different people. According to the Anxiety and Depression Association of America, more than 16.2 million adults in the United States have had at least one major depressive episode in any given year.
For some, depression manifests itself as constant tiredness and lethargy. For others, it can be a persistent anxiety, irritability, or dissatisfaction with life. Depression can also manifest as a lack of feeling anything at all, like a black hole that swallows all emotions and leaves victims feeling hollow. Depression is more common in women than in men, and whereas women are more likely to acknowledge and seek treatment for their depression, men are more likely to self-medicate using drugs and alcohol.
October is Depression Awareness Month. Part of the goal of this awareness push is to encourage people suffering from depression or whom experience depressive symptoms to seek treatment for their condition. It is also intended to shed light on the magnitude of the problem, provide access to information and psychiatric resources, and educate the public on the best ways to help a loved one deal with depression.
What is Depression?
From a clinical standpoint, depression is not having a bad day or being in a funk for a week. We sometimes throw around the word depression to describe everything from a mood to chronic illness, but this only makes the term harder to pin down and creates a stigma about coming forward with clinical depression. Depression is a debilitating and real condition that affects the lives of millions around the world, and if left untreated can be very dangerous.
Major Depressive Disorder
The most commonly diagnosed form of depression is major depressive disorder. Major depression affects roughly 1 in 20 Americans every year and is an equal opportunity illness, affecting people from all socioeconomic backgrounds and races. Major depressive disorder, sometimes referred to as clinical depression, is a serious medical condition that impacts mood, behavior, appetite, sleep, and function. When mental health professional diagnose this condition, they look for five or more of the following symptoms:
- Loss of interest in the things you used to enjoy, i.e. sex, video games, time spent with friends
- Feeling sad, down, or irritable most of the day, every day
- Feeling slow and lethargic all the time or restless
- Major changes in appetite
- Thoughts of death or suicide
- Problems concentrating, remembering, and making decisions
- Loss of energy and feeling tired all the time
- Feeling worthless or guilty about things that shouldn’t make you feel that way
- Trouble falling asleep, or sleeping all the time
Psychiatrists generally look for symptoms lasting for longer than 2 weeks in order for the patient to qualify for having depression. The symptoms must also interfere with the patient’s daily life in order to be considered clinical. The symptoms are useful for diagnoses, but this illness permeates down to your emotional core and the personal experience of depression can be captured better by hearing from people who suffer from it:
“I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.”
“Perhaps it was because I lacked the emotional depth necessary to panic, or maybe my predicament didn't feel dramatic enough to make me suspicious, but I somehow managed to convince myself that everything was still under my control right up until I noticed myself wishing that nothing loved me so I wouldn't feel obligated to keep existing.”
“Not wanting to do anything. Not wanting to be anything. Not wanting to be at all. I don't necessarily want to die. I just want to have never existed.”
“I haven’t felt genuinely happy or content for years. My default mood is apathy. If I'm alone in my own head for too long I start to spiral down. It feels like I'm emotionally drowning. I feel like I have a physical void in my chest, and I feel like I'm collapsing in on myself. I wonder if I'll ever have that feeling of just being happy again.”
“I have a pretty constant anxious knot in my stomach, a hard time getting out of bed, lot of self loathing, self hating thoughts(to the point it visibly affects my mood even at work sometimes), overeating as it feels like the only thing that gets me happy and distracted for a hot minute, but obviously getting sick from too much food and regretting it.”
As you can see, the pervasiveness of depression goes beyond simple, ordinary sadness. You might have these feelings occasionally, but when nothing resolves them and they last for months on end, it is likely depression.
Common Forms of Depression
Persistent Depressive Disorder (Dysthymia)
Dysthymia is a persistent dark mood that stays present for most of the day and lasts for most days for at least 2 years. It is similar to major depressive disorder but less severe. Dysthymia is diagnosed when patients meet two or more of the following criteria, including poor appetite or overeating, insomnia or hypersomnia, feelings of hopelessness, low energy or fatigue, low self-esteem, difficulty making decisions, and poor concentration. Patients may experience major depressive episodes when diagnosed with this illness.
Seasonal Affective Disorder (SAD)
Another type of depression is Seasonal Affective Disorder, or SAD. This is when victims suffer from Major Depressive Disorder during specific times of the year, usually during winter. This condition occurs in up to 5% of the U.S. population in any given year and affects women more than men, representing 4 out of 5 people with this condition.
Adjustment Disorder with Depressed Mood
This depressive disorder is diagnosed when the symptoms of depression occur within 3 months of a particular triggering event., such as moving, divorce, a new baby, or any kind of event that is stressful. The distress caused by the event is typically out of proportion and thus requires short term treatment in order to resolve it.
Bipolar disorder, or manic-depressive disorder affects roughly 2.8% of the U.S. population in any given year and occurs equally in men and women. This disorder is characterized by a manic or energized mood, called an episode, which is followed by an episode of major depression. The highs and lows of bipolar disorder are especially difficult to deal with.
Tips on Dealing with Depression
Clinical depression can be a life-threatening condition, but it is treatable. Unfortunately, according to the World Health Organization less than 50% of those with depression receive treatment. The most common treatment method recommended by professionals is a combination of medication and psychological counseling, but not everyone responds the same to each method of treatment. For that reason, you should consult with a licensed psychiatrist before pursuing any form of treatment. Here are some facts about treating depression:
- In adults with moderate to severe depression, 40 to 60% of patients who take antidepressants noticed improved symptoms within 1 - 2 months.
- According to a 2013 study, therapy had a lower rate of relapse at the one to to year follow up and psychotherapy was found to have significantly lower rate of relapse than medication by itself.
We understand that clinical treatment is not always available to everyone, so here are some concrete steps you can take if you suffer from depression or experience depressive symptoms:
You can visit mentalhealthscreening.org or make an appointment with your doctor to discuss your depressive symptoms.
Call for Help
If you are experiencing suicidal thoughts and ideation, call the National Suicide Prevention Lifeline at 800-273-TALK.
Talk to friends and family openly about your depressive symptoms. It can seem shameful or like you are burdening them, but those who care about you will do anything to see get better. The sooner you seek treatment, the better your outlook for success.
Address Sleep Issues
Problems such as sleep deprivation might be alleviated by a combination of exercise, healthy eating, and sleep supplements such as melatonin or antihistamines. Oversleeping may also be treatable with exercise, a healthy diet, or medication.
Having a high quality diet that mixes veggies, fruit, healthy fats, fish, and whole grains can go a long way toward improving your overall mood and mental health. Get more Vitamin D and C and eat a balanced diet.
When you begin to feel the symptoms of depression, take a deep breath and recognize that your judgement is being clouded by this illness. You’re no less of a person for feeling this way. If you feel depression rearing its head, practice your coping methods and talk to your doctor if you need further help.
Stress can trigger depression because it leads to feeling overwhelmed and inadequate to face the challenges of the day. Make a list of the important things you need to accomplish, be realistic about deadlines, and then focus on accomplishing them one at a time.
We understand that suffering from depression can make you feel like socializing is the last thing you want to do, but being with others in an environment where you can speak openly about depression will help you alleviate stress, expand your interests, and sharpen your mind.
Keep a Calendar
This tip is more applicable to when you start a new medication. Keep a mood calendar to track how you feel from day to day and week to week. You’ll be able to tell if a medication is doing an effective job working.
Getting up and moving is a good way to distract your from your thinking and get the body engaged. A heavy workout session can release endorphins and de-stress your body. Cardio and weightlifting in the morning have been known to improve alertness and energy all day.
The Dangers of Self-Medicating to Treat Depression
Sufferers of depression may resort to self medicating with drugs and alcohol in order to alleviate their symptoms. Repeated survey results from the National Survey and Drug Use and Health has revealed a repeated correlation between substance abuse and mental illness. In fact, persons diagnosed with a mental illness are nearly twice as likely to be at risk for abusing a substance, no matter what the substance. Of those suffering from mental illness, risk of alcohol dependence is nearly three times vs. that of someone with no mental illness. And in the case of a serious mental illness (SMI) is more than 4 times as likely.
No one should have to turn to drugs and alcohol in order to feel a semblance of normalcy. Contact Landmark Recovery today to learn more about our intensive outpatient, residential treatment, and drug rehab and alcohol rehab options today.
Depression and Suicide Resources:
National Hopeline Network: 1-800-SUICIDE (784-2433)
This national hotline is useful for those who have experienced suicidal ideation as a result of depression. Call the National Hopeline to connect with a depression treatment center near you
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
This national hotline is a valuable resource for people with or without depression who have experienced suicidal or thoughts of self-harm. This network of crisis centers provide emotional support and guidance to people in distress.