Between Depression and the Blues
National Depression Screening Day is observed on October 5, 2000 this year. In recognition of that fact and the continuing impact depression has on modern society, I thought it important to discuss several aspects of depression that may confuse people. Confusion is commonplace, for example, about what depression exactly is and what makes it different from just feeling down. There is also confusion surrounding the many types of depression (e.g., unipolar depression, biological depression, manic depression, seasonal affective disorder, dysthymia, etc.) that people may experience. There have been so many terms used to describe this set of feelings we've all felt at one time or another in our lives, to one degree or another, that it is time to set the record straight.
Symptoms of Depression
Depression is characterized by a number of common symptoms. These include a persistent sad, anxious, or "empty" mood, and feelings of hopelessness or pessimism. A person who is depressed also often has feelings of guilt, worthlessness, and helplessness. They no longer take interest or pleasure in hobbies and activities that were once enjoyed; this may include things like going out with friends or even sex. Insomnia, early-morning awakening, and oversleeping are all common.
Appetite and/or weight loss or overeating and weight gain may be symptoms of depression in some people. Many others experience decreased energy, fatigue, and a constant feeling of being "slowed down." Thoughts of death or suicide are not uncommon in those suffering from severe depression. Restlessness and irritability among those who have depression is common. A person who is depressed also has difficulty concentrating, remembering, and trouble making decisions. And sometimes, persistent physical symptoms that do not respond to traditional treatments -- such as headaches, digestive disorders, and chronic pain -- may be signs of a depressive illness.
The Blues... Or More?
Feeling down or feeling like you've got the blues is pretty common in today's fast-paced society. People are more stressed than ever, working longer hours than ever, for less pay than ever. It is therefore natural to not feel 100% some days. That's completely normal.
What differentiates occasionally feeling down for a few days from depression is the severity of the symptoms listed above, and how long you've had the symptoms. Typically, for most depressive disorders, you need to have felt some of those symptoms for longer than two weeks. They also need to cause you a fair amount of distress in your life, and interfere with your ability to carry on your normal daily routine.
Depression is a severe disorder, and one that can often go undetected in some people's lives because it can creep up on you. Depression doesn't need to strike all at once; it can be a gradual and nearly unnoticeable withdrawal from your active life and enjoyment of living. Or it can be caused by a clear event, such as the breakup of a long-term relationship, a divorce, family problems, etc. Finding and understanding the causes of depression isn't nearly as important as getting appropriate and effective treatment for it.
Grief after the death or loss of a loved one is common and not considered depression in the usual sense. Teenagers going through the usual mood swings common to that age usually don't experience clinical depression either. Depression usually strikes adults, and twice as many women as men. It is theorized that men express their depressive feelings in more external ways that often don't get diagnosed as depression. For example, men may spend more time or energy focused on an activity to the exclusion of all other activities, or may have difficult controlling outbursts of rage or anger. These types of reactions can be symptoms of depression.
A combination of these symptoms taken together could mean you may be suffering a depressive disorder. The specific type of depression probably isn't as important as going to seek immediate care for it from a trained mental health professional, such as a psychologist, psychiatrist, or clinical social worker. If you're like many Americans today enrolled in a managed care plan, your first stop should be your primary care physician. But don't stop there! Many general practitioners think nothing of prescribing an antidepressant medication for depression without any further referrals or treatment recommendations. Yet, the research is clear that medication should always be considered in addition to (not as a substitute for) psychotherapy.
Depression doesn't need a clear cause to occur -- it can affect any of us out of the blue. Depression is debilitating and sometimes even life-threatening. But depression is always treatable and, in most people, curable by getting help for it right away. If you believe you may have a depressive disorder, consider going to a local clinic for a depression screening. If the screening day has passed, consider seeking a professional's help anyway. It is a quick and relatively painless process that can result in your starting down the path to recovery.
Active Treatment of Depression by Richard O'Connor (to be published December 16, 2000)
Undercurrents: A Life Beneath the Surface by Martha Manning
Undoing Depression by Richard O'Connor
Copyright 1997-2000 John M. Grohol. All rights reserved. Reprinted here with permission. Visit Dr. Grohol's Website, Psych Central, for more information and resources.Date published: 10/3/00
Last reviewed: By John M. Grohol, Psy.D. on 26 Aug 2010
Published on PsychCentral.com. All rights reserved.