We all have down days where we are more sensitive to life, more affected by others and our own troubles. Those are the days where we feel “thin skinned”, not well protected or able to switch off. However pessimistic one feels on those days, they generally eventually pass and we are easily shifted back into a good space by good events.
However, if you find that you are feeling unhappy, depressed, unmotivated, pessimistic, lacking in energy or enthusiasm for an extended period – there is a chance that you are suffering from clinical depression.
Today we are exposed to information about depression, whether in articles, educational TV programs or embedded in the story line of your favourite series where a character becomes depressed. This information highlights how common depression is but also how debilitating it can be.
Depression is not just about a mood, it impacts on every area of the life of the person who is depressed – physically, emotionally, socially, occupationally and relationally.
It is often difficult for those who are around people who suffer from clinical depression to understand why they don’t just think more positively and do something to get out of their rut. Similarly it is probably impossible for someone with depression, particularly serious and ongoing (chronic) depression, to explain how difficult it is to do that.
Let’s look at some of the features of clinical depression (usually called Major Depression) to understand why it can be so paralyzing.
The symptoms below are present nearly every day for most of the day. Not everyone experiences them in the same way :-
Depressed mood most of the day, every day for at least two weeks
Reduced interest or pleasure in activities, including those that one normally enjoys
Significant increase or decrease in appetite for most days and a resultant increase or decrease in weight
Insomnia or hypersomnia (increased need for sleep)
Feelings of restlessness/agitation or being slowed down
Fatigue /loss of energy.
Social withdrawal even from close relationships and friendships
Reduced sex drive
Feelings of worthlessness/guilt where there is no reason to believe this
Feelings of emptiness and hopelessness
Increased irritability
Inability to think clearly e.g. poor concentration, poor memory, indecisiveness
Suicidal thoughts or actions.
Some of the above symptoms can arise from other causes e.g. hypothyroidism, brain injury, drug abuse etc. It is necessary to get a proper professional diagnosis which will guide treatment.
Depression ranges from mild to moderate to severe and depending on the symptom picture, just getting out of bed can be difficult. Routine activities like personal hygiene or cooking one’s food can be insurmountable tasks – even if doing them might be useful to provide structure.
For others, it would seem logical that the depressed person would feel better if they mobilized themselves and did something as there are no clear physical wounds to suggest that this is not possible.
Even with a mild depression, most things can feel like an effort, and while the person might still go to work and attend to life’s routine commitments, this is usually without any enthusiasm. Simple things seem to take up a huge amount of energy. People tend to feel worse about themselves the less they accomplish and the depression can deepen if untreated.
Myths that can prevent people from seeking help:
Only weak people get depressed
It is just sadness
It is about self- pity
Talking about it only makes it worse.
Only women get depressed
You will become dependent (on therapy/medication)
Depression knows no boundaries of gender, class, age or race/culture. However, the causes attributed to and name given to this constellation of symptoms might be culture specific.
The symptom picture tends to differ at different ages, with somatic (bodily) symptoms like stomach aches, bed wetting or acting out (misbehaviour) being common in young children and cognitive (brain functioning) symptoms being common in the elderly e.g. concentration, memory loss.
It is as if young children, being unable to communicate their unhappiness through words, do so behaviourally. With the elderly, depression can often appear to be dementia or general grumpiness. Illness, loneliness, multiple losses, loss of role or sense of value place the elderly at high risk for depression.
Depression is very treatable, and the method and length of the treatment will depend on many factors that would be assessed by those professionals who treat the person.
Depression can be unexpected and appear to have no clear precipitating events or to be clearly linked to stressful life events, changes or traumas. Either way, it needs to be taken seriously, even if you have no history of depression.
Despite the exposure there is to “normalizing” depression, there can still be a stigma which can lead to a resistance to recognizing it in yourself or allowing it in those in your life. This attitude limits help seeking and a faster recovery.