Depression: What it is and what it is not

What Depression Is, and What It Is Not

Depression varies in how it presents in the mind and body. Sometimes depression can visit us in a temporary episode of sadness. Other times, it can present as severe and persistent – this is known as major depression or major depressive disorder. And to be clear, this is not the same as feeling depressed due to a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder. More on this later in the article. Many doctors and mental health professionals use the symptom checklist in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) for major depressive disorder to diagnose clinical depression.

What Does Depression Look Like?

Signs and symptoms of clinical depression may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Sleep disturbances, including insomnia or sleeping too much
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Slowed thinking, speaking or body movements
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Angry outbursts, irritability or frustration, even over small matters
  • Anxiety, agitation or restlessness

These symptoms are usually severe enough to be noticeable in how they impact your relationships with important people in your life as well as your daily activities around school, work, or social events. Depressive symptoms usually improve with counseling (provided you are matched with a counselor you feel you can do good work with), medication (for those who are not interested in taking medication, please carefully read Alternatives to Taking Antidepressants), or a combination of both.

Depression and Terrible Life Events Must Be Conceptualized Differently

If you’re reading this article and thinking that you have depression, it’s possible that you’re not depressed, but rather, you’ve had terrible things happen to you. And maybe those terrible things have not been processed properly. Some things to consider for the person who feels that they may be battling depression:

  1. Do they have friends?

  2. A family?

  3. A meaningful job?

  4. Educational background appropriate for their level of intelligence and ability?

  5. Are they taking care of themselves?

  6. Do they have things to look forward to?

  7. Do they use their time outside of work productively and wisely?

If all of these things are going well for you, AND you feel terrible all of the time, then you are depressed. Perhaps the emotional regulation systems in your nervous system are not working properly due to something physiological. Your nervous system might need some stabilization if you’ve encountered many stressors at once. People who have this sort of a problem often benefit from antidepressants.

There’s another type of person who is suffering from depression because they are in trouble:

  1. Their educational attainment does not match their abilities

  2. They don’t have a job (or recently lost theirs)

  3. They have an alcohol or drug problem

  4. Their family isn’t functioning properly (or they don’t have a family)

  5. Their immediate or intimate relationship is not existent (or it’s terrible)

  6. Their friends are non existent (or their friends are destructive to be around)

  7. They don’t get along with their relatives

  8. They’re in poor mental and physical health

There are things that you can do. Remember, an antidepressant will not remove the facts of your life that are terrible. There’s no one simple answer. If any part of this article resonates with you or relates to someone who you know and care about, don’t hesitate to reach out for more information. Many therapists will give you their time and consult with you on the phone for free for a 20-30 minute chunk of time.

Disclaimer: This article is for general information purposes only and does not constitute the practice of medicine, psychotherapy, or other professional healthcare services, including the giving of medical advice. Note: No therapist patient relationship is formed. The use of this information is at the reader’s own risk. The content of this article is not intended to be a substitute for professional medical advice, diagnoses, or treatment. Readers should not disregard or delay in obtaining medical advice for any medical condition they have and should seek the assistance of their healthcare professionals for any such conditions.

Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to The Couple and Family Clinic Blog.

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