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Depression From A-Z

What is Depression?

Dr. Simon Rego

All about depression, from assessment and diagnosis to medical and evidence-based treatment options.

What is Depression?

So what is depression?  I wanna give you an idea of something a typical patient would write to me about what they experience when they’re going through a depressive episode.  Here’s an example of a typical person.  It was really hard to get up out of bed this morning.  I just wanted to hide under the covers, not talk to anyone, not even my partner.  I didn’t feel like eating and I was losing weight everyday. 

Nothing seemed fun anymore, and even the things that I used to find interesting, I just didn’t seem to find interesting anymore either.  My energy was low and I felt tired and sluggish all the time, and yet I wasn’t sleeping well either.  And there were days when I hate to admit it, but even thought that life’s not worth living.  Thank goodness I had my children around to keep me going and I don’t know how I even managed to keep my job.

There’s something to this cluster of symptoms that people experience that is powerful and real and yet, there’s probably elements in this story that everybody can relate to.  There is a commonality to the experience of depression and sadness that we all feel.  So before I get into some of the details about what depression is, I wanna talk to you a little bit about what depression is not, okay.

Depression is not the same as sadness.  Sadness is a common experience that we all feel as people.  In fact, the humorist and author, Mark Twain once wrote, what is joy without sorrow.  You have to experience both fully in order to appreciate the other.  There’s always going to be suffering and you have to look at your suffering and decide how you’re gonna deal with it.  That will define you.  So we all feel sadness from time to time and there’s something different when sadness spills over into depression.

And another thing that people experience often is grief.  Grief after a loss of a significant other in our lives is very common as well.  And so it’s natural for people who lose a, someone through death or divorce or moving away, to experience similar symptoms of depression, and yet, is grief the same as depression?  In grief, people typically experience waves of the sadness, but then followed by moments of joy and fond memories of a person they’ve lost.

Whereas in depression, it’s quite a constant, low state, day after day, without the reprieval.  And in grief, people’s self-esteem is usually maintained.  They feel good about themselves despite the loss.  They may feel bad about the loss, but their ego is strong.  Whereas in depression, people are often racked with guilt and insecurities, which persist along with the depressed mood.  So grief and depression are not the same either.

So then, what is depression?  Depression, especially clinical depression as we refer to it, or major depression, or a unipolar depression, these are all synonyms for what I’ll just call depression with you.  Depression is a medical disorder.  It impacts the way people think, the way people behave, it can cause medical complications, and it impacts the ability to function in life.  At its core, it is a persistent negativity.  It impacts and twists the way people interpret situations around them.  It causes errors in processing information in such a way that reality gets distorted and people feel bad constantly.

So, what we wanna focus on is not only the depression that’s caused in the individual, but recognizing how we could spot the signs and symptoms of that depression to make it easier for loved ones to understand, and to make it easier to be aware of the prevalence in general, in the general population.  The good news is once we can recognize depression, there are excellent treatments available to help.  In fact, 80% to 90% of people who ultimately get to treatment, can benefit from treatment and see a resolving, or at least a decreasing of their symptoms. 

The bad news is, many, many people with depression still go unrecognized and there are a number of reasons for this.  Some people think depression is a personal weakness or some sort of character flaw, and this is simply not true.  Remember, it is a medical disorder, like diabetes, or high blood pressure, or a kidney impairment.  Depression is an illness that should be treated by a trained professional.

Another reason why people fail to get help is that they simply do not recognize all the signs and symptoms of it.  So let’s just briefly go over some of those signs and symptoms of depression.  These signs and symptoms will include a persistent sad or low mood, most of the day, most nearly everyday, for at least two weeks, usually longer.  There is persistent feelings of hopelessness and pessimism.

There’s feelings of guilt or worthlessness or helplessness or hopelessness.  Some people with depression will get more irritable or more restless or more geared up or on edge or tense.  There’s also a loss of interest in one’s activities, or a loss of pleasure in the activities that people used to find pleasurable, including sex.  There are feelings of fatigue and decreased energy almost everyday.  People feel tired and lethargic, and there’s difficulty concentrating or remembering details, or even making simple decisions like what time to get up, what clothes to wear, what cereals to eat.

For some people, there’s also insomnia or trouble falling asleep or staying asleep or waking too early in the morning.  For other people, it may be excessive sleepiness and sleeping too much; and despite sleeping too much, still not feeling energetic.  Some people may overeat and gain weight.  Other people may lose their appetite and lose weight.  And finally, and most importantly, there’s often thoughts of life not being worth living, suicidal ideation, plans to end one’s life or even making attempts to end one’s life.

So it’s really important when looking at people who have any of these signs and symptoms, to consider asking about whether they’ve thought about taking their own life because the sad truth of it, is one person about every 40 seconds ends their life through suicide around the world.  The other thing to note is that some of these signs and symptoms look a little different in children and adolescents.  In children, we might see depression as we’ve discussed and some of the other signs, but we may also start to see disruptive behaviors, either in the classroom or in the home.  They just don’t act like their normal selves.  They’re being oppositional, they’re throwing things and tantruming more often.

And in adolescents, we might also see accompanying irritability, not typical to the adolescent stage, but excessive given the person that we know.  Those are the signs and symptoms you should be aware of. (End)

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