Believing depression is “sadness” is a common and destructive myth. No one ever asks for help for ‘sadness.’ When you’re sad, you watch a funny movie, go out with a friend, stay in bed for the day bingeing on Netflix, or eat a whole tub of chocolate chip cookie dough ice cream. Then you’re over it, and you get on with living. We all experience periods of sadness, sometimes a momentary mood quickly gone, and sometimes for a few days as we wrestle with life circumstances that aren’t ideal. Once the situation is resolved, or the sun comes out, or a friend calls, the mood evaporates and equilibrium returns.
Depression is something much, much more than mere ‘sadness’ or feeling blue. The protocol for assessing for depression is very specific and the DSM5* states:
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly attributable to another medical condition.
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful).
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness, feeling of excessive or inappropriate guilt on nearly an every day basis.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Obviously, “sadness” doesn’t even begin to cover it.
If you’re a human being, you might experience a depressive episode. If you’ve experienced one episode of depression, you have a really high chance of experiencing another.
The good news is that depression is treatable. In fact, research currently indicates that mild to moderate depression responds best to a combination of talk therapy and exercise. Yes, you read that right. Exercise. For severe depression, or depression with suicidal ideation, talk therapy and medication may be the best prescription, (plus exercise, this is a necessity). Notice what I did right there? Depression needs talk therapy. If you’re experiencing depression, you need to see a professional who focuses on evidence-based practice. Cognitive-Behavioural Therapy, medication, and lifestyle changes break depression and aid in recovery, and continued therapy may help prevent future episodes.
You know this, right? Depression is a mental health issue that needs to be addressed. It isn’t the blues. It isn’t feeling down. It isn’t something to ignore. Successive episodes of depression tend to be worse, last longer, and cause more dysfunction. Channeling ‘Eeyore’ as an alter ego is no way to live.
On the flip side, dismissing depression as ‘sadness’ is harmful; as if depression is nothing to worry about.
“Oh, he’s just depressed. He failed his midterm.”
“Why are you so depressed? She’ll call tomorrow.”
“I’m so depressed. I finished ‘Game of Thrones’ and I don’t know what I’ll watch next.”
This is not depression, and calling it that dismisses the agony that people YOU know are experiencing because they are truly depressed. Depression is feeling like you’re lost something but having no clue when or where you last had it. Then one day you realize what you lost is yourself.
If you can answer ‘yes’ to more than one of the criteria for depression, ask for help. Life hasn’t been enjoyable for a long time. Acknowledge that things are actually more serious than you’ve been willing to admit to yourself.
Depression IS treatable. You don’t have to live like this. Ask for help.
*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Copyright © 2013). American Psychiatric Association. All Rights Reserved.
Dr Susannah is a leading psychologist, registered professional counsellor and Master Practitioner in Clinical Counselling based in Canada. Follow @DrSusannah on Twitter and Instagram.