If you do a Merriam-Webster online Search and enter the word Depression, one of the meanings it gives is the following: a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentrating, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies.
That's the clinical meaning of depression. Seems pretty clear-cut and easy to understand, doesn't it? It is anything but.
Having experienced depression for most of my adult life, I am just now appreciating what the human mind is capable of.
Mild depression, or dysthymia, is not necessarily disabling. It is usually characterized by lack of pleasure or joy in life. You may not even realize you are depressed. This can go on for years. People who experience dysthymia may try to self-medicate with alcohol or drugs, usually to no avail. People with dysthymia also have a greater chance of experiencing a major depressive episode at some point in their life.
A major depressive episode is diagnosed when in the same two weeks, a person experiences five of the following symptoms:
- depressed mood,
- markedly decreased interest or pleasure in all activities,
- either a marked decrease or increase in eating/weight so as to be noticed by others,
- either excessive sleepiness or not sleeping at all,
- motor activity either agitated or retarded,
- fatigue/loss of energy,
- feelings of worthlessness, inappropriate guilt,
- trouble with concentration, indecisiveness,
- constant thoughts of death, suicide (with or without a plan), or suicide attempt.
A major depressive episode is very serious and needs to be addressed by a health professional. There is help available, thankfully.
Another illness on the depression spectrum is what used to be called manic/depressive episode, now more widely known as bipolar disorder. This disorder is characterized by severe mood swings - from overly "high" to sad and hopeless and then back again, often with normal periods in between.
Signs and symptoms of the "high" or manic phase are as follows:
- Increased energy, activity, and restlessness,
- excessively "high," overly good, euphoric mood,
- extreme irritability, racing thoughts and talking very fast,
- jumping from one idea to another,
- distractibility, can't concentrate well, little sleep needed, unrealistic beliefs in one's abilities and powers,
- poor judgment, spending sprees, a lasting period of behavior that is different from usual, increased sexual drive, abuse of drugs, particularly cocaine, alcohol, and sleeping medications,
- provocative, intrusive, or aggressive behavior, denial that anything is wrong.
The symptoms of the depression phase are much like that of a major depressive episode, including:
- lasting sad, anxious, or empty mood,
- feelings of hopelessness or pessimism,
- feelings of guilt, worthlessness, or helplessness,
- loss of interest or pleasure in activities once enjoyed including sex,
- decreased energy, a feeling of fatigue or of being "slowed down",
- difficulty concentrating, remembering, making decisions,
- restlessness or irritability, sleeping too much, or not at all,
- change in appetite and/or unintended weight loss or gain,
- chronic pain or other persistent bodily symptoms that are not caused by physical,
- illness or injury, thoughts of death or suicide, or suicide attempts.
All of this is treatable.. Some of the treatment options include antidepressant medication (Prozac, Effexor, Zoloft, Imipramine, to name just a few) or a combination of medication and psychotherapy. Lithium is used for bipolar disorder, though physicians also prescribe anti-convulsants such as Tegretol to help with mood stability. I have found in my journey through depression that it may take several medication changes and perhaps even therapist changes before hitting on the right combination. The important thing is to not give up.
I've only just scratched the surface here. We all know ourselves and how we really feel. If you are feeling any of these symptoms, seek help.
I waited so long because I got so tired of no one understanding me. I'd been to so many different therapists and had been tried on so many different medications, none of which ever made me feel any better for any length of time, really. Then I had my own major depressive episode. I wasn't sure what was happening to me. I knew I was unhappy, but that wasn't anything new. I couldn't remember the last time I was really happy. But, this was different. I just felt so sad, just so down, all the time. My husband noticed it as well, but I passed it off as being tired. I was working as an office manager for an internist, a position I had just started a few months before.
I was feeling overwhelmed at work trying to learn all the requirements of the job and dealing with the daily management of the office. I became increasingly withdrawn. I was tired all the time. I felt so sad. I thought about death a lot. I didn't want to actually kill myself, but I thought if I got sick and died, that would be okay. Very scary thinking. On August 1, I left for work and made it as far as the end of my street when I started crying and didn't stop for close to two weeks. I ended up in an out-patient group therapy program. I went four days a week, four and a half hours a day, for four months. It was structured, safe, and I think it may have saved my life.
Depression is treatable. If you are experiencing any of the symptoms mentioned above, talk to your physician. You can be happy again.
