What is “Real Depression”?

 “That movie was so depressing.”

“The lyrics are depressing.”

 “I’m so depressed.” 

For better or worse, depression has entered the public conscience and lexicon, and has since become synonymous with “sad”. However, depression is actually an illness as real as pneumonia or influenza and is a serious mood disorder that affects how an individual feels, thinks, and handles daily life. Depression is usually diagnosed when symptoms have been present consistently for two weeks or more. According to the National Institute of Mental Health (NIMH), common signs and symptoms include: 

  • Persistent sad, anxious, or “empty” mood 
  • Feelings of hopelessness, or pessimism 
  • Irritability 
  • Feelings of guilt, worthlessness, or helplessness 
  • Loss of interest or pleasure in hobbies and activities (anhedonia) 
  • Decreased energy or fatigue 
  • Moving or talking more slowly 
  • Feeling restless or having trouble sitting still 
  • Difficulty concentrating, remembering, or making decisions 
  • Difficulty sleeping, early-morning awakening, or oversleeping 
  • Appetite and/or weight changes 
  • Thoughts of death or suicide, or suicide attempts 
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment 

People usually associate depression with prolonged anhedonia – the inability to feel pleasure – sadness, and pessimism and with fair reason, as those are all symptoms of clinical depression. However, there is a common sentiment that an individual is “not really” depressed unless the depression has taken over their entire life—probably due the dramatized portrayal of depression in films and other media sources. Nevertheless, it is important to note that depression can be both chronic and episodic. Episodic depression can be caused by anything from major life changes, to stress, to a traumatic event—and even medication!  

Over the past few years, there has been some controversy over diagnoses of depression. The American public has seen a significant rise in antidepressant usage, prompting inquiry misdiagnosis among physicians and prescribers. Additionally, there have been disputes about the validity of diagnoses. While there is public concern regarding overuse of antidepressants, some individuals have raised the question: what is the difference between a self-diagnosis and one diagnosed by a psychiatrist? The individual in question will always know his or her body and mood best, and what is “normal” for him or her. Additionally, depression is not “one size fits all”, and unlike ADD/ADHD, there is no definitive method of testing or criteria to determine a diagnosis of clinical depression. Though this argument does have some merit, it is always best to seek a professional opinion, especially since there can be other issues at play.  

So what happens once a diagnosis is reached? Usually medication, psychotherapy, or a combination of both. There a few different classes of antidepressants, all of which take about a month to build up in the body and begin working. Often, patients will need to try several different types of medications before finding one that suits them. Like medication, there are many different psychotherapy techniques that a therapist will consider when evaluating treatment and patients may need to cycle through a few different therapists before finding one that they feel comfortable with.  

These methods are to be prescribed and overseen by medical professionals—but that does not mean you cannot take matters into your own hands! If you have been diagnosed or suspect you are depressed, some things you can do to boost your mood include being active and exercising (yay endorphins!), set realistic and attainable goals, and make a conscious effort not to isolate yourself. 

And remember, friends: the brain is an organ just like your spleen or appendix. It gets sick sometimes. If you’ve been feeling down, anxious, or have noticed that you do not enjoy activities that you used to, do not beat yourself up. Reach out. Be open. Ask for help. And know that things will get better—not immediately, but gradually. Just like recuperating from the flu, feeling well is a process—and a goal that we are all capable of achieving.  

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