It’s normal, healthy in fact, to feel sad, especially in overwhelming situations. It can help us navigate and cope with thoughts that are otherwise frightening. Normally these feelings fade over the course of a few days, but depression will complicate things.
350 million people worldwide suffer from depression (5 percent of the entire world population), and at least 16 million people in the U.S. have been the victim of at least one major depressive episode, according to a 2012 consensus.
Depression is a complicated issue, and it can really devastate lives forever, but what is depression exactly, and what causes it? What makes it different from the other negative emotions, and what sort of effects does it have on our overall health? The best way to answer these questions is to figure out what’s true, what’s false, how to see it, and how to treat it.
What’s the Difference Between Being Depressed and Being Sad?
Before we can talk about depression and its overall impact, we have to have a clear understanding of what it is vs. what it isn’t.
Depression is defined as feelings of severe despondency and dejection, but in the medical community it is considered to be a mental disorder. It’s definitely more than feeling a bit sad. It is a combination of many negative emotions, including helplessness, hopelessness, worthlessness, anger, fear, etc., and these feelings are long lasting. Every person has a different experience with depression, so it’s important to recognize the myths that surround depression.
It also isn’t completely true that depression is a form of grief. Depression may encapsulate grief, but the two do not always go hand in hand. Grief is normally positive and negative memories mixed together, but depression is either solely negative memories, or negative memories and positive memories that have been twisted to become negative. Grief rarely affects self-esteem, however depression will contort your perception of self-worth into a negative life. Grief is normally brought about by a tragic event, however depression has no real reason or rhyme to it.
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“Depression is made up.”
Americans tend to think depression isn’t a real illness, but that isn’t true. The saying goes “the greatest lie the Devil told is that he isn’t real”, and in a similar manner one of the greatest lies about depression is that it isn’t real. People avoid the subject constantly. Treating it in this way can lead to depressed individuals refusing to seek out aid.
“Only women are diagnosed with depression.”
This is absolutely incorrect. While it is true that depression is more commonly diagnosed in women, the argument can be made that this is due to social stigmas conceived by cultures. All genders are affected by depression, and if we’re looking at the numbers then it should be noted that men are 1.9 times more likely to commit suicide than women.
“Antidepressants always cure depression.”
You can treat depression, and there are a lot of ways to do it. But like we said before, every individual will have a different experience when it comes to depression. Some people may need something more than drugs, they may even need psychotherapy. Other times, patients may be allergic to medication or have extreme reactions to side effects, making their only outlet of relief in therapy, and in some cases that may be all that’s required. There’s no blanket cure for depression.
“You can just snap out of it.”
These sort of statements come from the idea that depression is a choice. No one chooses to be depressed. It isn’t some light switch you can turn off and on again. It’s about your brain function, structure, and chemistry, and there are both biological and environmental causes for it.
“It’s caused by trauma.”
While it isn’t incorrect, it isn’t completely true either. While it is common for depression to result from environmental sources, it is just as much a part of our genealogy. Depression that was dormant may be triggered by environmental sources. In other cases, depression doesn’t always have a logical source. Depression can sometimes even come from a positive influence. Depression is more than simply feeling sad, it’s having your entire self value and worth skewed.
“Talking about it only makes things worse.”
This is part of that taboo feeling in America. It’s often thought of as a weakness, and speaking about it will only encourage the negative thoughts and harmful habits. In reality, it’s just the opposite. People who talk with someone, anyone, can get that help to navigate through their more complex emotions, and being able to have that open discussion could mean the difference between life and death.
- Genetics: Like most disorders, depression can be passed down through the generations. For example, if a twin sibling has depression, there is a 70 percent chance that the other twin will also have depression.
- Biochemistry: There are a variety of things that can affect your brain that aren’t trauma related, and those things are able to influence your depression, including sugar imbalances, alcohol and drug use, lack of exercise, medications with side effects, poor diet, medical illness, and genetic conditions. All of these can cause depression.
- Personality: There are certain personalities that are more likely to have depression. It someone have perfectionist tendencies, is self critical, pessimistic, easily stressed or overwhelmed, or has low self-esteem, then they are at a higher risk of developing depression.
- Environment: A few environmental factors that could lead to a higher risk of depression are those in poor living conditions, who experience neglect, abuse, or are exposed to violence.
Basic Signs of Depression
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an individual must suffer the following symptoms consistently over the course of a 2-week period, including but not limited to:
- Spends most of the day, almost every day, in a depressed mood, as indicated by an observer (e.g., appears tearful) or by the individual themself (e.g., feels hopeless, empty, sad). (Do note that for adolescents and children this may manifest as an irritable mood as well.)
- 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.)
- A significant loss in weight (over 5% of body weight a month) when not dieting, weight gain, or a decrease or increase of appetite most days. (For children this may also mean that, rather than weight loss, they fail to gain the expected amount of weight.)
- Almost every day experiencing insomnia or hypersomnia.
- Psychomotor retardation or agitation almost every day, as observed by others.
- Fatigue or loss of energy nearly every day.
- Almost every day having an excessive amount or an inappropriate guilt, or feeling worthless.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Regular thoughts of dying, suicide ideation, or suicide attempts or planning.
Along with having these symptoms, these symptoms must cause significant distress or impairment in social or occupational environments, or other important areas in which function is disrupted.
Physical Problems Caused by Depression
Now that we’re more aware of what depression is we can begin to discuss how it impacts us physically. It obvious has an affect on our brain, and this is both chemically and biologically. For example, one of the more disturbing physical side effects of depression is a decrease in brain volume which can cause permanent emotional and cognitive impairment. This means that constant influence of depressive disorders can permanently leave the victim with a warped perspective on life. The implications of this are staggering, ranging anywhere from suicidal tendencies to sociopathic behaviors.
It affects more than just your brain. It’s been shown that depression can cause cardiovascular diseases in the heart. Depression can cause the release of an unneeded amount of adrenaline, which can damage the cardiovascular system over time. Blood clots and heart attack are also increased in risk due to arteries and blood vessels becoming stressed.
Individuals may note a worsening of both illnesses if that have depression and a another one, such as cancer, lupus, alzheimer’s, heart disease, AIDS, and HIV. At its worst, depression is able to cause physical pain, including chronic fatigue, irregular appetite, irregular sleep patterns, hindered movement or thinking, joint and muscle pains, headaches, and migraines. Depression has a major physical strain on the body, and in conjunction with other illnesses, can endlessly loop and feed into one another.
The Social Impact
Depression has a huge effect on social interactions. It can result in destructive behaviors, like substance abuse. It’s common for someone who is using to isolate themselves from others. They won’t just end up feeding their newfound addiction, but they’ll become codependent with their depression. These people will often refuse to seek out help, or may even refuse help that’s offered, because they have spiraled down into an opinion of themselves that is extremely low. They feel like a burden, and just want to let their troubles fester away from others.
This behavior will often be easily noticed by others at school and work as it’ll impact their performance, and it can strain, even break relationships. When this happens their support system is weakened, and often the victim secludes themselves further. They can’t perform well in working environments like jobs or schooling because ultimately they have a hard time seeing the bigger picture of what they’re doing because they now lack that support system from home. Humans are naturally social creatures; we perform best when we feel supported emotionally. Depression robs the victim of that security.
Ways to Treat Depression
Thankfully depression is one of the most treatable mental disorders, and has a variety of methods available. Almost all patients find relief from their symptoms, as about 90% respond positively to treatment.
Medication, in particular antidepressants, are the most common treatment for pression. Antidepressants will modify the chemical composition of the brain, now while that may sound a bit extreme you should remember that these pills won’t act as a sedative. The medication isn’t habit forming, and it won’t have any stimulating effects on individuals who don’t have depression.
Those with mild depression may attend psychotherapy, either on their own or with others they share a relationship with which may be affected or influenced by their depression. Psychotherapy allows the patient to talk about unhealthy thoughts in a safe environment, cautiously being guided to personal epiphanies. Depending on the severity of the case, psychotherapy can take a few weeks to a couple of years, but on average many patients note significant breakthroughs within 15 sessions.
Hormonal therapy can also help in patients that suffer from biochemical depression. Sometimes the patient suffers from disorders like hypogonadism or thyroid conditions, and may simply need supplements or medication to help regulate testosterone, estrogen, etc.
ECT (electroconvulsive therapy) is done under general anesthesia, and has small electric currents that are passed through the brain, which triggers a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. This is seen as a last resort treatment, done with patients who didn’t respond to the other treatments. It’s often viewed negatively and become controversial, however it’s done with doctor recommendation and patient consent.