Depression: Misunderstood

By Felicia Levy, LCSW

“I’m weak.” “Smile.” “Cheer up!” “Others have it worse.” “I can struggle through it.” “Focus on what you have.” “I should be happy.” These are just a few of the comments I frequently hear from clients – things that they have thought, or statements other people have made when they mention they are feeling depressed. In addition to their own struggles, one of the greatest challenges that come with depression is hearing other people’s comments and how you “should’’ feel-many of which are inaccurate. There are actually many misconceptions about depression. Fact: Depression is not something that can simply be fought through. People who experience depression sometimes feel depressed for no apparent reason. Sure, sometimes there are things that may bring it on, yet other times, the sun may be shining, friends, work, and family are all fine, there are no external stressors going on, and that feeling of depression is still there.

According to the National Institutes on Health (2010), 6.7% of adults in the U.S. will have a depressive episode at some point in their lives. Additionally, over 50% of those experiencing depression do not seek help. That is a significant number of people who could benefit from gaining an understanding about what depression is, what it isn’t, and how to feel comfortable reaching out for help if help is needed.

What causes depression?

The general scientific understanding is that depression doesn’t have a single cause. A person’s life experiences, genetics, age, brain chemistry, hormone changes, substance abuse and other illnesses all play significant roles in the occurrence and development of depression. It may also be that there is no observable trigger at all that leads to depression. Depression can occur spontaneously and be unassociated with any life crisis, physical illness or other currently known risks. Whatever the specific cause, scientific research has firmly recognized that major depression is a biological, medical illness. Scientists have also found evidence of a genetic predisposition to major depression. There is an increased risk for developing depression when there is a family history of the illness. Not everyone with a genetic predisposition develops depression, but some people probably have a biological make-up that leaves them particularly vulnerable to developing depression. Life events, such as the death of a loved one, a major loss or change, chronic stress and alcohol and drug abuse, may trigger episodes of depression. Some illnesses such as heart disease and cancer and some medications may also trigger depressive episodes.
People often casually say, “I’m so depressed.” What’s the difference between feeling “the blues” and experiencing actual “depression”? The blues are often related to an event or occurrence that may cause temporary sadness, which lasts for less than two weeks in duration. A positive event usually helps a person with the blues feel better. Daily functioning such as eating and sleeping are generally not impacted. When someone has depression, a positive conversation or outing typically won’t help someone feel better. People who are depressed may experience difficulty with sleep, appetite (too much or too little), concentration and increased addictive behaviors (substances, spending, eating, gambling, etc.). Some other symptoms of depression include irritability, anxiety, fatigue, feelings of worthlessness, disinterest in activities, and recurrent thoughts of death and/or dying. Another fact to note is that depression does not feel exactly the same for everyone. For some, it may appear like irritability and anger. For others, it may feel like anxiety and sadness. Remember, depression may happen for no particular reason, unlike the blues, which is usually related to an event or occurrence.
People who experience depression at times feel alone or as if they are the only one who has had these feelings and may feel a need to hide how they are feeling. Additionally, they may be embarrassed or ashamed to seek treatment or may not know where to look. What many don’t realize is that depression doesn’t discriminate, and they are not in fact alone. Because of the false belief that you should be able to “just get over” depressive symptoms, some people with depression may not realize that they have a treatable disorder. The good news is, there are ways to manage and receive help for depression.
How can you cope with depression? Awareness, patience, structure and support are the keys to feeling better.
Awareness. Learn about depression, pay attention to the individual signs and symptoms that you experience.
Patience. Once you have developed an understanding of your symptoms and start to manage your depression, remember, it takes effort and time!
Structure. Sticking to a regular schedule, including a regular time to get up and go to bed has been shown to help people struggling with depression. Many people find that setting up a daily routine can help with their symptoms. So try to get on a schedule.
Support. Lastly, making sure you have a good support system including people who are good listeners, encouraging, and are simply able to be there for you. Your friends and family can help you get through this hard time.
How do you know if you should reach out for help? If your mood is interfering with your personal or professional life; if self-help techniques are not working; If you have thoughts about death or dying. If you or someone you know might be struggling with depression, please don’t hesitate to reach out to speak to a counselor.