Sometimes even those who suffer with depression don’t understand what it entails. This article serves as an introduction to depression and some of its more common forms.
Part 1 : An Introduction To Depression
Who this article is for
I’m writing this not just for those who directly suffer from depression. It can be used by those closest to a sufferer as well. Friends, family and partners can all benefit from having a clearer understanding of what their loved one is going through. How the illness affects the sufferer varies from person to person along with the severity and duration; getting a better basic working knowledge of the illness is one of the best ways of supporting them.
It’s just being sad, isn’t it?
We all get sad, for some of us more frequently than others. There are events during each day which have the potential to upset us, and as we all know there are times in our lives that cause deep distress – making us feel particularly sad and down. For a short while these moments can often feel like we are suffering from depression, but depression itself is usually much longer lasting. In these situations depression is often being confused with extreme sadness or heartache.
What is sometimes just natural swings in emotion is wrongly felt by the sufferers and on occasion medical professionals to be depression – but the actual definition is something far more specific. In the same way that people with a bad cold will often say they have ‘Flu’, actual influenza is usually a much more severe illness than people realise.
Merriam-Webster defines depression as:
“…a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way…”
The DSM-IV has various conditions for defining a mood-disorder, perhaps the most poignant being:
“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 made by others)”
The DSM also requires at least five of the following symptoms to be present for a period of at least two weeks.
- depressed mood most of the day, nearly every day
- markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- significant weight loss when not dieting or weight gain … or decrease or increase in appetite nearly every day.
- insomnia or hypersomnia nearly every day
- psychomotor agitation or retardation nearly every day
- fatigue or loss of energy nearly every day
- feelings of worthlessness or excessive or inappropriate guilt
- diminished ability to think or concentrate, or indecisiveness
- 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
Five or more of the above systems would classify as a Major Depressive Episode, at least in the United States where the DSM is most widely used. There are variations to the symptoms for illnesses such as Bipolar Disorder, Schizophrenia etc but the above symptoms give a pretty clear definition of what depression entails.
There are a few misconceptions which are caused in part by a lack of understanding of what depression and mental illness actually is. These incorrect beliefs are what contributes to much of the stigma surrounding mental health and patients who suffer from depressive disorders. Some of the most damaging of these beliefs are below:
Misconception : “It’s a sign of weakness.”
Depression is a significant battle to fight, and that requires a great deal of strength both from the sufferer and those who care for them. It’s often called the curse of the strong, and with good reason; I personally believe that anyone suffering and surviving through it is incredibly strong and determined.
Misconception : “Why can’t you just snap out of it?”
If curing depression was as simple as clicking your fingers its unlikely it would have a grip on such a large percentage of society. Even putting the brain to one side for a minute there are significant physical symptoms of depression which cannot just be shrugged off. Lethargy, anxiety, a constant tiredness usually caused by poor sleep – these are all very real things which positive thought alone cannot cure. When you combine the emotional problems depression causes with the physical problems it is a huge and debilitating illness which no one can just ‘snap out of’.
Depression takes months, years and even lifetimes of treatment, millions is spent every year on research and antidepressants are one of the most commonly prescribed medications in western civilisation. To think that a simple conscious decision to feel better would be the cure is naive and often extremely insulting to the people suffering.
Depression is an illness…. not a state of mind.
Misconception: “Depression can’t be treated.”
As many as 80% of sufferers respond positively to combinations of pharmacotherapy and talking-therapy. Whilst treatment can take many months or years before benefits can be seen it’s essential to try. In some cases the underlying depression can’t be effectively treated (known as treatment-resistant) but the symptoms can often be managed or alleviated.
Misconception : “Depression can only be treated with antidepressants.”
Antidepressants are simply one tool that doctors can utilise to help treat and address the symptoms of depression. Talking therapies such as counselling, hypnosis, cognitive behavioural therapy are a few of the other resources that mental health patients often have available to them.
Not seeking out treatment for a mental health issue because you don’t want to be ‘on antidepressants’ is part of the reason so many people are campaigning to fight the stigma surrounding depression and the myth that being depressed is a sign of weakness. If you had the flu you would take medicine to relieve your symptoms, so not looking for a suitable antidepressant option is potentially needless suffering.
Fighting the stigma
The stigma surrounding depression and mental health problems in general has been found to be one of the main reasons people don’t actively seek treatment for their illness. Society has for a long time viewed depression and anxiety as a weakness, and as such believe it should be hidden, tucked away and not talked about. As a man the “big boys don’t cry” mantra that I was told from early childhood resonates with this so much.
How do we tell friends, families, employers that we are being treated for something which they potentially view as a flaw or weakness. Will we be looked at the same afterwards? thought of the same? Will other people’s false impression of the severity of our illness impact how they judge or feel about us? Will our job be safe or will we be considered a liability?
This fundamentally boils down to education, and requires that significant work is done in improving everyone’s understanding of mental health problems and the related illnesses. For anyone suffering from these simply telling your friends and family members what depression really is can often be enough to improve their understanding and subsequently their support.
Part 1: An Introduction to Depression
Part 3: Getting Help For Depression