Understanding Depression

photo-1516027828283-84217f09f3c4Depression and anxiety are the two most common types of mental illness present in today’s population. Depression is a mental illness that tends to be misunderstood and there are many misconceptions about what it looks like and how it affects the person coping with depression. Around this time of year, depression starts to affect more people because the days are shorter, people get less sunlight, and weather tends to be more depressing in general. This type of depression is known as Seasonal Affective Disorder, and will be explained a little bit more in this article. The good news is that there are some skills you can start to practice to cope with symptoms of depression.

What is depression? General depression, or what we tend to think of when we hear depression, is a very common and serious mood disorder. General depression is also known as Major Depressive Disorder (MDD) or Clinical Depression. The current version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM 5) indicates that someone can be given a diagnosis of MDD only if they are experiencing five or more of the following symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:

  • 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;
  • A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down);
  • Fatigue or loss of energy nearly every day;
  • Feelings of worthlessness or excessive or inappropriate guilt nearly every day;
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day;
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

As you can see from the above list, depression is not just sadness; a common misconception of Depression is that people who are depressed are just really bummed out (as Dwight Schrute once inquired of Michael on The Office).  Sadness is a normal, human reaction to something that is upsetting; sadness becomes depression when it interferes with your daily functioning, has no apparent causation, and is persistent. Depression doesn’t have to look like just sadness. In fact, depression can also be just a general feeling of “blah”; people who are depressed don’t have to be sad, they can also feel as if they don’t have much emotion at all. Another common misconception about people suffering from depression is that they are lazy. This is a very common myth, as it isn’t laziness but instead a lack of motivation and energy caused by a chemical imbalance in the brain. What may appear like laziness from an outside perspective, is the brain’s inability to muster up an adequate amount of energy to give someone that push to do something. A final common misconception about depression is the “it’s all in your head” mentality. Depression is a serious and legitimate illness, and just as any other illness is taken seriously and treated with the proper interventions, so too should depression. Someone with depression can’t simply “turn it off” on a whim.

Up until this point the main focus has been on general depression, or Major Depressive Disorder (MDD), however there are several different types of depression that fall into this mood disorder. Some other types of depression include the following:

  • Persistent Depressive Disorder (previously known as Dysthymia): A milder form of depression that lasts for 2 years or longer. Some symptoms may include change in appetite (not eating enough or overeating), sleeping too much or too little, lack of energy or fatigue, low self-esteem, trouble concentrating or making decisions, and feelings of hopelessness.
  • Bipolar Disorder: Someone with bipolar disorder, which is also sometimes called “manic depression,” has mood episodes that range from extremes of high energy with an “up” mood to low “depressive” periods. When you’re in the low phase, you’ll have the symptoms of major depression.
  • Seasonal Affective Disorder (SAD): Seasonal affective disorder is a period of major depression that most often happens during the winter months, when the days grow short and you get less and less sunlight. It typically goes away in the spring and summer.
  • Psychotic Depression: People with psychotic depression have the symptoms of major depression along with “psychotic” symptoms, such as hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs), and/or paranoia (wrongly believing that others are trying to harm you).
  • Peripartum (Postpartum) Depression: A major depression that occurs in women in the weeks and months following childbirth. Typically the same symptoms associated with Major Depressive Disorder are present.
  • Premenstrual Dysphoric Disorder (PMDD): This is more than just your typical PMS. Women with PMDD have depression and other symptoms at the start of their period. Besides feeling depressed, they may also experience: mood swings, irritability, anxiety, trouble concentrating, fatigue, change in appetite or sleep habits, or feelings of being overwhelmed.
  • ‘Situational’ Depression: This isn’t a technical term in psychiatry. But you can have a depressed mood when you’re having trouble managing a stressful event in your life, such as a death in your family, a divorce, or losing your job. Your doctor may call this “stress response syndrome.”
  • Atypical Depression: This type is different than the persistent sadness of typical depression. It is considered to be a “specifier” that describes a pattern of depressive symptoms. If you have atypical depression, a positive event can temporarily improve your mood. Other symptoms of atypical depression can include increased appetite, sleeping more than usual, feeling of heaviness in your arms and legs, or oversensitivity to criticism.

There are steps you can take to try to cope with any depressive symptoms! The first and foremost (and probably one you’ve heard quite a bit) is to take care of yourself, physically and mentally. Set appropriate boundaries in your life and learn how to say no, but do not be entirely opposed to experiencing something new. Make sure that you are sleeping 8 hours a night, drinking water throughout the day, getting some sunlight, exercising for at least 30 minutes a day, etc. When your body feels good, your brain will feel better as well.

Getting support from others is another way to cope with depression. Identify or find a solid set of people you can turn to when you are in distress. Go to a support group, find online chat rooms, like pages on social media that promote connection to others who are also experiencing depression. A wonderful app that lets you talk to peers who are experiencing the same symptoms you are is called “Wisdo”. It may seems silly, but even finding special interest groups online, like at meetup.com, can help you to develop a support group of like-minded people.

Take care of your mental health. Go to therapy. Capital EAP is always here if you need anything! Give us a call! Journal; journaling has been demonstrated through research to have many different positive benefits for mental health. Try to practice more mindfulness, even if it’s just taking a couple minutes to yourself during the day to sit and focus on your breathe. Take breaks throughout the day. Go for short walks. Make sure you have an established routine set in place.

One final skill to help you cope with depression is to create a “Wellness Toolbox”, which is really just a list of things you can do for a quick mood boost. Some things you might include in your Wellness Toolbox include listening to music, writing, playing with a pet, reading, watching your favorite TV show, talking to a friend, list some things you like about yourself, and spending some time in nature. Whatever makes you feel good, and can be done for about 10-minute bursts, put them on your list.

 

By: Marion R. White, MHC – LP, EAP Counselor

 

References:
https://www.webmd.com/depression/guide/depression-types#3
https://www.unitypoint.org/desmoines/article.aspx?id=a655c7e2-fe37-4817-887b-c762ff455b23
https://www.psycom.net/depression-definition-dsm-5-diagnostic-criteria/
https://www.helpguide.org/articles/depression/coping-with-depression.htm