Understanding Depression

A startling finding: The World Health Organization has determined that depression is the most burdensome disease in the world today. It robs adults of more productive days of life than AIDS, cancer, or heart disease.

What is depression?  What is it not?  We all know the feeling of being sad or "blue" after experiencing a loss or disappointment.  It may last a few days or a few weeks.  But when do we start talking about an actual "depression" in clinical terms?

Common signs of clinical depression include:

  • Frequently feeling sad and/or guilty
  • Eating more or less (including significant weight loss)
  • Sleeping more or less
  • Loss of interest in things you usually enjoy
  • Low energy, fatigue
  • Irritability
  • Difficulty concentrating and making decisions
  • Thoughts about death and suicide

While the above signs are more common, everyone is different.  The following may also indicate depression for some people:

  • Increased use of alcohol and drugs
  • Anger
  • Difficulty envisioning a hopeful future
  • Helplessness
  • Increased aches, pains, or bodily ailments

Depressive episodes can be situational - that is, they occur after a stressful event or events (for example, death or loss of a loved one, diagnosis of severe or terminal illness, children leaving home, divorce, persistent stressful job conditions, academic stress/difficulty, job loss, and other extremely stressful situations).  Or, it can happen for what appears to be no reason at all, literally out of the blue.  Research shows that clinical depression can also occur when stressors in the environment combine with a genetic or biological disposition.  If depression runs in your family, you are likely more vulnerable to also being depressed.

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Depression is a complex and serious illness, comparable to diabetes or heart disease.  You can't just "snap out of it" by pulling yourself up by your bootstraps or thinking happy thoughts.  People with depression need professional treatment, just like people with diabetes and heart disease do.

What helps?  Talk therapy can help individuals determine what life circumstances may contribute to their depression and how to address them.  Therapy can also teach important skills to lower stress and address recurring negative thoughts that happen with depression.  Antidepressant medications can help normalize chemical imbalances in the brain that contribute to depression.  A helpful analogy to consider when thinking about antidepressants:  Just like insulin can help a person with diabetes whose pancreas no longer produces it, antidepressants can help a person with depression whose brain may be low on certain chemicals, or neurotransmitters.  More and more novel treatments are being researched and becoming available for people with recurring and treatment-resistent depression.

Only about one-third of individuals with depression seek treatment.  It is quite common for someone to live with depression for years, even decades, before deciding to seek help.  The sooner a person can get treatment, the higher their chances for recovery.  

If you know someone who is depressed, offer a supportive, non-judgmental, and listening ear.  Then offer your support in getting the person professional help and treatment.  Remember - depression is an illness that can linger, worsen, and/or recur if left untreated.  Remember, there is hope and there is help.

 I am a Houston psychologist who specializes in treating depression.  

Please click here for an inspiring article in the New York Times on new approaches of treating depression in developing countries, impacted by war, famine, AIDS, natural disasters, and other trauma.