Depressive disorders are whole person illnesses; they touch the body, feelings, thoughts, and behavior. The depression itself can make us feel as if it’s of no use to search for help. The nice news is that 80 to 90 percent of people with depression can be treated successfully, but the bad news is that only one sufferer in three seeks treatment. More bad news is that not quite half the American public perceives depression as a character flaw, rather than an illness or emotional disorder. In addition, only half of all cases of depression are exactly diagnosed, and only half of those get adequate treatment.
We tend to muddle depression, sadness, and grief. But the opposite of depression is not happiness, but vitality – the power to experience a full range of emotion, including happiness, excitement, sadness, and grief. Depression is not an emotion itself. It’s not sadness or grief, it’s an illness. When we feel at our worst, sad, self-absorbed, and helpless, we are experiencing what people with depression experience, but they don’t recover from those moods without help.
The trademark of depression is a insistent sad or empty mood, sometimes experienced as tension or anxiety. Life is with out pleasure. People with slight depressions may go through the motions of eating, sex, work, or play, but the activities seem like pointless; people with more severe depression withdraw from these activities, feeling too worn-out, tense, or hostile to take part. There is often a nagging fatigue, a sense of being incapable of focusing, a feeling of being inefficient.
People with depression generally feel a lowered self-esteem. In a depression, you may feel that you are a defenseless victim of fate, but also feel that you don’t deserve any better. Feelings of guilt, shame, and hopelessness are common.
There are often a host of physical symptoms, of which sleep disturbances are key. People may have trouble falling asleep or may wake up early without feeling refreshed. Others may sleep excessively, again without feeling rested. Appetite may increase or decrease. There may be difficulty in sexual functioning. There may be harassing aches and pains that don’t act in response to medical treatment. But there are physical illnesses that cause symptoms like depression – Lyme depression, diabetes, thyroid conditions, anemia – and depressions can cause physical symptoms like other diseases.
If you are feeling depressed, it is important to be sure that an underlying health problem does not exist, and you should see your physician for a checkup. At the same time, if you know you have a health problem and are feeling depressed, don’t presume you will feel better once the health problem is under control.
There is a sequential process in the recognition of depression. First is a stage of confused pain in which the sufferer knows he suffers, but doesn’t know why. People often blame circumstances. Adolescents blame their home lives, married people blame their spouses, and employees blame their bosses. But there is recognition that the pain is not ordinary.
The second stage is recognition that something is definatley amiss. It may be that external circumstances have changed but the pain is on going, or it may be a slow recognition that the suffering is so dangerous that circumstances can’t be blamed. This is a painful recognition that often takes years. It is an acknowledgment of a damaged self. But because of the nature of depression, the self-blame and guilt that are manifestations of the disease, this acceptance does not always lead to seeking help.
People then may move to the third stage, a crisis that frequently leads to professional intervention and diagnosis. It is often a suicide attempt or psychiatric hospitalization. The diagnosis often provides hope, that treatment or a cure is possible, and explanation, a way to understand what has only been confusion before. The fact is that this is a diagnosis of a mental illness, with all the shame and stigma that that entails.
The fourth stage involves acceptance of an illness identity. Depression comes to be seen as an outside agent invading the self, rather than as a manifestation of the self.
It is essential that anyone suffering from depression gets good help from a competent, qualified professional. If the warning signs are clear, always seek a professional diagnosis. Going to a health professional with your problems could prove, at worse, embarrassing, if the problem is really just a seasonal case of the blues that can be treated with without medical intervention, but the potential cost of failing to diagnose a serious case of depression should far outweigh any concern about conceivable embarrassment.
By David B. Smith