The words depressed and depressing have become such commonly used expressions in our vocabulary that it’s not surprising that their clinical meaning is lost. When you’re using the word depressed to describe everything from how you feel after a bad day at work to what the family dog looks like when you don’t throw the ball for him, you’re actually conflating depression with sadness. The difference is sadness is a temporary emotion. Depression often lingers for weeks, months, even years if left untreated.
It's normal to experience feelings of sadness when you are experiencing challenging life events--like the loss of a job, a divorce, aging and illness, or the the death of a loved one. But if the feelings persist or get worse, it's important that you seek help.
In order to determine if the feelings you are experiencing are fleeting, like sadness, disappointment, or situational grieving, or if they are indicative of actual clinical depression, we first need to banish a few popular myths about what depression is and what it isn’t. Read on to learn the depression symptoms you should be aware of.
Myth #1: Sadness is the primary indicator of depression—and outward happiness means a lack of depression
While it’s true that feeling sad—particularly for an extended period of time—is a symptom of depression, it’s far from the only one. According to the National Institute of Mental Health, the following are depression symptoms you should be aware of:
Short-term memory loss, especially of small details
Low energy and persistent fatigue
Feelings of guilt, worthlessness and helplessness
Feelings of hopelessness; a belief that life will always be like this
Insomnia, waking up early, or sleeping excessively and yet still not feeling rested upon waking
Loss of interest in activities and hobbies you once found pleasurable
Loss of interest in sex
Overeating or loss of appetite
Physical symptoms that include headaches, body aches, and digestive problems
Persistent sad, anxious and/or feeling of emptiness
Suicidal thoughts, suicidal ideation or actual suicide attempts
Other depression symptoms you should be aware of include isolating from others--so if a close friend stops calling or visiting and they don't have a logical explanation, such as they're out of the country or have a newborn, you should reach out to them to see if depression might be the culprit.
Indeed, friends might need a gentle push. According to WebMD, “Approximately half the people who experience symptoms never do get diagnosed or treated for their illness.” The result is months or years of needless suffering and/or suicide. The CDC reports that suicide “is the 10th leading cause of death in the US for all ages.” So it’s imperative that once the depression symptoms you should be aware of are identified, you seek help for yourself or for a loved one from a primary care doctor, a licensed psychiatrist, psychologist or social worker.
Also keep in mind that just as sadness is not a sure indicator of depression, the outward appearance of happiness is not always indicative of solid mental health. If you’re familiar with that old Smoky Robinson song “Tears of a Clown,” you know that sometimes the people who are the quickest to make others laugh are actually suffering inside. In a society that rewards the happiest, most materially successful individuals, there are those who go out of their way to hide their depressive symptoms, making a joke out of their pain while inwardly despairing.
A classic example is comedian Robin Williams. His suicide in 2014 was so shocking because he made a career out of making people laugh—how could someone so funny be hurting so badly? Even those who knew Williams personally were taken aback by his death. Fellow comedian Chevy Chase said of Williams, “Robin and I were great friends, suffering from the same little-known disease: depression. I never could have expected this ending to his life, and to ours with him.”
Myth #2: Depression is a character flaw or weakness that can be overcome by sheer force of will
According to a Harvard Medical School professor, "The rate of major depression is five times as high among soldiers as civilians.” This is one of the findings of what CNN.com reported as “the largest study of mental-health risk ever conducted among the U.S. military.” The military is known for instilling toughness in its recruits—both physical and emotional. The myth that depression is a weakness or a character flaw is rampant in the military.
In a recent book about PTSD, depression and suicide in the military, The Invisible Front by Yochi Dreazen, Dreazen tells the story of the Graham family. The Grahams have two sons who served in the Army and both died: one in combat in Iraq and one to suicide. The reaction from the army to the two young mens’ deaths was vastly different: the man who was killed in combat was treated as a hero; the man who killed himself was ignored.
Talking about the subject of his book on The Diane Rehm Show, Dreazen said, “It's worth noticing that more soldiers have killed themselves than died in Afghanistan, which is really, when you think about it, really shocking number.”
But as the number of suicides in the military increases, so too does the knowledge of the depression symptoms you should be aware of and the risks and realities of depression as a real condition—not one that can simply be reasoned away or combated by machismo or a stiff upper lip.
Myth #3: The only effective treatment for depression is medication
While it’s true that antidepressant use is at an all-time high in this country (“researchers estimate that 8 to 10 percent of the population is taking an antidepressant,” reported Julia Calderone in Scientific American) it is not the only remedy.
Often the most effective treatment is medication along with individual or group talk therapy. Sometimes therapy alone, like cognitive behavioral therapy—which teaches people to challenge their negative thoughts and thus diffuse their power—is sufficient.
Also gaining both popularity and lasting results are a combination of exercise, yoga and meditation for assuaging symptoms of mild to moderate depression.
According to the Journal of the American Medical Association (JAMA) Internal Medicine, “mindfulness meditation may rival antidepressants in easing the symptoms of depression.”
The study looked at 47 randomized clinical trials, including 3,500 participants who were told to practice meditation (mindfulness or mantra) or to enroll in another treatment, like exercise. The results showed an effect size for meditation on depression was 0.3—the same as antidepressant medication. And another advantage of using meditation in treating depression is it doesn’t have the side effects that often accompany SSRIs, such as weight gain, loss of libido, and nausea.
Depression: Beyond the Myths
Now that you have a better sense for what depression is and isn't, and the depression symptoms you should be aware of, you should feel empowered to seek help if you think you might need it. Treatment may take some work on your part, but it is an investment in yourself and your well-being. And what is a better life investment than that?