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Part One: Depression -- Myths and Facts


Depression is one of the most common reasons that people seek medical care and/or psychotherapy, and is often referred to as “the common cold of mental health.”  Despite this fact, many depressed people continue to misunderstand what they are dealing with, and to negatively judge themselves as they struggle with the condition.  The following information may provide a more accurate understanding of this very common problem, and position you to cope with depression more effectively. 

Misconceptions about Depression

Many people are quite judgmental about depression, based on lack of understanding of what it really is.  Many believe that “clinical depression” is just a fancy term for the normal down feelings that we all get from time to time, and that it’s silly to make a fuss over it when you just need to buck up and keep moving.  Many believe that depression shows weakness of character or inability to cope with life, or that it’s “all in your head.”  Many believe that depression is a choice, and that you can just as easily choose to not be depressed if you’re motivated.  Most depressed people, burdened by these inaccurate beliefs, spend months or years in depression, trying to either ignore it until it goes away or to pull themselves up by their own bootstraps.  Many depressed people suffer in isolation, believing that nobody else really experiences this, and that no one would understand.

The Truth about Depression

There is the feeling or mood of depression, which we all get, and which comes and goes in normal life, and then there is the medical condition of Depression (hereafter referred to with a capital D for clarity), which happens to also include feeling depressed – hence, perhaps, the confusion between the two.  Clinical Depression is a completely different entity, involving disruption of neurological functioning.  Your nervous system works by conducting electrical impulses along chemical pathways from nerve cell to nerve cell throughout your body.  This process makes possible every move you make, every thought you have, and every unconscious bodily function that performs without your notice in the background. 

Clinical Depression refers to depressed (reduced) functioning of the nervous system.  This occurs when the system’s chemical activity changes in a way that interferes with optimal transmission of electrical impulses, as described above.  This creates the wide variety of symptoms that are typical of Depression, and which make day-to-day life so difficult.  Trying to operate your body in a depressed state is much like trying to operate your car on really bad gasoline: it will generally still get around, but not very well, because it’s just not working the way it’s supposed to.

Here are the guidelines suggested by the American Psychiatric Association for making the diagnosis of Depression:

At least one of the next two symptoms, for at least two weeks’ duration:

    1. Depressed mood most of the day, nearly every day.
    2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day.  This is particularly telling with the activities you normally enjoy the most.

And at least four from the next group of symptoms, for at least two weeks’ duration:

    1. Significant appetite and/or weight change (either higher or lower).
    2. Significant change in sleep (either more or less).
    3. Physical agitation or sluggishness nearly every day.
    4. Fatigue or loss of energy nearly every day.
    5. Feelings of worthlessness, or excessive or inappropriate guilt nearly every day.
    6. Diminished ability to think or concentrate, or indecisiveness nearly every day.
    7. Recurrent thoughts of death.

Other symptoms that may be experienced include:

    1. Tendency to isolate from others, make excuses, avoid plans.
    2. Less interest in sex.
    3. Lower activity level.
    4. Irritability.
    5. Increased risk for accidents (personal, household and automotive) due to loss of concentration, reduced ability to process incoming information, and slowed reaction times.
    6. Memory problems.
    7. Less motivation for personal hygiene.

The number of symptoms varies from person to person.  Some experience a few symptoms in a very pronounced way, but can keep up with most of the daily business of their lives.  Less fortunate sufferers of Depression may find themselves practically unable to function at all, such that making it out of bed in the morning constitutes a major victory for the day. 

A frustrating aspect of Depression is that the symptoms lead you to live in a more and more constricted way, which itself leads to greater Depression.  Imagine forcing someone who is not depressed to stay in bed for hours, keeping the curtains drawn, not showering or changing into fresh clothes, eating junky food, and staying parked in front of the TV.  This is something a depressed person might feel very much like doing, but which would cause an otherwise healthy person to become depressed.

The challenge of self-management then, is continuing to move when you don’t feel like it, continuing to take care of yourself when it doesn’t feel like it matters, and choosing to keep your life operational when your heart just isn’t in it.  Your determination to do this – at whatever level you can – will be an important factor in reducing the severity and duration of a depressive episode.

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Please see Parts Two and Three of this series for additional, important information that will empower you in coping with Depression.  If you suffer from Depression, consider asking your loved ones to read Part Four, so that they can support you more effectively.


Copyright © 2009, Elizabeth Babcock, LCSW.  All rights reserved.