Is your two-day, Netflix binge of “Black Mirror” and “Stranger Things” a bout of laziness and apathy, a case of “the melancholies,” or … clinical depression?
Maybe you think you’re depressed, or you’re just using depression as an excuse to be lethargic – only to realize this itself might be a symptom of depression. It’s tough trying to figure-out your head with your own mind, right?
The brain is an organ that can malfunction like any organ. Mental illnesses are illnesses of that organ.
Brain scans show that there is a physical difference between a healthy brain and a sick brain. Telling someone with depression, “You don’t have an issue, it’s all in your head” is as inane as telling someone with diabetes, “You don’t have an issue, it’s all in your pancreas.” Any organ is susceptible to disease or disorder.
When you’re feeling down, it’s imperative to distinguish feelings of sadness versus depression because confusion can lead you to avoid evaluation and treatment of a serious condition. Alternatively, you might overreact to a normal emotional state of sadness.
“And, here’s why the distinction is crucial: If we (or a loved one) are depressed, it has huge implications for our long-term mental health, physical health, and longevity,” says NYC Psychologist and author Dr. Guy Winch. Sadness and apathy are normal emotions. “Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation,” says Winch. This also means that when something shifts, or we’ve gotten over the hurt or event, the sadness also wanes.
“Whereas depression is an abnormal emotional state; a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive and chronic ways,” says Winch. Depression can occur in absence of any of the triggers that cause sadness. Sadness is about something and depression is about … nothing.
Criteria for Depression
Depression is classified into different types using a book with diagnostic criteria for mental health disorders. Now in its fifth edition, the book is called the Diagnostic and Statistical Manual of Mental Health Disorders. But, everyone just calls it the DSM-5. Think of it as the owner’s manual for the brain but – like an iPhone user guide – you must make an appointment with an accredited genius to see one.
The DSM-5 outlines the following criterion to make a diagnosis of depression.
Note: These serve only as a guideline. You need to see a mental health professional for a conclusive diagnosis. The individual must be 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.
To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition. Afterall, a bottomless mimosa brunch or afternoon of beers is enough to spur a days-long depressive spell, as booze and other substances are known depressants.
Anxiety and depression disorders are often interlinked.
“It’s very hard to find patients who are depressed who don’t also have anxiety. It’s equally hard to find people with anxiety that don’t have some depression,” says Charles Goodstein, MD, a professor of psychiatry at New York University School of Medicine. So, don’t berate yourself if you’re feeling anxiety on top of everything else. It’s more likely than not to occur. And though signs of depression, anxiety disorder, and even bipolar disorder have similarities, each requires different treatments right down to the therapy and medications used. This is why a professional diagnosis is so important to obtain the correct treatment regimen.
A Quick Lesson in Sourcing the “Why” in Your Life…
One of the most poignant examples of suffering and sadness is the story of Viktor Frankl, a physician and psychiatrist who survived four Nazi concentration and death camps, including the infamous Auschwitz. Frankl epitomized the words of Nietzsche: “He who has a Why to live for can bear almost any How.” As a prisoner, Frankl kept himself and his hopes alive by a desire to see his wife again and one day teach about man’s quest for meaning.
Sadly, Frankl’s parents, brother, and pregnant wife were killed; but he was able to cope, source the importance of it all, and move forward with a renewed life purpose to include writing one of the most moving and significant books of our time, Man’s Search for Meaning. Frankl teaches us that “if there is a meaning in life at all, there must be a meaning in suffering. Suffering is an eradicable part of life, even as fate and death. Without suffering and death human life cannot be complete.”
We all face the opportunity to achieve something through our own suffering. Our unique opportunity lies in the way we bear our burden, and in our attitude toward difficulty while pondering our meaning. Make no mistake; you have a decisive and purposeful meaning in this world. For many of us – myself included – it takes suffering and hardship to find it.
We are supposed to feel like we can’t handle things alone sometimes. That’s when we find the grace or help through others. In times when life becomes unmanageable, we must be willing to ask for help and support one another. It’s by design. We can be with one another amid suffering, helping each other bear the weight. Part of life is the realization that sometimes we can’t make it on our own. For some, a spiritual leader is a person to whom you can turn and say, “I have a burden that I cannot bear.” All it takes is walking into a local church, mosque, synagogue, or temple and asking for help.
Live to the point of tears. -Albert Camus