The truth about clinical depression

“I’m depressed!” is a phrase you have heard from friends multiple times. Maybe you have even stated that yourself sometimes. Such a complaint is so widespread that psychologists refer to it as the flu of mental illnesses. Feeling down for a few days, however, is not a sufficient symptom to diagnose yourself with clinical depression.

Sadness is a natural emotion and no-one is immune to it. It is normal to feel sad after having a traumatic experience – end of a relationship, loss of job or home, loss of a loved one, or anything else that you deem important. Mentally stable people overcome sadness without their daily functioning being interrupted. On some occasions though, sadness may get out of proportion and lead to problematic changes in behavior. This is when we start talking about clinical depression.

Media and the Internet are filled with various claims regarding depression. Some of those “facts” are close to fiction.

One of the most popular myths about depression is that it is solely a matter of attitude. Everyone around you who suggests you simply “take it easy” or “pull yourself together” surely believes that myth. On the contrary, clinical depression has a proven biological component – hormonal levels in your body are either too high or too low for you to believe that everything will be fine.

Another common notion is that depression is always triggered by a specific negative event. In reality, such an event often lacks. Many of my depressed clients indicate that they have been feeling this way for as long as they can remember, and they can’t tie the beginning of their depressive symptoms to certain events from the past.

Many people view depression as women’s illness. That’s because it is mostly women who talk about it. Men, however, are equally likely to suffer from it. Social stereotypes are what make it unacceptable for men to speak up. Statistically speaking, it is 4 times more likely for men to actually commit suicide as a result of depression than women.

Depressed people never smile. Wrong! That’s the most absurd claim ever made. Depressed people do smile, do say that they are fine, and do often claim to have no problems. Overall, they are masters at hiding their true suffering.

Contrary to the common notion, depression is not a single illness. There is a whole depressive spectrum, just as there is an autistic spectrum. Some of the depressive disorders are less bearable than others. Some are chronic, meaning they can be there for years without causing significant dysfunction. Let’s examine them one by one.

The earliest sign of mood problems is disruptive mood dysregulation disorder that occurs between ages 6 and 18. These children exhibit violent temperament, irritability, anger, and aggression. Because mood swings are common in children, many parents overlook the symptoms of the disease. Subsequently, these children often develop other affective disorders as adults.

A period of at least two weeks characterized by feelings of sadness, emptiness and hopelessness, frequent crying, lack of interest and pleasure, change in weight, sleep, fatigue or lack of energy, feelings of futility or guilt, difficulty in concentrating and decision-making, suicidal ideation. Having a single depressive episode does not always require treatment, as sometimes people manage to cope with it by themselves. When such episodes begin to recur or interfere with day-to-day functioning, you need to consult a specialist to determine whether this is a clinical depression (recurrent depressive disorder) or another disorder.

This is the so-called chronic depression, which is milder but lasts for years. Very often it starts before the age of 21. The early onset of dysthymia is also associated with a number of anxiety and personality disorders. In the course of the disease, those affected might also go through more severe depressive episodes.

From the men’s point of view, the upcoming menstrual cycle of their partner is simply an excuse for her unstable mood. They are usually right. However, for 6% of women, the week before their cycle is really full of changes in their psychological state.

Have you noticed that many people complain of depressive symptoms in the fall and winter? For those who are prone to depression, these are difficult seasons in which the symptoms get worse. Distinctive features of this type of depressive disorder are hypersensitivity, increased appetite and a hunger for carbohydrates.

As we have said, depression has a solid biological factor, so depressive episodes can also occur as a result of the intake of certain substances – medications, drugs, and alcohol. Depression can also co-occur with another medical condition, acute or chronic disease. Affective disorders from the bipolar spectrum are also characterized by recurrent depressive symptoms. Early and accurate diagnosis is essential for effective treatment and relapse prevention.

A number of international studies in recent decades have identified cognitive-behavioral therapy as the most effective treatment for depression. The biggest advantage of CBT is its effectiveness in preventing relapse. Compared to pharmacological treatment, which produces equally good results immediately after completion, CBT results in a lasting improvement in the quality of life established at intervals of six months, one year and five years after completion of therapy. That is why it is the preferred choice in treating depression.