Depressed and confused person

What do you think about when you hear the word “depression”?

Many people resonate with this term. Having a bad day is a common experience—whether it’s triggered by an argument, loss of a job, or simply a product of a rainy day. For many people, such experiences leave them saying things like, “I feel depressed.” But in fact, not many people are aware that there is a major difference between feeling depressed and having depression.

 

Feeling depressed vs clinical depression

The difference is important because depression is a major mental illness. It’s not just a normal temporary feeling of sadness. That’s something we all experience by virtue of the fact that we are human. Clinical depression is different. It accounts for the leading cause of disability…in the world! It’s that significant. It causes that level of impairment.

And most importantly, depression won’t go away, just because you want it to.

Of the 10% of Americans who struggle with depression, many will go untreated and suffer in silence. It’s possible to suffer in silence because depression, like many mental illnesses, is a master at disguise.

 

“What is depression?” video

Partnering with TED-Ed on the animated short-film, “What is depression?” has allowed this once stigmatized and daunting concept to be better understood on the world stage. And it’s a good thing, too, because depression is very treatable!

The overwhelming number of views the film received, shortly after its launch, is a testament to the fact that people are curious about depression. And despite many public campaigns aimed to increase awareness and reduce suicide, people are still confused over what depression really means.

Few sufferers look like tattered souls—homeless, loitering on the streets, and incessantly talking to themselves. In fact, they look like you and me.

 

Symptoms

There might not be specific blood work or a biomarker (yet) that can definitively diagnose depression, but the symptoms tend to manifest in a number of different ways. Frequent crying spells or fluctuations to one’s mood that oscillate between sadness to extreme irritability are tell-tale signs, for example. Loss of interest in former hobbies, decreasing energy, and trouble sleeping or concentrating are also warning signs. Many people experience depression as having low self-esteem. Others will notice changes in their appetite or feeling restless or slowed down. In extreme cases, depression can lead to the most dangerous of symptoms: suicidal thoughts.

 

Treatments

But just like hypertension or diabetes, depression is a chronic condition that can be treated. There might be flare-ups over time but it is possible for symptoms to subside. For example, healthy diets, regular exercise, and open communication are all vital to success. In some cases, talk therapy with a professional is beneficial along with medication management. And in extreme cases, people can go to the hospital for more intense treatments that run the gamut from enhanced supports to electroconvulsive therapy.

Depression is not a weakness or a personality trait. It is a disorder and should be treated as such openly without fear of stigma. Caring communities have the power to transform stigma into hope and acceptance. What works for one individual might be different for the next, but the point is that there is always hope!

Helen M. Farrell, MD
Helen M. Farrell, M.D., is an award-winning Harvard psychiatrist, keynote speaker, and writer. Dr. Farrell is a staff psychiatrist at Beth Israel Deaconess Medical Center and an Instructor in psychiatry at Harvard Medical School. She is a medical graduate of Trinity College Dublin, Ireland. Dr. Farrell writes extensively on mental health and wellness and is often quoted in media outlets. In her TEDx Talk, Creating Hope for Mental Health. Dr. Farrell blends the art of storytelling with informative content and optimism. Dr. Farrell’s animated short-film, “What is Depression?” received nearly a million views on YouTube shortly after its release. Dr. Farrell is optimistic about the progress of mental health and believes that everyone can create his or her own bright future, and many can also use a little help along the way.

38 COMMENTS

  1. As a retired body-psychotherapist with more than 25 years experience I have met a fair share of people diagnosed with depression by their doctors. Depression as a symptom was of major interest to me because my own life was blighted by undiagnosed depression from my mid-teens to my late twenties. It was only when a Gestaltherapist helped me to feel anger that something shifted in me.

    This anger was about a conflict I was helpless to solve and therefore I had repressed it. Of course, this is only a short version of a much more complex issue, However, the search for the repressed and seemingly unsolvable conflict proved to be an important starting point in every encounter with a depressed person who came into my consulting room.

    My findings taught me that feeling depressed is a principally healthy response to a life that cannot be lived fully. It just points out that something has and is going wrong and needs attention. Only, when the attention is not given for all sorts of reasons, not least a relentless social pressure to be cheerful, do we develop ‘depression’, a ‘disease entity’ that was created when the pharma industry had developed powerful psycho-pharmaca in the 1960ies. Medication more often than not dulls the capacity to feel the emotional pain that doesn’t seem to have any discernible source and therefore doesn’t make sense. We want it to go away, abort it.

    However, with careful exploration of life circumstances, social situation, beliefs about themselves and the world it is possible to not only discover what it is depression points a person to but also to find meaning in it. That allows either to change the unbearable situation that was hidden before or to find a new stance towards it – both give birth to a new self.

    Medication can be useful, even necessary, for a short while – particularly when suicidal thoughts become stronger.

    Yet true and lasting change towards health comes through finding meaning in depression and ways of changing or adapting with the help of a non-judging sensitive listener who is skilled in taking in the whole person in their life world and helps them to realize that, yes, they do have a good reason to be depressed and there is a way out.

    Not everyone does or wants to find meaning for a variety of reasons. The idea of depression as being caused by some change in brain chemistry, of it being an illness that needs to be medicated away absolves us from exploring our feelings and having a really good look at our lives and beliefs which is often rather uncomfortable and demands – at a certain point – that we take responsibility and action. Then medication seems to be the only way – but it is not a cure for what has only become chronic because the underlying conflicts have been ignored far too long.

    • I really appreciated your comments on this forum. I too have suffered from depression and only recently have I realized that my failure to deal with conflict and/or unhappy experiences from my past has contributed to my depression. Feelings of anger, powerlessness and low self esteem have dogged me all my adult life. In my case childhood abuse by one of my siblings over the course of almost ten years, and not being believed by parents or friends when I have tried to speak up about it, has been a constant shadow in my life. Only recently & with the help of a therapist have I started to allow myself to feel justifiable anger. To know that what happened to me was not ok. Anger has been the first step in letting the poison out. It is exactly as you wrote. Thank you so much for comments.

  2. Really, snap out of it ! Why would anyone allow alleged reality decide how they feel about themselves or anything else . About the only power we truly possess , is how we act or react. Once you realize it is an act, act as you wish!

    • Omg. I can’t believe you openly said that. You have no understanding of clinical depression. “Snap out of it” is like telling my son in a wheel chair to “walk it off”. You have no idea how many times I’ve wished I could snap out of it. How much of life I’ve missed due to depression. I hate it but it is my reality. It is people like you that make it very difficult for people like me. What a horrible horrible thing to say. You should be ashamed of yourself…and maybe educate yourself a little bit.

      • Hi Amanda,
        Thank you for adding this very personal and touching comment. A lot of people struggle with the nebulous nature of depression and have an urge to say “snap out of it” or even more benign things like, “I know how you feel.” As you rightly point out, depression is a serious medical condition and it won’t just go away. Sharing personal stories and advocating for education, as you’ve done here, is a great step towards helping people better understand depression and reducing its stigma. I hope you and your son are well and wish you the best of health and happiness!

    • “Alleged reality”
      Interesting.

      That would be similar to saying, “ignore the alleged python wrapped around your windpipe and just breathe; YOU control when to breathe, not the alleged python.”

      What is quite obvious is that you have absolutely no understanding of the disease as a disease. Do people have emotional difficulties that have run their course and they snap out of? Yes. That’s not what depression is.

      I did the whole, “be strong and decide thing”. It only took 30 years to realize that it was (literally, chemically) eroding my brain. Being stoic doesn’t mean that the chemistry of depression will stop. And just because we lack a full understanding of the mechanisms of depression does not mean that it is fake. You’re working from a false dichotomy and you seem to feel superior to those who don’t have your mental capacity, chemistry, or (what you think is) will-power. One day you may realize that you were wrong by experiencing the illness. That would be unfortunate. It would be better for you to listen to the experience of the many people who have had the illness themselves and try to empathize rather than designate a failure of inner strength (which indicates moral superiority of some sort) to them.

    • You idiot! It’s like saying chickenpox doesn’t itch. You have no idea what your saying. IL give you an example. As a child I didn’t suffer from hayfever and thought people overreacted to it, BUT few years ago I started with it and now I understand how bad it is. Untill you understand something your in the dark about it, just as you are! yes I totally agree we can tell ourself to snap out of certain situations but feeling down is not the same. It’s like aan Olympic sized swimming pool being compared to the ocean. My partner suffers from depression and believe me it’s very hard. It takes a lot of patience and understanding to bring her round, something over time I have learned to do. There are many exercises iv come up with that helps, but ultimately it just eases the situation untill the next episode.

  3. “Major Depression”–a clinical term used to describe a constant sense of hopelessness and despair–is in fact a physical illness of the brain. The assertion that depression is not caused by “some change in brain chemistry,” but rather by maladjusted thinking, is not only flat-out wrong, but it is also dangerous in that it may mislead readers who suffer from major depression away from medication that may be critical to treating their illness.

    Neuroscientists have determined, conclusively, that depression is a physical illness caused by an imbalance of brain chemistry. With medication, depression can be lifted to a point where talk-therapy, exercise, meditation, and so forth can absolutely further help. But studies of identical twins separated at birth an raised in dramatically different environments show that depression, like other mental illnesses, are simply a result of the influence of one’s genes on one’s brain chemistry.

    So, whatever your opinion about the pharmaceutical industry generally, don’t let that influence your decisions about treating a painful illness. “Big pharma” didn’t invent depression as a physical disease any more than it invented hepatitis (for which it recently found a cure, by the way).

    • If the neuroscience is so conclusive, could you please tell us what this imbalance is; to my knowledge there are no GP’s who can measure depression on the basis of a material imbalance and prescribe a specific medicine to remedy it.

      • There are neuroimaging studies that show that the amygdala (a part of the brain that is important for negative emotions) is more active in people with major depression. Not everything Adam says is true, but the overall jest is.

    • Adam, your assertions are not correct. Firstly, nothing conclusive has been found about any physical or genetic cause of depression. In fact, quite the opposite.
      See here, for a great article about so called chemical imbalance depression.
      http://www.dorothyrowe.com.au/articles/item/192-the-real-causes-of-depression-february-2007
      As Dorothy Rowe points out the ‘…Royal College of Psychiatrists and the Institute of Psychiatry have accepted that depression isn’t caused by a chemical imbalance.’
      It is currently not even possible to measure or describe in any meaningful way what a chemically balance brain looks like, let alone one that isn’t balanced.
      As an analogy, when a person is hungry, their insulin levels change. All manner lf ‘chemical’s change. But what causes hunger? Fluctuating levels of various substances in the blood, or not having eaten any food?
      In any case, EVERYTHING in the body is chemical.

      Here too is an interesting article about the discovery that twins studies have not in fact proved that we are mainly our genes, but that actually our environment claims the Lions share of the reasons why we are who we are.

      In short, the notion that depression is a physical, biochemical disease that we a) have not physical test for and is diagnosed solely on symptoms of behaviour, but but at the same time can be healed by talking is a myth.

      As for medication it is largely no more effective than placebo, as discussed below.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

      This myth is in fact the source of a dangerous and ignorant understanding of mental health that condemns people to a life of misery: drug addiction and side effects and the believe they are broken and can’t be fixed. As the first comment above points out, we can ALL heal from the symptoms of depression, which is a form of defence against an unresolved issue connected to our pasts, our belief systems, our meaning structures, etc.

      I have suffered depression for most of my adult life (I’m 44) and am only alive due to the patient care of my analyst who helped me face the abuse i suffered as a child, and grieve and process it.

  4. I have depression and because I understand it, I don’t need toxic drugs to handle it. All my life, up until approximately 10 years ago I was prescribed useless drugs. Psychiatry is a pseudoscience; therefore, all that one needs is someone with whom to talk that also understands the condition. I am 65 years-old. That does work. Reading Toxic Psychiatry confirms what I write as true.

  5. I have fallen into depression a few times in my life. It may be true that for some people depression comes ouf of nowhere. But I truly believe that depression is environmental. In the absence of stressful situations the normal state for any living thing is a state of happyness. 10% of americans are depressed because of our society. In countries with severe economic crisis or war it is even higher. Loosing your employment, your social status, your lover, etc can lead to depression. I was fired from a job I loved at age of 56 and I remember promising myself as I walked out of the office that I would not let this destroy my happiness. Well 5 years later I have not found work and yes I have become depressed. In Japan they allow workers to keep their jobs as long as they want. Society should put effort into the just treatment of its people and not in developing new chemicals to alter brain chemistry. Brain chemistry will be just fine if everything is ok in your life

    • Hi Jim, there certainly are situational depressions and losing a job you loved is depressing. There are also depressions that have an inherited component. The more we learn about epigenetics (the environmental factors that impact gene expression), the more we may find traditional lines of separation blurred. I hope you will soon find another job and that you feel happier soon. Pat

  6. I have all 5 things they was saying in the video n still don’t get help beside they tho putting me in a state hospital wud help but it didn’t I have tried so many time to leave this place but it don’t happen the drs here don’t wanna they just want money n to tell u how its ur fault that u have this but its not its something that never hose always at all no matter what u tr to do don’t get me wrong there r ppl out there that really do wanna help but them there’s not

  7. Hi..
    I’ve been sick for a very long time, and for my whole adult life. I have not had an easy life, but always pushed myself really hard.
    But did I know then what I know now, I would have listened to my body, heart and Soul.
    Eight years ago I god diagnosed with chronic Cluster headache – also called suicide headache.
    What I have learned from all this meaningless pain and following depression is; things don’t always get better, they can get worse…
    Be thankful if your health is ok and you have the choice of going outside in the Sunlight or rain. Be thankful if you have a Family and friends, a job, a car and most importert; if You’re not in pain!
    Show compassion and empati to us who are and don’t have s choice.
    I know that depression is a sneaky diagnosis that comes when you least need it, and when you don’t have the strenght to fight it..

    Just a few Word from a girl in Norway.
    I wish you all the best, and take care of your health.

  8. I view my depression as a mental injury rather than a mental illness. The comparison to a broken arm is a very good one in my view. Although some people are predisposed to depression (as they are to brittle bones, or diabetes for that matter) the condition only appears after a mitigating factor (or a series of them) appears. For example, @jimsmith above writes that he lost a job he loved at the age of 56 and 5 years later has not been able to find work. That, in my mind, places undue pressure on him causing, if you will, a mental injury. As time passes for him, the injury becomes worse as the pressure builds. I went through something similar although it followed a separation/divorce and the loss of contact with my twin sons whom I dearly love. As things pile up, the depression (in the form of hopelessness and worthlessness) gets worse. I was on meds for a while, but thankfully things are better and I was able to go off meds. Healthy diet and exercise are key to treating depression but meds are sometimes necessary to get the sufferer healthy enough to eat right and exercise.
    To anyone reading this who sees no way out, please don’t give up! Chip away at it, you will get through it!

  9. As someone who has battled with depression for years, I appreciate this text and agree with most of it.
    However, I do not believe that depression can (yet) be cured very well. What doctors often slip is that one does not know very well if the medication we have actually work against depression or not. Everything in this area is based on (more or less reasonable) assumptions. As a patient, you are a guinea pig that has to try out all kinds of medication until there’s the one that works at least a little (it surely does not work as effectively as pain killer etc. on many people).
    Also, what is often not mentioned is that all kinds of therapy are far from being unambiguously helpful. All the talking about life problems often makes the problem worse, if it does not lead to practical solutions. Many disciplines have their own assumptions that often contract each other. Last but not least, many therapists are mediocre counselors who do not seem very interested in actually helping others. Maybe years of ‘service’ have led to disillusions….

  10. People need access to effective psychological therapies like Cognitive -Behavioral Therapy (CBT) and all its related forms. They work for depression even severe depression. Treatment of depression is best done with a combination of CBT and medication. It is not an either-or situation like many people here say. You need both. Good luck. Try CBT. You can get it online. Thanks. Bruce Hutchison PhD Clinical Psychologist

  11. I often feel like crap. Regret plays a large role with me thinking I have wasted my life; that I lost or rather gave up so much of my life to alcohol and drug abuse. It is a terrible feeling which too often leaves me feeling mentally exhausted and extremely depressed. Suicidal thoughts tend to arrive all too soon.

    I’ve been sober and clean for almost 12 years now and, still I can not seem to shake off these feelings of hopelessness. One day at a time – it’s all I can do to keep on keeping on.

    • 12 years of sobriety is an amazing accomplishment – Congratulations! Thanks for posting here, Paul. Your words will likely give many people hope – something we all need and eventually find as we ‘keep on keeping on.’ Best wishes.

  12. I suffered depression, but it’s under control thanks to my magnificent psychiatrist. Yes I’m on medication but she also uses hypnotism. My poor granny also suffered, but all she got in sympathy was “she should just snap out of it, she’s an intelligent woman”.
    James Currie MD

  13. So pleased for those with perfect health, perfect lives and perfect intelligence to be able to diagnose and treat others malaise with just a few words. Lacking obviously in social grace, no empathy and a complete lack of understanding. Still, in your world of nightly pub trips, 40 a day cancer sticks and wall to wall TV escape from reality, alone is the best wsy for you to be.

  14. Well the only thing I’ve found to relieve 8 years of depression is smoking cannabis, and that’s after counselling, prescription drugs, alcohol dependence, hypnosis and countless self-help attempts. Is being a citizen in a world you feel excluded from not supposed to be depressing? Seems healthy to feel this way really.

    Unfortunately a cabin in the woods, space to grow crops and a lake to sit by in the evenings all don’t come in blister packs! Otherwise I think we’d all have a “cure”.

  15. I have border line personality disorder i suffer depression and anxiety. I take anti depressants and haver over come a drink problem all in the last couple of years. I completed a two year course in dbt. An intense course, yet it turned my life around. My therapist was my saviour. I am not ashamed of the fact i have mental health issues. Depression can be cruel, deprives an individual of a happy healthy life. I have a six year old daughter and my parenting is as good as any other mother. I have been taught how to be self aware and recognise when i am haveing a bad day. This enables me to put certain copeing skills in to place. I would now going through what i have would love to bring awareness to people who suffer depression and help them.

  16. Hi to all. I’m just writing to say thank you to everyone who has posted. I’m not a suffer of depression but my girlfriend is and I find it hard to understand but reading your comments has helped me understand a little bit more. I wish you all the very best. Thanks

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