Post No.: 0198
This follows on from Post No.: 0122 on our all-important journey towards understanding depression better…
The symptoms of depression may include – having what feels like low energy, a down or erratic mood, (undeserved feelings of) guilt, finding it difficult to concentrate on things, rumination/thinking a lot yet not talking to others much about those thoughts, self-stigma and the beating of oneself up over everything (including possibly for the depression itself), irritability or anger, a reduced self-esteem, a loss of interest in the things that one used to enjoy, a loss of interest in sex if one is an adult, not fully enjoying or embracing social relationships or the wider environment (which can mean staying indoors a lot), having a poor outlook about the future, and suicidal thoughts. Not all sufferers will exhibit all of these symptoms but they will exhibit several.
Not being able to see a future for oneself, or seeing this future as dark, and therefore not feeling a motivation for (continuing with) life, is a classic sign of depression. Depressed people and people with a risk of suicide may not implement long-term plans for the future because they can’t see any future for themselves.
There can also be changes in appetite and weight, changes to sleep patterns, a reduced attendance to self-care or one’s appearance (not spending much time, effort or money on oneself due to thinking it’s pointless or one is not worth it), a reduced attendance to the tidiness and maintenance of one’s house or possessions, an unintentional neglect of any children (hence parents who neglect and risk depression in their children are often victims of depression themselves e.g. postnatal depression, and so the cycle must be broken by supporting the parents as well as the children), a depressed immune system and an increased risk of non-communicable (chronic or not caused by infectious agents) diseases, attempts at self-medication, alcohol/substance abuse, self-harm, and giving personal belongings away (getting affairs in order in preparation for suicide).
Some therefore argue that it’s more like a syndrome. It’s not just about a down or empty mood (dysphoria) and/or the loss of interest/pleasure in living fully (anhedonia), plus irritability, an inability to concentrate, abnormal or inappropriate feelings of guilt/shame, feelings of being unworthy and undeserving, a sense of uselessness, powerlessness and hopelessness, self-punishment, a rumination on regrets and/or suicide ideation – it involves many somatic symptoms such as sleep problems, appetite problems, agitation, slowing and fatigue as well, which in turn can leave a sufferer vulnerable to other diseases and problems such as obesity, diabetes, heart attacks, job loss or relationship breakdowns too.
Not all depression symptoms will be the same for all sufferers e.g. some will lose pleasure in doing things they used to like doing, whilst others will try to compensate and increase the frequency of the hits of pleasure they can get whenever they can via increased comfort eating, impulsive shopping, drug-taking or empty sex, for instance. The common pattern though is that there’ll be more unhealthily unbalanced behaviours i.e. doing too much or too little of something. One sufferer (or the same sufferer at different times or situations) may sleep a lot and another not be able to sleep at all, or one may eat a lot and another lose their appetite. Some days will be better than others too.
Now experiencing any of these symptoms alone doesn’t suggest depression – it’ll be a combination of them plus the chronic duration of them. Many of these symptoms alone are nothing to be alarmed about, and many of them aren’t exclusive to being depressed. But exhibiting a combination of several symptoms and having them for a few weeks or more indicates a high probability of depression.
Distraction is often a good technique to get one’s mind off from a stressful situation, but turning to and relying on e.g. alcohol, recreational drugs, comfort eating, gambling or retail therapy for a distraction and for instant (but temporary) ‘highs’ amidst the long ‘lows’ can lead sufferers into problem debt or other, co-morbid, health problems, which are stressful in themselves – hence a terrible vicious cycle. These kinds of attempted self-medications or self-therapies can make the situation worse in the long run. Some depression sufferers don’t want to go out much or socialise (even to step outside of their house and onto their driveway sometimes) and can gradually cut out contact with their friends and family, and this too creates a vicious cycle of loneliness.
Some people describe depression as not so much about feeling sad or glum all of the time but feeling nothing at all, or ‘numb’, much of the time – feeling no joy in almost anything at all. Depressed people don’t mope all day – they feel more empty than sad. Yet depressed people can have a laugh like anyone else now and again. Low or depleted dopamine, serotonin and noradrenaline levels are correlated with depression, obsessions and compulsions, and feelings of low energy, respectively. Some say that good mental health is about having a positive sense of well-being, confidence and self-esteem. It enables us to fully enjoy and appreciate other people, daily life and our environment. When healthy, we can form and maintain constructive relationships, use our abilities to reach our potential and deal with life’s other challenges. Depressed people find these precise things difficult.
One analogy for sadness versus an episode of depression is like limb soreness versus a serious or persistent limb injury – with limb soreness (e.g. a bruise), it feels painful but you sense that it’s just temporary and it’ll eventually fade away soon, whilst with a serious or most of all persistent limb injury, it’s painful and you don’t know how long it’ll take to heal; if it ever will heal. Everyone has felt sadness, a little poorly or under the weather before and it’s a feeling that you know will pass soon, but depression is perceived to have no foreseeable exit, relief or solution – it’s essentially a long-term brain injury, like a long-term limb injury except it’s a long-term injury to one’s mental self – one’s very ‘spirit’ – as it were. It’s an exhausting impairment or metaphorical ‘handbrake’ somewhere in the brain hence it’s far more impacting and worse than even a limb injury.
Would you rather have no limbs but be happy or have all your limbs but be depressed? Having said that, losing limbs would be a major stressor in life and so would be a risk factor for developing depression. However, for the sake of the thought experiment – most people would rather be happy than not.
Depression is relatively invisible from the outside but it’s physically real and serious – the brain is a physical organ after all, and the mind is a product of the brain. So it would link to our own naïve superficialities if we judged people according to only what we could see on the surfaces. Depression is not a trivial condition.
Therefore if you’re blasé about your own supposed negative mental health experiences, or if you say, “I’ve felt that way before and it’s nothing so snap out of it”, then you don’t or didn’t have a mental health problem at all and you haven’t truly felt the same way as someone who has before – you’ve been fortunate so far and you’ve merely experienced the equivalent of a ‘soreness’ instead of a profound and lasting ‘injury’.
Many people generally live with their minds not knowing much more than only the experiences they have personally experienced before. Without education, deep empathy and understanding, people won’t intuitively realise that other people can experience, think and feel things very differently to oneself (e.g. not everyone had joyful birthdays or Christmases when young, or understands what it feels like to live with depression, anxiety, an addiction or compulsion).
Some people also think that certain mental health problems are strictly gender specific (but they’re not, apart from things like postnatal/postpartum depression or psychosis – however males can obviously experience depression or psychosis too but as a result of other impacting life events or major biopsychosocial changes, for which giving birth to a child is just one example of such an event, and happens to be an event that only females can go through) or are even fake – until they suffer from one themselves and finally understand what it feels like (just like one won’t know what it really feels like to be shot by a bullet in the shoulder until or unless one does).
It’s not about how you (assume you’d) feel if you were in someone else’s shoes but about how they feel in their shoes.
Woof. Learning more about the causes, symptoms and treatments of and for mental health disorders or diseases like depression, which is a fairly common disorder or disease across the world – whether one is a sufferer or not – will help us to recognise the problem so that we can treat it as soon as possible, and will help us to better empathise with and behave compassionately towards sufferers without misconceptions or misperceptions.