You feel sad most days. You can’t seem to enjoy yourself. You aren’t sleeping well and don’t have enough energy. Are you depressed? Possibly, but you may also be appropriately grieving a difficult situation in your life.
What is depression? How is depression different from sadness? What causes depression, and more importantly, what are my treatment options? Knowledge is power. Understanding depression will help you recover.
Sadness is a Normal Emotion
Sadness is a painful emotion. While sadness is unpleasant, it is not dangerous or abnormal. Sadness is an emotional response to an unwanted loss. That loss may be the death of a loved one, the loss of a relationship or opportunity, the loss of health (physical pain), or the loss of anything valued.
When individuals feel sad, they often express emotion through crying, facial expressions, and a changed tone of voice. Behaviors often change when one is sad. People generally are not as energetic and often want to be left alone when they are sad. Irritability and anger often accompany feelings of sadness.
The emotion of sadness is an experience that makes it more likely that we will slow down and grieve our losses. This can be adaptive and help foster personal growth. Deeper insight into one’s loss and how life is now different helps create wisdom.
While sadness is a painful emotion and may interrupt some activities, sadness alone will not create a serious disruption in functioning. People can be sad and still perform adequately at work. Sadness does not stop people from meeting their responsibilities or disrupt relationships (though it may temporarily interrupt or reduce efficiency in these tasks). Depression, however, has a very different functional impact than depression
Depression is Not a Normal Emotion
Depression is relatively common. According to the National Institute of Mental Health statistics, over 17 million adults (7% of the population) in the United States met diagnostic criteria for depression in 2017 (the most year the statistics are available, as of 2020). While depression is common, it is not a normal or adaptive emotional experience, but serious illness.
Depression is one of the most common mental health disorders. Depression can lead to major impairment in a person’s ability to function at work and in their personal life. Depression. The National Network of Depression Centers estimates that the cost of depression in terms of lost earning is $210 billion per year. Depression is the leading cause of disability in the United States among those aged 15-44.
Recognizing Signs of Depression
There are a variety of types of depression. Diagnosing depression is complex. If you believe you or someone you care about may have a variant of depression, the condition should be evaluated by a qualified healthcare professional (such as a physician, a licensed counselor, a social worker, or a psychologist).
Duration is one factor that makes it more likely that someone is not merely sad, but has an emotional illness. Sadness for more than 2 weeks suggests that this person may need more evaluation. The frequency of symptoms is another indicator that the condition may be more serious than sadness. If a person tends to experience sadness multiple times per day (vs occasional feelings), they may be experiencing a type of depression. Severity is also a warning sign. Does the sadness seem to be much more intense than typical?
There are a number of signs that may indicate depression. No one sign alone suggests depression, but the more signs an individual has, the more likely it is that he or she has a mental health problem vs. the normal emotion of sadness. The following list summarizes the signs of depression.
- Feelings of sadness
- Sleeping more or less than normal
- Changes in appetite
- Decreased energy
- Decreased ability to enjoy life or recreation
- Decreased motivation
- Decreased sex drive
- Negative thoughts
- Increased thoughts of death
- Suicidal thoughts
- Poor concentration
Causes of Depression
Understanding depression can help motivate you to seek treatment. The causes of depression are not fully known, but the stress-diathesis theory is the most accepted explanation. According to this theory, people have a genetic predisposition for depression, which may or may not lead to the actual illness. The experiences and stress that a person is exposed to over their lifetime make it more or less likely that they will eventually meet the diagnostic criteria for depression.
Biological aspects of depression include chronic pain, chronic medical conditions, hormone balance, and neurotransmitter balance in the brain. Brain anatomy and function helps to regulate biological processes, such as appetite, sex drive, concentration, and energy level. If the brain is not functioning properly, this can lead to decreased energy, sleep problems, and the inability to take pleasure in activities that would normally be pleasurable. Neurotransmitters such as serotonin, norepinephrine, and dopamine are relevant to these functions.
Medical treatment of depression can be extremely effective and is often necessary, particularly when individuals have more severe symptoms of depression. Many primary care providers are willing to provide medical treatment of depression, but complex cases sometimes require treatment by a physician who specializes in mental health treatment, known as a psychiatrist. While medications can be very effective in treating more severe types of depression, research suggests that psychotherapy can be more effective in treating mild to moderate forms of depression and that medication and psychotherapy together is often the most effective form of treatment for depression.
Psychotherapy should only be performed by a licensed mental health professional. There are many types of psychotherapy. Psychotherapies which have the most empirical support for effectively treating depression include:
- Cognitive-behavioral Therapy
- Interpersonal Therapy for depression
- ACT Therapy
- Behavioral Activation
While these therapies are very different, some common factors predict success. The individual seeking therapy must be willing to participate. Therapy is not a passive activity but requires teamwork between therapist and patient. There must be good chemistry between therapist and patient. If the patient doesn’t feel safe with his or her therapist, the therapy will not be effective. The therapies listed above involve coaching the patient in changing negative thought patterns, and/or increase positive behaviors (such as spending time with friends, doing pleasant events, or exercise). These changes in thinking and behavior help in healing from depression.
Getting Help Today
Depression is a serious health problem which warrants professional treatment. If you have questions about how to get help for depression, please contact us at Piedmont Counseling Center. You can reach us by phone at 336-293-7406. Talk with your primary care doctor, clergy, or teacher and they may be able to recommend help for you. If you or someone you care about is having suicidal thoughts, call the crisis line at 1-800-273-8255.