By Larry F. Waldman, Ph.D., Phoenix-based psychologist | Guest Commentary
Recently, I overheard an adolescent tell her friend, “I was so depressed yesterday but I’m fine today.” Her friend replied, “Yeah, I understand; I get depressed sometimes, too.”
This conversation reflects the very common misuse of the term “depression.” Most individuals mistakenly refer to depression when, in fact, they are simply sad or unhappy. We all occasionally “get down,” “get bummed out,” or have “the blues,” but these feelings usually last a few hours or a day or two, and the individual can manage their life — eat, sleep, work, socialize, etc.
True depression, sometimes called clinical depression, is far more severe than a few hours or day or so “down in the dumps.” An average episode of clinical depression lasts approximately six-nine months; in some cases it can last a year or more. It is a deep, prevailing sense of sadness and darkness, often accompanied with the thought that, “I will never feel better.”
Truly depressed persons cannot carry on with their lives because they are unable to focus or concentrate, have no energy, cannot sleep or sleep excessively, cannot eat or overeat, and strictly avoid socialization. Depressed persons typically develop low self-esteem and anxiety. It is also common that physical symptoms accompany depression, like head- and/or backaches or GI distress. The term depression has clearly lost its meaning.
Depression at times is brought on by some negative environmental event but just as frequently depression begins with no apparent cause. Individuals with family members whom have struggled with depression, and thus may be genetically predisposed, are more susceptible to this kind of depression with no obvious precipitant. (Psychiatrists refer to this as endogenous depression.)
Depression is dangerous: People with clinical depression lose their ambition, confidence, and their jobs — even their careers. They have great difficulty fulfilling their role as parent and/or spouse and thus those relationships become tenuous. Depressed people may abuse drugs and/or alcohol in an attempt to ameliorate their symptoms. Finally, the prospect of suicide becomes more likely as the depressed patient becomes convinced they are defective and “will never feel normal again.”
To suggest that one can be depressed yesterday but be fine today, like the two teens referenced above, is ludicrous. This failure to appreciate the true gravity of the word depression is significant in many ways: Persons with clinical depression don’t get the family or social support they deserve because others think we all “get down” now and then. Employers will be most considerate if an employee breaks their ankle, for example, but will provide relatively little understanding to the employee who requests time off for depression.
Until recently, insurance companies covered physical problems much better than mental ones. Finally, the depressed person may not fully understand their condition, feeling shame and refusing help.
Treatment of depression requires a multi-faceted approach: consider medication; receive psychotherapy; eat right; sleep right; exercise; and socialize. Lying in bed in a dark room, waiting to feel better, will only prolong the depressive episode.
I recommend that we speak more specifically about this topic and not use the word depression as a generic “grab-bag” term that includes feeling down, being disappointed, having our feelings hurt, or being bereaved. By the same token, if someone we know or love is clinically depressed, we must offer them the emotional support they deserve and will need — and this most definitely includes employers.
It is important that we cease misusing the word depression and recognize the serious medical/psychological condition it is.
