The term “depression” is becoming increasingly commonplace today. Often people believe they have gone through depression but today we want to question whether it is really so! The number of people suffering from depression is definitely on the rise, but while it is as widespread as to be the common cold of mental disorders, it still isn’t as common as common cold!
3 Ways of Differentiating ‘feeling depressed, low or sad’ from the Clinical Diagnosis of Depression:
I. Number of symptoms:
Almost every person goes though times when he/she ‘feels depressed’, but that in no way implies that the person is suffering from the clinical disorder of depression. Sadness of mood, which we often term as ‘feeling depressed’ is just one of the many symptoms of depression and does not alone qualify as the disorder.
Depression is a mood disorder which comes with its own battalion of symptoms and requires both pharmacological and psychological therapy. The symptomatic criteria of depression have been laid down by the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). We have attempted to explain and simplify the criteria for you.
Remember: a majority of the symptoms mentioned below must be present for the diagnosis.
i) Sadness of mood:
As expected, feeling low/down or sad is the primary symptom of depression. This however is different from the temporary situation-induced mood swings that all of us go though. This sadness is more pervasive and at times can feel over-whelming.
You may feel empty, hopeless, dejected, miserable, tearful and unhappy. You may simply be unable to get out of the dumps and even bright sunny days might feel like damp cold winter nights. However, there is a good chance that you might not feel any of these things and may instead suffer [and make others suffer] with irritation, anger outbursts and low frustration tolerance. This is often the case with children, teenagers and men, not that it can’t happen with women. Here, the tragic hero is branded a villain instead. So be aware, that irritating friend, who is getting on your nerves because she is cross and grouchy all the time, may just be suffering internally and simply being unable to express it.
The depressed mood persists ‘most of the day, nearly every day’. This state is noticeably different from your usual temperament and you might often find your loved ones enquiring ‘what’s wrong?’There might also be diurnal variation in mood, which means that the person may feel worse in the morning and somewhat better later in the evening.
ii) Loss of interest and pleasure:
Life seems boring, dull and well, lifeless. All the things that got your blood pumping with adrenaline until a few days ago – be it Hrithik Roshan or Formula 1 races, dancing or playing cricket – suddenly feel like tiresome chores which you just don’t want to do even if you’re paid for them. Even ice-cream doesn’t taste as delicious anymore! Basically, you might simply feel bored and disinterested in just about everything.
Interests change and passions wane, and at times we all just feel like doing nothing but laze around. It’s okay. No red signals there, unless you feel like a leaking balloon with all your enthusiasm for life just pouring out.
iii) Appetite/Weight Changes:
Is the weighing scale treating you differently these days? Has it been especially kind (or unkind) to you without any conscious provocation from your end? Has food become tasteless sawdust which you gulp down only to survive, or on the other end, do you find yourself attracted to everything eatable in sight for the sake of it or to just have something to do apart from feeling bad?
iv) Sleep Disturbance:
Do you find yourself wishing for more hours in the day because the 15-20 hours that you’re sleeping are just not enough? Or have you been up for nights counting stars. Insomnia – lack of sleep or hypersomnia – excessive sleep nearly every day are indicative of possible pathology.
Then again, sleep cycles do get disrupted now and then due to factors ranging from anxiety to indigestion to exhaustion. But here, the body has the natural tendency and capacity to return to its regularity. Before jumping to conclusions, remember, those dark circles and bags below your eyes are probably due to a not so healthy life-style rather than depression.
v) Psychomotor Agitation/Retardation:
Agitation: Have you been feeling too keyed up recently? Feeling unable to relax and just be? Have to keep doing something or the other all the time, even if it’s completely pointless? Just can’t seem to stop even though you might be exhausted? Irritability, restlessness, moodiness and being easily frustrated or angered are also symptoms of Depression. So just check if your ‘mood swing’ has persisted a bit too long.
Retardation: This is life in ‘slow-motion’. Thinking, speaking, moving and just about everything is an effort, and one which seems to take a lot of time to get done. Your sentences might have extended pauses and arithmetic sums of your kids or brother might suddenly feel like Ph.D. level calculus.
Being tired all the time, even when you wake up in the mornings, without sufficient activity or stress to account for it is a red flag. You don’t feel like getting out of bed at all because you just don’t have the strength to. All your energy seems to have been sucked out by some invisible vampire and no amount of Glucon-D helps. Get Help!
Are you thrashing yourself for not scoring well, for being late for work, for forgetting to call your ill friend, for not taking the week off to help your mom/mother-in-law, for not fixing your building’s drainage problem, for not giving your salary to the needy old-age home and for not even ensuring world peace?! Does all this make you feel useless- someone who is making nothing out of his life? Excessive inappropriate guilt and/or feelings of worthlessness are common in Depression.
viii) Difficulty thinking:
Are you mulling endlessly on what to cook for dinner, which tie matches your shirt or whether to start a conversation with ‘hello’ or ‘hi’? Has choosing the coffee you want become a decision requiring careful and detailed thought? Having to come up with a new idea is a nightmare? Feels like your I.Q somehow went down and you don’t know how? Relax, the bulb in your mind may have been fused simply because of Depression and this indecisiveness and diminished ability to think or concentrate is reversible. The bulb can be fixed.
You have all the burden of the world on your fragile shoulders, making you feel overwhelmed. You feel like it is all too dark and no light at the end of the tunnel? You want to end the suffering, end it all. Suicide seems like a simple or perhaps only solution to all of life’s never-ending problems. One might even find oneself planning how to go about it- gun, roof, blade, poison, rope. In psychological terms that is called suicidal ideation. You might have even had an actual test run – the attempt obviously failed as you are still reading this.
If you have ever felt or currently feel any of the above, do yourself a favor and tell someone. If you find no one you can depend upon, tell us. Before you decide to do something, just give someone the chance to lend you some balm for your aching shoulders.
If you nodded in agreement to most or many of the above symptoms, it’s time for you to get some help.
II. Duration of symptoms:
The symptoms must be present for 2 weeks or more so don’t go looking for anti-depressants every time you feel blue. Wait. In all probability, you’ll get over it before you manage to get a prescription.
Also, it must represent a change from previous functioning. So if you are temperamentally reclusive and have few interests and have been this way for as long as you remember, perhaps it’s just who you are as a person.
But, depression, especially the milder version of it – Dysthymia – can persist for years without being identified. So if sadness seems the norm for you, we still recommend you get professional help. A happier higher functioning life might be within reach.
III. Severity and dysfunction :
The symptoms must be severe for a diagnosis. The simple benchmark for judging if you issues are severe enough to require professional help is to take stock if and how much of a problem they are creating for you in your personal and/or professional life. If you are managing all the areas of your life just fine, but still often feeling low, you could think of talking to a therapist or you could choose to manage it yourself for a while. But if there is impairment, if you find you are not your old self and you seem unable to handle life with interest and cannot feel any pleasure, it’s time you do something to bring back the joy in life. What can you do? Well, that’s for article I will write some time soon.
For a quick way to find out if you are depressed take this test here
Post contributed by: Mahima Gupta (Psychologist, Inner Space, 2010-2012)