It’s not news that depression has become a kind of invisible epidemic, afflicting millions of people. We live at a time when depression is approached as a disease. That has a good side. Depressed people are not judged as weak or self-indulgent, as if they only need to try harder to lift themselves out of their sadness. Yet depression, for all the publicity surrounding it, remains mysterious, and those who suffer from it tend to hide their condition – the medical model hasn’t removed a sense of shame. When you’re in the throes of depression, it’s hard to escape the feeling that you are a failure and that the future is hopeless.
Before considering how to handle depression, let’s ask the most basic question: Are you depressed? The bad side of the medical model arises when people rush to be medicated because they don’t like how they feel. Doctors barely bother to get a correct diagnosis, because the easiest thing to do –and the thing that patients demand – is to write a prescription.
Let’s see if we can get beyond this knee-jerk reaction.
Becoming sad or blue isn’t a sure sign of depression. Life brings difficulties that we respond to with a wide range of normal emotions: sadness, anxiety, resignation, grief, defeated acceptance, helplessness. Moods are cyclical, and if these feelings are your response to a tough event, they will subside on their own in time. If they linger, however, and there seems to be no definite cause or trigger, such as losing your job or the death of a loved one, depression is accepted as the conventional diagnosis.
Depression isn’t one disorder, and even though an array of antidepressants have been thrown at the problem, the basic cause for depression remains unknown. For a diagnosis of major depression, which is more serious than mild to moderate depression, at least five of the following symptoms must be present during the same 2-week period..
- Depressed mood (feeling sad or empty; being tearful)
- Markedly diminished interest or pleasure in all, or almost all, activities
- Significant weight loss when not dieting, or weight gain, or decrease or increase in appetite
- Insomnia or hypersomnia (sleeping too little or too much)
- Slowing of thoughts and physical movements
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide
If you can count five or more of these as being present, know that your list must contain “depressed mood” or “diminished interest or pleasure” before you’d be considered medically depressed. We’ve come to recognize different kinds of depression that fit certain circumstances:
- Dysthymia is mild, chronic depression. It must present for at least 2 years for a diagnosis of dysthymia.
- Seasonal affective disorder (SAD) is a form of depression that generally arises as the days grow shorter in the autumn and winter.
- Postpartum depression begins after a woman has given birth and may get worse as time goes on.
Even though no one knows exactly what causes depression, it is clearly a state of internal imbalance. Balance is essential for the healthy functioning of both your body and your mind. The upsetting factors that make it more likely you will get depression form a long list: genetic predisposition, being female, death or loss of loved one, major life events (even happy ones, like a graduation), other mental illnesses, substance abuse, childhood trauma, certain medications, serious illness, and personal problems such as financial troubles. What these things have in common is that they disrupt the normal balancing mechanisms of mind and body. A treatment that aims at restoring balance therefore makes the most sense, and in tomorrow’s post I will outline measures for rebalancing.
Stay tuned for Part 2 tomorrow!
For more information go to deepakchopra.com
PHOTO (cc): Flickr / madamepsychosis
Originally published October 2011