Secret Sadness, Secret shame. Depression

[cyndilouwhoo]

The holiday season seems to go hand in hand with “the blues”. Stress, social isolation, the palpable sadness that comes with the absence or loss of a family member and financial worries can all contribute to the difficult feelings we sometimes experience.

But is it simply a case of “the blues”—or is it depression?

It’s important to understand the difference.

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When she could focus long enough to think clearly she would sit in bed, sometimes all night long, and ponder why the fates had chosen to deliver unto her what seemed to her to be an almost unbearable burden of loneliness and sorrow.

At those times she would absently speculate as to what she had done to deserve the load she seemed to carry with her day in and day out, the weight that each day became a little heavier, a little harder to carry, a little more difficult to manage; a lingering aura of sadness that seemed one day, without her realizing it, to simply become a part of her.

The feelings hadn’t descended on her all at once, she knew that much. Out from the light that had once used to be the happiness that was her life she seemed to slip, rung by rung down a ladder of guilt and worthlessness, descending into a darkness so deep, so profound that pain now seemed to hug her body like a second skin.

And nobody knew.

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It is estimated that depression directly impacts 19 million Americans every year—and about one in ten of us will go through at least one experience of this illness sometime within our lives. The magnitude of its impact on society, as well as that of the emotional and financial toll it takes on the family and friends of the depressed person, can’t be as precisely quantified.

According to the National Institute of Mental Health, depression is the most common serious neurological illness in the United States—and that we spend about $31 billion annually on the direct and indirect costs associated with treating depression.

Depression is best defined as a mood disorder—which means that the illness affects our perceptions about ourselves. Depression can be mild or it can be severe, manifesting itself in a number of different forms. It can be a distinct condition in and of itself, or a direct byproduct of any number of other forms of physical or mental illness.

Regardless of its severity, depression can distort your ability to see yourself as you really are, and prevent you from viewing your life as the worthwhile thing it truly is.

And at its worst it comes like a thief in the night, stealing your mind, your body, your soul--and if left untreated, your life.

15% of all those diagnosed as depressed will die by their own hand. 90% of all suicide victims suffer some form of major depressive episode before taking their lives.

Severe depression has no beginning that can be recalled, no end that can be imagined by those who suffer from it.

It just is—just as it was yesterday, just as those who suffer from it believe it will always be.

Are you depressed?

Answer yes or no to the following questions

· Do you feel “down” for most of the day?

· Have you lost or gained weight recently without consciously changing your dietary habits?

· Are you sleeping more (or less) than is typical for you?

· Are you more (or less) physically active than you would consider “normal”?

· Have you lost interest in things you used to enjoy?

· Do you feel fatigued or have you lost the energy you once had?

· Do you feel worthless or guilty?

· Are you having difficulty concentrating or thinking clearly?

· Have you thought about suicide or believe that others would be better off without you around?

These are the 9 classic diagnostic benchmarks of depression. If you answered “yes” to 5 or more questions, and if these feelings linger for longer than 2 weeks, you could be suffering from depression—and it is important to ask for help.

You don’t have to live with these feelings. You can feel good again.

Neuroscientific and behavioral researchers have made great strides in understanding the complicated illness that is depression. As recently as 20 years ago, it was thought that depression was purely psychological, the result of environmental and behavioral elements both within and beyond the realm of control of the sufferer.

But with the advent of new diagnostic and scientific research tools, it has been discovered that although behavioral factors can still play a role, the roots of depression can be traced directly back to chemical imbalances within the brain, imbalances which impact specific neurological sectors responsible for controlling such things as emotion, cognition, appetite and sleep.

These leaps in the identification and understanding of the causes of depression have led to heartening news for those who suffer from this most difficult of illnesses.

New drug therapies used alone or in combination with any number of different psychotherapeutic interventions such as behavioral or “talk” therapy can successfully treat up to 80% of those who suffer from depression.

But the sad part of the illness that is depression is that those who suffer from it can fear seeking treatment almost as much as they dread the suffering that comes from the illness itself.

Some myths and facts about depression

Myth: Depression is a disease of the weak.

Fact: Depression is not something that can be willed away through strength of character. Depressed people cannot get better by being told to “snap out of it”. Depressed people are not faking their illness in order to get attention or to get out of something.

Myth: This too shall pass.

Fact: Depression is an illness, like heart disease or cancer. You can’t “ride it out”. Depression does not go away on its own.

Myth: If I “tell” I will lose XXXXX.

Those who are depressed fear admitting their illness. They worry that “others” will think less of them if they are discovered. They fear losing their livelihoods or the love and respect of their loved ones.

Fact: Neither of these things are true. An illness like depression does conjure up the fear of stigma within those who suffer from it. But depression is an illness that most of us understand because we have been there ourselves—or have experienced it through the eyes of someone we know or love. Talking with others and asking for their support while in recovery is the first step in the recovery process. Employee Assistance Programs in the workplace as well as the Family Medical Leave and Americans with Disabilities Act protect the rights of working people while they recover. It should be noted that far more people lose their jobs or family relationships because they can’t bring themselves to ask for help than those who do so.

Myth: The cure is worse that the disease.

People suffering from depression sometimes believe that articulating their feelings and exploring their causes can be even more painful and difficult than continuing to suffer with depression. They fear being “drugged out” or adversely impacted from side effects associated with prescription medication. They fear being “locked up”.

Fact: A compassionate clinician can provide the guidance and support necessary to help those suffering from depression take back control of their lives. All but the most severe forms of depression can be treated on an outpatient basis. New drug therapies can enable people to begin to rebuild their lives without debilitating side effects. Because each person is unique some medications work better for some than others. The key is not to give up if one medication or form of therapy doesn’t work for you.

Getting help

If you suspect you are suffering from depression, whether mild or serious, it is important to seek out help.

Make an appointment with your family physician.

Depression can be a byproduct of other kinds of physical illnesses, so it is important that your care and treatment is appropriate.

Not only can your doctor rule out other possible causes for your symptoms, (s)he can be an invaluable resource of help and support if you are in fact found to be suffering from depression. (S)he can provide referrals to therapeutic professionals, prescribe medication and act as an advocate with your insurance company if necessary.

Talk with your family

Whether you realize it or not, the people who love you know that there have been changes in the way you are experiencing life. Helping them to understand and giving voice to your illness by talking about it with them can help them to help you. People do care and they will help if you only ask.

A word to families and friends

Depression is an illness whose byproduct is fear. Fear of looking different, of appearing weak. Although it is difficult to ask for help, a person suffering from depression can sometimes be so debilitated that they can’t ask.

It is your job to help them get to a place where they feel safe asking for your support.

Think about these things if you believe that someone you care about needs help.

Be Aware

Those with depression sometimes hide their feelings or try and dismiss the signs. Sometimes they hope you will do so as well. Understanding and awareness of the symptoms of depression can help guide you toward getting the depressed person the help that (s)he needs.

Don’t wait for the person to tell you—ask in open-ended and non-threatening ways. Almost all depressed people say that the relief that comes with being confronted with their illness, while sometimes painful and difficult in the short-term, is enormously helpful in getting to a place where they can acknowledge their illness and get help

Be Understanding

Depression is a difficult and complex illness that cannot be “willed away” by the sufferer. Telling a person that although you might not be able to understand their level of pain, you do in fact understand that they are suffering, can be tremendously helpful.

Don’t judge. Empathize.

Be Supportive

Assure the person suffering from depression that you will be there for them. Validate that what they are going through is hard right now but that it will get better—and that you will be there to help.

Offer support in concrete ways—a blanket offer to “help in any way I can, just tell me how” can be overwhelming for a person suffering from depression because they can’t clearly articulate their needs to themselves, never mind to others. Encourage the person to talk about their feelings--and listen to what they have to say. Accompany the person to medical appointments. Bring over a casserole and dine together. Volunteer for an afternoon of childcare or offer to tidy up his/her house.

Be the kind of person you know yourself you’d need if you were in your loved one’s place.

Depression will affect all of us sometime in our lives whether directly or indirectly. It is important to acknowledge its existence, whether it lives within you or in someone you care about.

No one has to live in the shadows--even one more day.

[soxfan[$]]

Excellent advice, Cyndi. Thank you.

Ailsa

[mjfrombuffalo[$]]

One of the best articles I've read on the subject. Great work!

mj

[magenta321]

Thanks. Luckily, I am not suffering from the blues at the moment, but a lot of us are. I think this is a great article for everyone to read, because we all feel that way from time to time.

[lynnzop[$]]

Great article, nice job.

[nicholmere]

If someone is helping their spouse during their depression, then they (the helper) must be prepared for their spouse to end the relationship. Perhaps a 'if you love them, let them go' type philosophy is necessary. My Aunt spent several years trying to convince my uncle to receive treatment for his clinical depression. He finally found someone to help him, then never felt better in his life. After about a year of treatment he decided he'd missed out on so much growing up that he wanted to start over - so he divorced my aunt and started dating someone new the next week. We're all happy that he has a new zeal for life, and I do believe that what was done was for the best, he needs to be happy. But it has been very hard on my aunt and the rest of the family.

[cyndilouwhoo]

Thanks all of you for the nice comments.

Since this was one of those pieces that didn't flow effortlessly from my brain to the keyboard, I especially appreciate the compliments.

And Katherine, you are right--folks who recover sometimes shed relationships, for all sorts of different reasons. Recovery can sometimes be as painful for the supporters as it is for the person in recovery.

As I said, it's a complicated--and very difficult--illness.


Cyndi