Depression, Not Just Sadness

Keep in mind that all of my blog posts are intended for general information, which I hope is helpful. Please consult with a professional when you or someone you know is motivated and ready to undergo treatment.

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People tend to think that depression is synonymous with sadness, but it’s really so much more than that. Something I often hear from patients goes something like this: “I don’t think I have depression because I don’t feel sad.” Plus, many people figure, if life is going generally well and I have no good reason to be depressed, how can I be depressed?

Sadness is just one of many symptoms that mental health professionals look for when assessing for depression, so even if sadness isn’t your primary problem it doesn’t mean depression should be ruled out completely. It’s also important to remember that feeling sad can be normal and shouldn’t always be seen as pathological (caused by mental illness), so even if you feel sad it doesn’t automatically mean you also have depression.

So what are some other symptoms to look for? Well, some common symptoms that I tend to see in my practice beyond sadness include (but are not at all limited to):

  • Crying easily and often not knowing why
  • Getting very angry very easily or just quickly becoming irritated by others
  • Not wanting to spend time with friends or loved ones and isolating yourself
  • Losing interest in things that you normally find enjoyable
  • Feeling hopeless about the future
  • Difficulty getting restful sleep
  • Feeling physically tired and weak; can’t work out, get off the couch, or out of bed
  • Having a hard time concentrating on school work or work duties
  • Increased feelings of anxiety (for more on anxiety, click here)
  • And yes, many people talk about sadness but actually, maybe even more often than that, I hear about people feeling empty, which is very different

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What it is NOT: it is not a defining characteristic that says you are a sad person that doesn’t know how to appreciate life or what you have, that only affects those who are mentally or emotionally weak.

What it is: it is a helpful way for a psychologist to categorize your symptoms and to formulate a treatment plan that works for you (which may or may not include medication), to help not only ease your symptoms but to improve your ability to fulfill important roles in your life (e.g., if you are a mother, a student, or a husband) and ultimately accomplish personal life goals.

Being depressed can be more difficult due to the pressure we feel to constantly remind the world that we are happy and positive. So, especially when we seem to “have it all,” we might feel some shame if we are depressed and would rather not tell anyone about it. For many of you, this might mean you secretly live with it and end up dealing with it alone.

The important thing, if you think you or someone you know is depressed, is to seek appropriate support. In addition to a supportive community, having a professional discuss these things with you to develop a plan that suits your specific concerns may help you determine if psychotherapy and/or medication might be helpful. There may be reason to have hope that help is out there if you need it.

Getting To Know You: Anxiety

Anxiety is a common yet poorly-understood internal experience. Ask anyone with anxiety what it feels like to have anxiety and they might have a hard time putting it into words. Some will be able to explain how they deal with their anxiety because that often involves behavioral or cognitive techniques that help them cope with their symptoms (commonly known as ‘coping skills’), but aside from that anxiety can be a bit of a mystery.

Not all anxiety is made equal so one way to start dealing with anxiety is to begin to identify what it is for you. You can start by simply dividing your experience into categories such as physiological (your body), cognitive (your thoughts), and emotional (your feelings). These are your first steps.

Physiological Symptoms. In terms of your physical experience of anxiety, what do you feel in your body when you first start experiencing anxiety? What are the physical signs that help you know that anxiety is about to happen or is currently happening? Many people describe difficulty breathing, feeling like their body temperature goes up, cold hands or feet, tingling in different parts of their body, or uncontrollable sweating.

Cognitive Symptoms. In terms of your cognitive experience of anxiety, what is happening to your ability to think when you are anxious? Some people describe difficulty concentrating (thoughts might feel clouded), inability to answer easy questions, general disorientation (not sure where you are or where you are going), and negative thoughts tend to take over. In more severe cases you might think you are dying and may need emergency treatment, which could be part of a panic attack.

Emotional Symptoms. In terms of your emotional experience, how is your mood when you are feeling anxious? Many people say that they become very easily irritable, especially when others insist on knowing what is wrong. They get upset, angry, even depressed – meaning, they get sad, feel hopeless, and would rather be alone. This all can have a pervasive more long-term effect in the way we see ourselves, which may include a negative impact on our self-esteem and confidence, and even on our sense of self-worth.

If you or someone you love experiences anxiety, which most people do at some point in their lives, you can do something about it. One of the first steps is to familiarize yourself with your experience and to clearly identify your symptoms. If you have kids, ask them about it in the way described above (hopefully not when they are in an anxious state). Learning about the origin of your anxiety through a thorough evaluation helps professionals like psychologists develop targeted, effective treatment plans, which can lead to long-lasting positive results. Take the first step, get to know your anxiety.