Depression is more complicated than a lot of people think. Well, in my experience, anyway. To a lot of people, depression is just sadness, albeit extreme sadness. It lasts for an unknown period; with some people, it’s situational, with a distinct cause, and once that cause has been overcome, the depression goes away. For others – like me, for example – it is chemical, something wrong with basic brain chemistry, and as far as I know, there’s no cure, just regulation and management.
Depression can be so much more – and by more, I mean worse – than just sadness, though. Among common symptoms of depression are:
- Persistent sad, anxious, or “empty” feelings
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details, and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment. (Source: http://www.nimh.nih.gov/health/topics/depression/index.shtml)
Even then, that probably isn’t the whole picture. One of the things that was frequently mentioned at Menninger was that depression was anger directed inwards. Instead of taking your anger out on things around you, in healthy or unhealthy ways, you internalize it all and direct it at yourself. You make yourself believe that nothing you do is ever good enough, or ever will be good enough. You hate yourself for the way you feel, or don’t feel. It can manifest in extreme sadness, or, because you hate yourself so much, you don’t want others to know how pathetic you are and so you try to just show nothing at all.
Anxiety is also a frequent component of depression – if not as a part of the depression, then as a complementary issue. Up until I got to the step-down, I never considered that I might have anxiety issues; I knew I was uncomfortable in most social situations, but I figured it was just because I was an introvert. I felt strange, irregular heartbeats, and I would get dizzy or start sweating, but I just thought I was eating too much junk food, or over-exerting myself. Eventually, though, I figured that those were all components of anxiety attacks – not major ones, but enough to worry me seriously. Some people have extreme social anxiety – they don’t want to be around too many people, or they don’t trust others; some are scared just to go outside. Anxiety manifests in a lot of ways, and it’s brutal.
One of the more insidious problems that affects people with depression is one with a variety of different manners – for lack of a better term, we call them cognitive distortions. According to this article, “Cognitive distortions are simply ways that our mind convinces us of something that isn’t really true. These inaccurate thoughts are usually used to reinforce negative thinking or emotions — telling ourselves things that sound rational and accurate, but really only serve to keep us feeling bad about ourselves.” These are things like black and white thinking – things are either good or bad, up or down, black or white, with no middle ground; catastrophizing – assuming things will always go the worst possible way; or filtering – seeing only the negative aspects of a situation, and ignoring the positive so that only bad things are seen. The article linked above has many more.
Cognitive distortions aren’t unique to people with depression, or even other mental disorders; if you look through the list, you might see a few that you fall prey to. They are worse on people with mental disorders, though, because our minds are already somewhat compromised. We are already prone to thinking about the negative over the positive.
So yeah, depression is more complex than just feeling sad all the time. And it’s rough, because depression is one of the easier mood disorders to describe. I know friends with bipolar, with borderline personality disorder, with extreme anxiety disorders, with schizophrenia. I don’t know that I could describe them. I can only describe depression because I’ve been living with it for over a decade. It’s not something we can just think our way out of. Without the right combination of therapy, treatment, and medication, there’s not much we can do against an enemy inside our heads.