Depression affects people differently. Put most simply, it is a profound sadness that takes away all the interest you used to have in life. Things that you used to enjoy lose their appeal. If these feelings persist for weeks or months, then you may have a depression serious enough to justify drug therapy. This would certainly be the case if you have a history of depression and there is no immediate and obvious cause for your sadness. Put another way: sadness would be considered quite a normal feeling while you are going through a divorce or when one of your close family relatives has died. An absence of such trigger events would be a cause for concern.
It is relatively "normal" to feel sad or down although usually not more than once or twice a month and without it affecting your ability to get on with your life and earn a living. Perhaps this sadness creeps up on you every now and again when you are tired or stressed. But it does not last longer than a day or so and no-one would feel that it was necessary to go and see a doctor. These feelings go away on their own, often because friends and family are around and cheer you up.
Another kind of "normal" sadness arises out of situations as a reaction to significant events. You might call this grief if there was a death in the family or “ordinary” depression if you were going through a divorce or unexpectedly lost your job. Such feelings hit anyone regardless of whether there is any history of depression. Similar feelings can also be caused by news of medical problems. Perhaps you have just been diagnosed with cancer or the doctor is recommending a dangerous operation. Even the strongest of people has negative feelings when their bodies fail. Finally, depression can be a side-effect when taking certain prescription drugs. Except for the last case, no-one would advise consulting a doctor unless the feelings did not slowly ease. Your family and friends would be there to offer their support. It would not feel like any kind of medical emergency. Perhaps as a last resort, you might think about having grief counselling or some other form of psychotherapy, but you would resist the idea of taking antidepressants. You can change to a different medication to see if the side-effects diminish. If sleep is being disturbed, you might take something short term for that. But no-one is going to think you are ill.
When you cross the threshold into clinical depression, what might you be feeling?
- You are unhappy and anxious and these feelings do not go away.
- Whereas previously you were optimistic, now you feel hopeless and pessimistic. You may even have considered the idea of suicide as a way of solving your problems.
- Your confidence has been worn away leaving low self-esteem and a sense of worthlessness. In some cases, this may also be associated with feelings of guilt about things undone or things done badly.
- Whereas you used to take great pleasure in your work and social activities, you have lost interest (including a loss of interest in sex).
- You used to be active but now you feel tired a lot of the time — as if you have no energy.
- There seem to be problems in sleeping. Perhaps it is not yet a full case of insomnia, but you find it difficult to get to sleep and/or wake early.
- Life used to be easy. If there were choices to be made, you could sum up the options and make a decision. Now this decisiveness has deserted you. Your concentration is not what it was, your memory seems poor and, because of a new anxiousness, you find it difficult to take those decisions. This is combined with a general restlessness and some irritability — probably because you find it more difficult to take the stress of your life.
- Gone are the days when you could eat without worrying. Now you are either eating a lot less or you are putting too much weight on.
- And now there are those symptoms. You feel unwell but cannot quite explain precisely what is wrong. You have more headaches and stomach disorders than before. When you try different remedies and treatment, nothing seems to work.
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