1. Signs and Symptoms of Depression: Major Depressive Disorder
These days there is a lot of talk about depression. Recently I picked up a news magazine which had a caption about how to prevent depression. It turned out that the depression the article was addressing had to do with economics. But there is a lot of focus on depression that pertains to emotions and mental health as well. I’d like to talk about the different types of depression. Usually when someone writes on this subject, the focus is clinical and the terms and descriptions come out of the textbooks. While I intend to include some of that language, mostly I want to talk about what the different types of depression actually feel like – what someone experiencing these symptoms feels.
I’ll start by talking about clinical depression, what is called Major Depressive Disorder. The textbooks tell us that what defines this condition is that for most of the day for the period of two weeks a person has either a loss of interest or pleasure or experiences a depressed mood. And while the duration of symptoms is important in terms of making a diagnosis, what a person feels and experiences will indicate if one is depressed.
Clients whom I have worked with who are experiencing such a depression talk about their loss of motivation to do anything. Generally they feel a pervasive tiredness or loss of energy and, consequently, their overall functioning is greatly impaired. They lose their ability to concentrate – they can’t read the newspaper or watch a video or TV program. They will describe long periods of staying in bed, sometimes sleeping, or sometimes just laying there, ruminating, their minds racing, filled with anxiety and worry. In fact, anxiety often accompanies depression. They just do not feel like themselves. They may not be eating (having lost all interest in food) or they may be eating nonstop. And quite often a depressed person feels hopeless, extremely pessimistic and lacks any sense of self-worth. Given this degree of suffering, a person may be having thoughts of suicide or have made attempts. One client who felt suicidal told me that it wasn’t that he actually wanted to die; he just wanted to stop this pain.
This is what Major Depressive Disorder looks and feels like. While the causes for this degree of severe impairment are many – generally it is thought that there are genetic and biochemical factors, as well as the presence of severe stressors that overwhelm the person — the most effective treatment involves a combination of medication management by a physician and psychotherapy. In my experience, I have not found alternative approaches to be helpful. A person experiencing these symptoms needs professional help. However, seeking help might feel like the most arduous task imaginable. As one client put it, it’s when you need help the most that you feel most incapable of reaching out for it.
2. Signs and Symptoms of Depression: Differences Between Women and Men
While the experience of depression can be very similar for both women and men, there are some gender differences that are worth noting. Factors that influence a woman becoming depressed may be different than for a man, and the way a man experiences depression and responds to it may be different.
Depression is more common among women than among men. Biological, life cycle, hormonal and psychosocial factors unique to women may be linked to women’s higher depression rate. Researchers have shown that hormones directly affect brain chemistry that controls emotions and mood. For example, women are particularly vulnerable to depression after giving birth, when hormonal and physical changes, along with the new responsibility of caring for a newborn, can be overwhelming. Many new mothers experience a brief episode of the “baby blues,” but some develop postpartum depression, a much more serious condition that requires active treatment and emotional support.
Some women may also be susceptible to a severe form of premenstrual syndrome (PMS), sometimes called premenstrual dysphoric disorder (PMDD), a condition resulting from the hormonal changes that typically occur around ovulation and before menstruation begins. During the transition into menopause, some women experience an increased risk for depression.
Men often experience depression differently than women and may have different ways of coping with the symptoms. Men are more likely to acknowledge having fatigue, irritability, loss of interest in once–pleasurable activities, and sleep disturbances, whereas women are more likely to admit to feelings of sadness, worthlessness and/or excessive guilt.
Men are more likely than women to turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, irritable, angry and sometimes abusive. Some men throw themselves into their work to avoid talking about their depression with family or friends, or engage in reckless, risky behavior. It may be more difficult for a man to admit to these feelings, believing that doing so makes him less “manly” and able to cope with his problems. Though more women attempt suicide, many more men die by suicide in the United States.