“I don’t know what’s wrong with me. I’m sleeping all the time. I don’t have an appetite. I’ve stopped responding to texts, and sometimes I just stay in bed, if I don’t have to be anywhere. Sometimes, I wish I wasn’t here. It doesn’t make any sense. I have good life. I feel guilty for not being able to pull out of it. I think my partner is getting tired of it all. I wouldn’t blame them if they left me.”
Depression is defined by a collection of symptoms which occur in various situations. The duration determines if you could be diagnosed as depressed. The most common question I hear from people who are depressed is “why?“ The answer is often complicated.
Despite the diagnostic criteria given for depression in the Diagnostic Statistical Manual (DSM) – the ‘bible of psychiatry,’ there is debate within the mental health community about when a diagnosis of depression, or anti-deppresent medication, is appropriate.
There’s rarely one answer as to why someone is depressed. There are many factors which might result in the symptoms described by the person at the start of this post.
Sometimes there is a clear triggering event: a relational break up, the loss of someone close, living in a conflictual situation, or difficulty finding employment. These events trigger a normal psychological response; most often this is grief. It might be prolonged grief, or it might be complicated grief, but it is worth considering if you’ve experienced something that warrants grieving (see Giving Grief the Time of Day).
Sometimes mistreatment or loss in childhood needs to be grieved. Sometimes there are big things happening around us, current events, disasters, political issues, or environmental issues that are worth grieving.
A doctor may prescribe anti-depressants based on symptoms alone, but I strongly encourage you to consider doing grief work (see next post “Good Grief Work) if grief is the origin of your depressive symptoms. This may require counselling or a support group.
Sometimes, the origins of these symptoms are less clear, such as, living within a community where trauma has occurred throughout previous generations.
There may be situations that are now ‘normalized’ that continue to cause trauma, such as parents having difficulty communicating affection to their children, addictions, and violence. There may be historical trauma which may not be overtly on the surface, such as wars or famine in previous generations. Scientists have discovered that trauma can be carried in DNA (see this podcast in Scientific American) and believe that this can impact personality. Fortunately, a review of more recent research by Katharina Gapp, et. al. shows that positive experiences, including talk therapy, can help reverse some of those effects.
Sometimes there are physical factors such as low iron, thyroid issues, or depleted vitamin B.
Hormonal changes can also contribute. It is worth checking with your doctor if you suspect any of these items as contributing.
If there is no major loss requiring grief, physical symptoms, or previous trauma, it may be helpful to consider whether negative thought patterns might be contributing to your mood.
See this paper on cognitive distortion to check if you might be stuck in one of these distortions and find out ways to combat these distortions. This exercise is part of the main treatment recommended for depression, called Cognitive Behavioural Therapy (CBT). CBT can be useful no matter where the depressive symptoms originated, but it is still important to acknowledge the origin, so that, like panic attacks (see A Good Time to Panic), you are clear on where this is coming from. You don’t want to get caught in a cognitive distortion that tells you that the fault is all due to your own failing. Guilt is a very common symptom of depression. Don’t give in to it. Reach out. You are not alone. If you need to talk to a counsellor, don’t hesitate. Asking for help does not mean that you have failed it means that you are a mature adult who knows what they need and how to get it.
NOTE: If you are suicidal, please call a crisis line for support. In Manitoba the suicide help line is 1-877-435-7170.
NOTE: If you are currently taking anti-depressants, do not discontinue without consulting your doctor as there are potentially dangerous side effects if you discontinue without medical supervision.
Check out Jenny Lawson’s story of living with severe depression and anxiety. She is a comedian (language and quirky humour warning). She has a unique way of looking at her illness that I found inspiring and sometimes just plain bizarre;) It’s called *Furiously Happy: A Funny Book about Horrible Things. I like the audio version, but my husband warns that her vocal style drove him a little batty (I personally found it entertaining). Another great read is Hyperbole and a Half by Allie Brosh, a graphic autobiography based on her experience of depression. Allie also has a blog http://hyperboleandahalf.blogspot.ca from which much of her book is derived. It’s a fantastic, beautiful, and hilarious look at a tragic experience.
*Please note: I have signed on as an affiliate sales person for McNally Robinson which means that if you click on the above link, and decide to purchase the book I’ve recommended, I will receive an affiliate’s fee. I only recommend books I have read and believe to be worth recommending.
For more about mental illness see Mental Illness – A Relationship Story
For more about Grief see Good Grief Work
For more about connection & community see What do Adults do for Fun?
For articles about anxiety/panic attacks see A Good Time to Panic