by Keith Sonnanburg, Ph.D.
Clinical Psychologist
We all get sad at times. Sometimes we are unhappy with our circumstances. On occasion, we grieve. Tears are an expected response to many situations. All of this is perfectly normal. None of this is what is meant by "clinical depression."
There are distinctive signs and symptoms that health professionals evaluate in order to recognize depressed feelings. The trouble with reviewing such a list, is that professionals are trained to use ordinary words in peculiarly specific ways. For most of us, it is easy to recognize, from our own experience, feeling blue, losing enthusiasm, a sense of weariness, loss of confidence, self-criticism, feeling irritable. Certainly there are moments when we really would prefer to stay in bed. There may even be times of acute despair when we ask ourselves whether it is worth living, but then quickly reject the option. Such normal experiences can be described with the same words that define depression, but the reality is profoundly different.
"Depression" describes a range of human experience. The depth of depressed feelings can be an annoying inconvenience or totally disabling. In some cases, depression even reaches psychotic proportions. How can we distinguish depression from ordinarily unpleasant emotions? There is a distinctive quality of depression: the moods persist despite changing circumstances, the lack of energy can be oppressive (like a bad case of the flu), certain autonomic nerve responses (beyond our direct control) can be involved, there are predictably characteristic patterns of thinking, and bodily functions can be affected in more severe cases. Perhaps the most personally salient features of the experience are profound feelings of hopelessness and helplessness.
People seek relief from depression in many ways: dietary changes, exercise, activities, companionship, spiritual guidance, using drugs. The clinically proven and reliable treatments are: psychotherapy and/or psychotropic medications. Psychotherapy alone is superior to medications alone, for mild to moderate depression. The combination of psychotherapy and medications is better than either one by itself, in the short-term (e.g., six months). Better long-term adjustment and increasingly beneficial effects are demonstrated in those with mild or moderate depression who receive psychotherapy alone, rather than the combination of the two.
What is most important for depressed people to learn is this: there is help to be had and life is not, in fact, hopeless (even when it seems to be so).