More Than Just Having the Blues
Written by Randi Fine
Narcissistic Abuse Awareness and Guidance with Randi Fine
Though we may use the word “depressed” to describe the sadness we are feeling at times, these occasional, temporary episodes do not actually fall under the clinical umbrella of true depression. Major depression is more than just sadness. It is all-encompassing, intense, and unrelenting despondency. It overshadows us with feelings of helplessness, hopelessness, and worthlessness. It makes us feel empty; fills us with despair.
Depression disrupts our day to day lives and impedes our ability to function normally over long stretches of time. It impairs our thoughts, health, and behavior. It is a serious illness that not only affects the individual who suffers from it; those who are around them and care for them suffer too.
There has been a stigma associated with depression for a very long time. There will always be people who don’t understand mental illness, fear it, or judge it. Some see depression as a weakness of character. It is not. Depression is an illness that is no worse or better than any physical illness. Left untreated it can be a dangerous, even deadly disease.
Depression is the most common of all mental illnesses. Studies show that between nine and twenty-five million American adults suffer from it each year. That is a huge spread, but the discrepancy may be explained by the fact that depression largely remains undiagnosed and untreated. It is estimated that two-thirds of those suffering from it do not seek treatment or get the help they need.
Depression does not discriminate—it can occur at any age, along all gender lines, and among every race and ethnicity. Depression doesn’t care whether the person is in a high, middle, or low income bracket.
Those who come from families with histories of depression are more prone to the disease, but the challenges of life such as loneliness, marital or relationship problems, unemployment, or financial problems can be just as responsible for bringing episodes on. Those who suffered childhood abuse or are currently suffering abuse of some nature are highly prone to it. Those with addictions and substance abuse problems have a higher than average chance of having depressive episodes.
The suffering of chronic pain, long term or serious illnesses, or other health issues can often be responsible for preceding, causing, or accompanying bouts of depression. And studies show that depression can exacerbate the existing symptoms of chronic disease, make adaptation to the disease even harder, and make the condition more difficult to treat.
Major depression, also known as clinical depression, major depressive illness and unipolar mood disorder – characterized by a significant change in the way one normally functions and the constant, prevailing inability one has to enjoy life.
Indicative of a depressive disorder are multiple symptoms, symptoms that are hard to ignore, and long lasting symptoms. Symptoms can occur gradually or suddenly, range in intensity from moderate to severe, and vary in duration. Most people who suffer from major depression will have recurring episodes. Some will have only one.
It is not unusual for those suffering from depression to have unexplained and untreatable physical symptoms such as joint pain, stomach pain, headaches, back pain, or sore muscles. The brain chemicals that influence our moods also influence our threshold of pain. When depression is the cause of physical symptoms the symptoms will not respond well to treatment.
The DSM-IV defines a major depressive episode as having five or more of the following symptoms. These symptoms must occur together, occur daily or close to daily lasting the majority of the day, and last for the duration of at least two consecutive weeks:
The symptoms in no particular order are:
- Constant feelings of sadness, emptiness, helplessness, hopelessness, and powerlessness
- Fatigue, sluggishness, and loss of energy
- Feeling worthless and self-loathing, overly critical of self, and excessive or inappropriate feelings of guilt
- Difficulty concentrating, making decisions, and remembering details
- Disruption of sleep patterns; insomnia and sleeping too little, or hypersomnia and sleeping too much.
- Diminished or loss of interest in things previously enjoyed; difficult to feel happiness or pleasure
- Feelings of restlessness or agitation, lower than normal tolerance levels, short tempers or violent behavior
- Significant changes in eating habits or body weight
- Preoccupation with death or suicide.
Suicidal warning signs are:
- An unusual preoccupation with death or dying.
- Thoughts or talk of death or suicide.
- Making an attempt to commit suicide
- Aggressive behavior or impulsiveness
- Expressing strong feelings of hopelessness or being trapped
- Reckless behavior that indicates a death wish
- Contacting or visiting people to say goodbye
- Getting affairs in order, giving away prized possessions, or tying up loose ends
- Telling others that they would be better off without them or saying that they want out.
- Suddenly switching from extreme depression to calm and happiness.
Those who have previously attempted suicide are at a higher risk of attempting it again and completing the act. Anyone who feels or expresses suicidal thoughts or intentions should be taken seriously and must be immediately evaluated. The hotline to call is 1-800-SUICIDE or 1-800-273-TALK
Other types of mood disorders fall within the spectrum of depression:
- Major depression with psychotic features – experiencing all the symptoms of major depression, plus delusions, hallucinations, and/or the hearing of voices – withdrawing from reality, experiencing paranoia, and/or the belief of possessing special powers
- Mood disorder with depression, commonly known as manic depression or bipolar disorder – characterized by mood changes that gradually switch from extreme highs to extreme lows, with each extreme lasting several weeks at a time. When depressed or experiencing the low extreme, the typical symptoms of major depression will be present. The high extremes are known as mania or manic episodes.
- Dysthymic disorder, also known as dysthymia or mild chronic depression – characterized by chronic low-grade depression that lasts two years or longer. The symptoms are milder than major depression but are ongoing
- Seasonal Affective Disorder, also known as SAD – brought on by gloomy weather or limited sunlight, typically experienced at its worst in the fall or winter months – commonly treated with light therapy
More than six million men in the U.S. alone have at least one major depressive episode each year. Since depression is often associated with weakness and is largely seen as being a female condition, men tend to deny what they are feeling. Some men find depression a threat to their masculinity. Some fear the impact that a diagnosis might have on their career. These apprehensions make many men reluctant to seek treatment. Instead of admitting to the feelings and emotions they are having some men may seek relief through aggression, violence, substance abuse, or reckless behavior.
The Center for Disease Control reports that men are four times more likely to commit suicide than women. Men often hide the warning signs, tend to act on suicidal thoughts more quickly than women do, and use more lethal methods than women do to carry it out.
There is a wide discrepancy in numbers, but it is estimated that depression occurs between fifty and seventy percent more frequently in women than it does in men. One out of every seven or eight women will experience a major depression in their lifetime. Hormonal changes may contribute to the depression as do stressful lifestyle situations.
Children are not immune to depressive disorders. Boys and girls are equally prone to developing it. Some say one out of every thirty-three children meet the clinical criteria. If indications of depressive illness present in your child, have an evaluation with a pediatric mental health right away.
Teens are at a higher risk for having major depression than children are. Some say that one in eight teens meet the criteria. Occasional unhappiness is nothing to be alarmed about. If the sadness lasts for more than two weeks and major depression symptoms are present, do not ignore it.
Sadness is not always the predominant symptom in teens; irritability is. The teen may be hostile, grumpy, short tempered, and/or may complain about aches and pains that can’t otherwise be explained.
Between one and five percent of senior adults in America suffer from severe depression. It can sometimes be a side effect of medications. High risk groups include those who do not have strong support systems, and those who are restricted to living in senior facilities or dependent on home health care.
Some new mothers, about ten to fifteen percent, suffer hormone related post-partum depression, also known as the “baby blues”. It usually develops within a few weeks , but could develop anytime within six months of giving birth. Left untreated, postpartum depression can be very serious.
Depression is a disease just as diabetes or arthritis is. It just happens to be a disease of the mind instead of the body. It is not a sign of weakness or inadequacy.
Many factors contribute to the development of depressive illnesses. Biological, environmental, genetic, and psychological factors all contribute to it.
Major depression can effectively be treated by any of the following or a combination of them;
- anti-depressent medications or SSRI’s
- lifestyle changes
- stress management and/or relaxation techniques
- electroconvulsive therapy – only used in severe or treatment resistant cases
Anyone experiencing symptoms of depression should seek care from a health care provider. The health care provider will evaluate the symptoms and provide treatment, or refer him or her to a mental health professional.
Randi Fine is the author of the groundbreaking book Close Encounters of the Worst Kind: The Narcissistic Abuse Survivor’s Guide to Healing, the most comprehensive, most well researched, and most up-to-date book on this subject. In addition to helping survivors recognize their abuse and heal from it, this book teaches mental health professionals how to recognize and properly treat the associated abuse syndrome. She is also the author of Cliffedge Road: A Memoir, the first and only book to characterize the life-long progression of complications caused by narcissistic child abuse