You may have heard that from a friend or co-worker. You may have even said it yourself, after having a rough day or feeling down about something. But clinical depression is more than a bad mood or disappointment about how things are going in your life. While it is considered a very common mood disorder (affecting 121 million people worldwide, according to the World Health Organization), a diagnosis of depression includes very specific criteria.
Those suffering from “major depression” experience depressed mood for most of the day, every day, for at least two weeks. The affected report poor concentration and a lack of interest in activities they once enjoyed. They may have feelings of guilt, worthlessness, hopelessness, and helplessness. They often experience disturbed sleep and changes in appetite. Those experiencing less severe forms of these symptoms over a longer period of time may be diagnosed with dysthymia. Also a mood disorder, dysthymia is a chronic condition occurring more days than not over the course of at least two years.
Many of my clients have asked the questions “Where did my depression come from?” or “Why me?” The short answer is that anyone can suffer from depression at any time. Genetics, a history of abuse or loss, serious illnesses — all may be at the root of depression, but for many it is simply a reaction to difficult circumstances. I’ve found that many of my clients appreciate the old psychodynamic tenet that depression is “anger turned inward.” When we have unresolved feelings about a situation or experience, and no place to release those feelings, they stay with us. Our resentment toward outside factors turns against us, and over time, this can impact our brain chemistry.
The good news is that depression treatment works. Medications and counseling work well together, and clients who take charge of their options have positive results. But the WHO notes that only 25 percent of those affected by depression actually receive treatment due to lack of resources and social stigma. Luckily, there is growing understanding about depression’s biological nature, and many groups — including the U.S. Department of Defense — are taking steps to combat the embarrassment that many people have felt when asking for help. Meanwhile, there are low-cost options available. Group therapy may be less expensive than individual work, and nonprofit groups (like PC&CC and the Imago Center) may offer services on a sliding scale or pro bono basis.