Depression remains narrowly understood yet almost half of the population suffers from it at one point in their life. It is treated twice as much in women than men and quite often gets confused with sadness.
There are by all means similarities between those who are sad and those who are depressed. In both you cry, withdraw from the world, feel helpless, hopeless and complain with little if any relief having an overall sense of alienation from normal life.
Mourning is a healthy and normal process that is necessary for the recovery of a loss and can be seen as the opposite of depression. In depression, also called melancholia, there is very little self-esteem and what feels lost or has been damaged is a part of the self.
The main difference between the two is that the sad person knows why and what they’re sad about whereas for the depressed it is impalpable and remains unconscious. This impalpability leads the depressed person to unreasonable charges of faking, disguising, malingering or exaggerating. Other symptoms are a loss of appetite, sleep disturbance, libido loss, boredom, feelings of insufficiency, psychotic symptoms like delusions and in severe cases suicide.
In Mourning and Melancholia (1917), Freud was the first to compare and contrast the two and writes that it is difficult to see that in melancholia the patient cannot consciously grasp what he has lost : “ Indeed this might also be the case when the loss that is the cause of melancholia is known to the subject, when he knows who it is, but not what it is about that person that he has lost. So the obvious thing is for us somehow to relate melancholia to the loss of an object that is withdrawn from consciousness, unlike mourning, in which no aspect of the loss is unconscious”.
Many seek pills as rapid solutions with anti-depressants all though Psychotherapy can be slower and arduous but a more effective solution on the long run.
Because Psychotherapy suggests that the depressed person isn’t depressed for no reason. There is a very deep sadness that has forgotten it’s true causes. Many times it is anger unable to be directed and then turned against the self. In other words, one becomes self-hating instead of taking the risk of directing that hate to someone else.
What could these causes be?
Perhaps the death of a relative, the loss of an occupation or realizing one married the wrong person. Having a chronic or fatal illness, aging, going through surgical operations, experiencing war, traumas, emigration, finishing school or university studies or the birth of a child ( post-partum depression). Anger towards a parent for their lack of care in childhood, moving, a divorce to list a few but not always as concrete and visible. Often it is something deeper and more complex that triggers the symptoms.
Depression is nothing to be ashamed about and those who suffer need above all a chance to be listened, supported and eventually reach insight. In some cases, when a conversation is hardly possible or the person has become physically impaired, medication can be of temporary benefit to lift the person’s mood and be able to speak as well as being allowed to understand and know one’s pain and anger and eventually be able to mourn one’s losses.