Everyone experiences episodes of unhappiness, grief, and stress and has felt saddened or taken to an extreme low which we sometimes call the “blues.” The loss of a job, divorce, broken relationships, and financial distress, are some examples of situations, which can triggerthose feelings. This is when most people use the term “depression” to describe the functioning of the normal emotional health of an individual.
It is common to feel down during or after a crisis but then we bounce back as we begin to feel like ourselves again.
When we talk about clinical depression, or a person “living with depression,” it refers to a diagnosed infirmity of the mind, body, mood, and thoughts, an illness that can challenge your ability to perform even routine daily activities, affecting your behaviour at home, at work, at school or socially. The term “chemical imbalance” is a familiar indication, which intimates biological changes, linked to the functioning of the brain. But research suggests that we do not know exactly why depressive crises occur.
The University Health Services of UC Berkeley says about the onset that, “The causes of depression are quite complex. Very often it is a combination of genetic, psychological, and environmental factors.” (uhs.berkeley.edu) Living with depression over time has taught me to identify certain stressors, which precipitate a crisis.
Even with daily medication, there are still episodes of “overwhelm” which may come with increased pressure in any aspect of my life—relationships, finances or even changes in environmental circumstances. Anyone can have symptoms of physical, emotional and behavioural /attitudinal alteration, but it’s a combination of factors, which makes for particular diagnoses and which should prompt intervention by professional counsellors or a psychiatrist.
While personal investigation may point to a particular condition, seeking a medical opinion—and a second one, if necessary—is always recommended. Beware too, of self-diagnosing and “neighbourly” dispensing, features of our culture made easier with access to a wealth of Internet resources.
The symptoms
There is a line in one of my poems which says, “I cried because I did not know why I cried” that aptly describes an emotional aspect of clinical depression.
One or more of the following accompanies that hapless crying “for no reason”:
• Persistent sadness that can last for days up to two weeks
• Feeling helpless and, or hopeless
• Being irritable, uptight and aggressive
• Thoughts of insignificance or guilty feelings
• Thoughts of death or suicide
In crisis, I have found that it is difficult to concentrate and also not a good time for decision-making.
In fact, vacillation is characteristic in the behaviour of the depressed.
It took a while, also, to associate neglecting my responsibilities with depression, but that is a telling trait.
I’ve found for example, that I now have to coax myself to do dishes, an out-of-character conduct. If you find that you have no regard for your commitments or appearance, along with a growing lack of interest in people, sex, sports, and activities to which you were given, it is definitely a tell-tale sign.
Among the physical symptoms of depression for me are severe recurring headaches. According to www.emedicinehealth.com, the following are significant physical changes in the depressed:
• Significant increase or decrease in appetite
• Significant weight loss or weight gain
• Change in sleep pattern: inability to sleep or excessive sleeping
• Fatigue or loss of energy
Depression is treatable
Depression is not selective. Males and females of all ages, ethnicity, or culture, religion or persuasion can be afflicted with the illness, though there is scholarship to support varying experiences in men and women. “Men and women sometimes show depression differently. Specifically, men are more likely to experience irritability, sleep problems, fatigue, and loss of interest in activities they liked previously whereas women tend to have overt sadness and feelings of worthlessness and guilt when depressed (emedicinehealth.com).”
Regardless of the cause, depression is almost always treatable—and yet, as common as it is, medical professionals agree that it is frequently unrecognised by the person affected, and untreated. Throughout the years I have found it difficult to get people to accept that this is a serious medical infirmity with severe physical, psychological, and emotional effects. People living with depression do not just “get over themselves” or “come out of it” or “pull themselves together”—it is a situation beyond feeling sad and then being cheered up. Often though, it is those closest to you who see the changes and for that reason and more, depression is a burdensome illness not just to the individual but also to their families or peers. Sometimes that burden can seem overwhelming.
This is an edited version of a published 2012 column titled Living with clinical depression.
Caroline C Ravello is a strategic communications and media professional and a public health practitioner. She holds an MA with Merit in Mass Communications (University of Leicester) and is a Master of Public Health With Distinction (The UWI).
