Depression: A Simple Word With a Wealth of Complexities!
Yes! “A simple world with a wealth of complexities!” This statement was made by a good friend who has been through the mill of these complexities, having to fight for herself through family treachery, homelessness and finally ending up taking residence in a trailer park.
Taking the DSM (Diagnostic and Statistical Manual of Mental Disorders) list of the Symptoms of Depression, and giving examples of these, we can start to understand the complexities of this unfortunate condition called Depression.
- Depressed mood for most of the day, nearly every day – Can you imagine being down all day, nearly every day? In a state like this it is hard to hold down a job because it is hard to focus, concentrate and give out the productivity expected by employers. Some manage being productive but many suffer in silence and lose their jobs. They also find it hard to do most other things.
- Markedly diminished interest or pleasure in all or most activities – You don’t enjoy the things you liked doing any more, being it reading, listening to music, watching TV, playing video games, cooking, gardening, and anything else. To a great extent it’s like there is nothing to live for any more. A lot of support from loved ones is about the only thing that can sustain someone who is going through this.
- Significant weight loss or weight gain – This is very common: Some give in to “comfort eating” because eating makes them feel better for a while, but in the long run, the weight starts to pile on, and once it’s there it’s hard to get it off! This lowers the self esteem, which can lead to more depression and places the individual at higher risk for diabetes and heart disease. The opposite can also happen with some individuals, they are so down they can’t bother to prepare food or to eat, so they lose weight, leading to lowered immunity and increased susceptibility to infection.
- Insomnia or hypersomnia nearly every day – Insomnia can be classified in three major categories: Trouble getting to sleep, trouble staying asleep or waking too early. And it’s not a case where the individuals can “utilize” the awake time. They can’t because they are tired and in a depressed mood. The opposite to insomnia is hypersomnia – and that means sleeping too much, usually to escape the depression. It is not a case where the extra sleep makes the individual feel better. The opposite is true, it can make the individual feel worse and remorseful for having “wasted the time.”
- Psychomotor agitation or retardation, noticeable by others, not subjective – The individual is visibly agitated i.e. pacing, rocking back and forth or making sudden sharp movements. Anyone who has been around an agitated person can tell you how uncomfortable they can feel. The opposite to agitation is retardation, where the individual’s movements can be slow, speech is slow or even silent. Unfortunately it may appear to others that the individual is antisocial, and this is not always the case.
- Fatigue or loss of energy nearly every day. – This is awful. There are no symptoms of any physical illness but the patient feels tired, worn down and it can take a major effort to do something as easy as brushing one’s teeth, having a shower or getting dressed. Patients in this condition find it hard to maintain a job because they need frequent rests during the work day. Then some patients just cannot seem to get moving at all, as is the case in severe melancholic depression, where patients actually have to get helped to maintain basic hygiene.
- Feelings of unworthiness or excessive or inappropriate guilt – I have a fully functioning friend who says he always feels guilty, and can’t really explain why. But depression patients can have very low self-esteem and feel as if they are good for nothing. How often have you heard the expression “I can’t seem to do anything right?” These patients feel guilty whenever something goes wrong for someone around them, tending to blame themselves for others’ suffering, and constantly apologizing, saying “I’m sorry.”
- Diminished ability to think or concentrate, or indecisiveness nearly every day – A depressed person has trouble thinking or concentrating. Thoughts are often circular in nature or confused and jumbled, definitely not clear. And focusing or concentrating on a prolonged task or one that requires a lot of thought is extremely difficult. This is a major reason why a depressed person cannot hold down a job.
- Recurrent thoughts of death, suicidal ideation – This is the most dangerous of all the symptoms because it can turn depression into fatal illness. It is unfortunate how a patient gets locked into a pattern of thinking and feeling that leads to the idea that suicide it the only solution. I was once working in a psychiatric ward when a patient was brought in after being saved from jumping over a cliff. The following day, after having been sedated he asked me “do you think a man should have the right to take his own life?” I replied “No! Because you never know the slightest thing that someone could have said, or someone whom you may have met that would have made you change your outlook on life completely! “
In an interview with a Psychiatrist discussing depression he said “do you know there are many types of depression? There is even a laughing depression, cases when patients are depressed and laughing all the time!” Therefore as my good friend said: “Depression is a simple world with a wealth of complexities!”
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P.S. to learn more about depression click here.