Depressed or Just Sad?

Depression can leave someone feeling hopeless, lethargic, and unmotivated. It can last for a brief period of time, or what seems to be forever. Grief can leave people feeling similarly, so what is the difference?

Around 1 in 10 American adults experience depression and it is one of the most common disabilities in the US. The majority of people first experience depression in their teen years or early twenties and it more commonly affects women. With this said, women are more likely to seek help, whereas men are less likely to seek help.

The Differences Between Sadness and Depression

  • In grief, there are mostly feelings of emptiness and loss. In depression, there is persistent depressed mood and inability to anticipate happiness or pleasure
  • Feelings associated with grief are likely to decrease in intensity over days to weeks, and occurs in waves. These waves tend to be associated with thoughts or reminders of the deceased. The depressed mood in depression is more persistent and not tied to specific thoughts or preoccupations. Usually thoughts in depression are associated with self-criticism or pessimism
  • The pain of grief may be accompanied by positive emotions and humor that are uncharacteristic of the chronic unhappiness and misery characteristic of depression
  • In grief, self-esteem is generally preserved. In depression, feelings of worthlessness and self-loathing are common
  • If self-loathing is present while grieving, it typically involves perceived failings about the deceased (not visiting frequently enough; not telling the deceased how much he/she was really loved)
  • If those experiencing grief think about death and dying, such thoughts are generally focused on “joining” the deceased. In depression, such thoughts are focused on ending one’s own life because of feeling worthless, undeserving of life, or unable to cope with the pain of depression. It is important to note that the possibility of suicidal behavior exists at all times during a major depressive episode. All suicidal statements and threats must be taken seriously, regardless of whether you think it is a grief reaction or not.

The Symptoms of Depression

  • Depressed mood most of the day, nearly every day (sad, hopeless, empty)
  • Diminished interest or pleasure in all, or almost all activities most of the day, nearly every day
  • Significant weight loss when not dieting, or weight gain, or decrease in appetite nearly every day
  • Insomnia or hypersomnia (sleeping excessively) nearly every day
  • Feelings of restlessness or feeling slowed down
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive inappropriate guilt nearly every day
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day
  • Recurrent thoughts of death or suicidal thoughts

An individual who is struggling with depression will struggle to cope with the daily stresses of life. The basic activities of life, getting up, bathing, dressing, leaving the house feel like insurmountable tasks. In addition to the emotional aspects, it is common to experience physical ailments such as headaches or body pain. In some cases, the person may feel emotionally numb.

Therapy and Depression

Depression is one of the most common reasons for which people seek therapy. Unfortunately, there is still a stigma surrounding mental health problems, and in many cases people are afraid to seek treatment. The most effective way to manage grief or depression is by finding a therapist and potentially a psychiatrist for a medication evaluation.

Untreated depression may lead to substance use and coping in other ways that are maladaptive. It is common for people with depression to self-medicate with alcohol and drugs in an attempt to manage their symptoms and provide boosts to their mood, no matter how temporary. Unfortunately, this amplifies symptoms making the symptoms potentially more intense and last longer over time.

Managing a relationship while depressed is a complicated task, and just as complicated is dealing with a spouse who has depression; especially if they are self-medicating. Everyone is different, of course, you may find your depressed spouse is highly dependent and very needy, or the polar opposite may be true. It makes sexual intimacy a challenge and interferes with clear communication.

If you or someone you know is suffering from depression or grief, it is essential to help get them to a practitioners office. Help in the form of talk therapy and/or medication has shown to be very effective forms of treatment. If you or someone you know is experiencing suicidal thoughts, or are in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-8255; text the Crisis Text Line at 741741; or call 911. Dr. Forshee is experienced in treating individuals and couples who have suffered from both depression and suicidal thoughts.