What is a major depression?
Since it is so common, depression has long been known as the common cold of mental health conditions. If only depressive disorder were as short-lived and conveniently managed as a cold. At its worst, it is a lot more like a serious bout of the flu than a cold: You will not want to eat, you lose weight, you simply cannot sleep, you are feeling tired, and you also could not keep your mind on anything besides how lousy you feel. In severe depression, you may feel numb as opposed to miserable. You can work only with great effort, or you may not be able to work at all. You do not care about the people you used to love and the things you used to love to do.
In contrast to the flu, however, which in most healthy people lasts only a couple of weeks, depressive disorders can last months and quite often years.
And frequently, unlike the flu, it might not disappear completely if not treated. Untreated depression raises the likelihood that the sufferer will have another depressive episode. If you have had one bout of depression, you have a 50 percent likelihood of having another. After two bouts, you have a 70 percent likelihood of having another. After three, there is a 90 percent chance you will have a fourth episode of depression. Finally, people suffering from major depression are at serious risk of committing suicide.
What is the difference between major depression and normal sadness or grief?
The loss of a job, the failure to attain an important goal, the end of a relationship, or the death of a loved one can all lead to intensely painful yet normal feelings of sadness and grief. The early symptoms of intense grief often resemble some of the symptoms of depressive illness. It is not uncommon for someone who has just lost an important relationship to feel sad or empty, cry easily, have
trouble sleeping, and lose his appetite.
Depressive illness can and frequently does develop, however, from what began as a normal grief reaction. A clue that depressive illness may have taken over is the persistence or worsening of symptoms. Another clue is a growing impairment in a person’s ability to function.
In addition, the appearance of other symptoms suggests that grief may have developed into depressive illness. Depressive illness will lead to a decrease in self-esteem. A depressed person will become pervasively self-critical. Instead of having difficulty falling asleep, the person with depressive illness will have trouble staying asleep. She may begin to wake up early in the morning and be unable to get back to sleep. She will start to have problems thinking clearly, remembering, and concentrating.
Sadness and grief respond to the concern and caring of friends and the passage of time. But in depressive illness, the concern shown by family and friends may not help at all. Family members usually find themselves at a loss as to how to help someone with depressive illness. After a while, in fact, family and friends will begin to feel frustrated and irritated. No matter what they say or do, the person with depressive illness stays stuck in a gloomy, pessimistic mood.
Sadness and grief clear up in a reasonable period of time, and then a person gets back to normal. Some forms of depression do improve temporarily if things go well, but this is usually short-lived. And although depressive illness can improve over time by itself, it usually takes longer to do so than does normal sadness or grief.
In summary, if a depressed mood is hanging on for months, is disrupting your functioning, and is associated with the symptoms mentioned here and in chapter 3, you should seek a professional consultation.