What is depression?
It’s not cut and dry.
Sure. There’s a textbook answer. But what about a real-life one?
The textbook answer to “what is depression?” is great for diagnosing but not as helpful for day-to-day descriptions. But why?
Depression looks different on everyone
Sure, there are commonalities in depressive episodes. If there weren’t they couldn’t be diagnosed. But ultimately, they look different for different people.
There is a pervasive idea out in the world that depression looks like someone who can’t get out of bed, can’t brush their teeth, can’t shower, can’t make themselves food. That person absolutely exists. I’ve been that person, and I know them well. But that’s not the only face of depression. Not by a long shot.
Some depressed people go to work every day. They get praised for what a good job they’re doing, go out with friends and laugh with them. They are seen as ‘happy’ and ‘chipper’. But it takes their everything to keep up that façade. When they get home, they collapse, and it all falls apart. I’ve been that person too. I also know them well.
And there are people in all points between and beyond. There is no one profile of a depressed person.
Everyone’s had these symptoms
Another tricky thing is depression includes symptoms everyone experiences at some point. So, it can become easy to dismiss it as something that “happens to everyone”. The difference is how long they persist as a cluster of symptoms. It’s an important nuance.
Some things to remember:
- Depression is a cluster of symptoms, but it doesn’t mean all symptoms. (DSM-5 indicates depression when there are 5 or more symptoms for at least 2 weeks)
- At least two weeks is an important piece — we all have shitty weeks where these things can cluster together. Depression is when our brains and bodies can’t pull us out of those.
- Depression is usually very treatable. But the earlier you catch it, the better.
- There are lots of treatment paths for depression depending on type and severity. Meds are great for moderate and severe depression. Mild depression may respond just as well, or even better, to other interventions.
What are these symptoms?
Remember — These are things that would persist over two weeks AND a cluster of 5 or more at a time. All of these are things that we all experience at some point in our life.
Symptoms: (pulled from WebMD)
- Your mood is depressed for most of the day, especially in the morning.
- You feel tired or have a lack of energy almost every day.
- You feel worthless or guilty almost every day.
- You feel hopeless or pessimistic.
- You have a hard time focusing, remembering details, and making decisions.
- You can’t sleep, or you sleep too much, almost every day.
- You have almost no interest or pleasure in many activities nearly every day.
- You think often about death or suicide (not just a fear of death).
- You feel restless or slowed down.
- You’ve lost or gained weight.
- Feel cranky and restless
- Lose pleasure in life
- Overeat or stop feeling hungry
- Have aches, pains, headaches, cramps, or digestive problems that don’t go away or get better with treatment
- Have sad, anxious, or “empty” feelings
The challenge, of course, is none of this really gives you a picture of what depression looks like. It’s all very generic and textbook. That goes back to the part where it looks different for everyone.
But what does it look like in real people?
For a picture of what depression looks like, you need to find people talking about their own experiences with it.
Many years ago, when I was in the midst of an intense depressive episode, I did a lot of public writing about it. I had a friend who said to me until then, she really didn’t understand depression. She told me about a lightbulb moment for her. It was a piece about me standing paralyzed in the shampoo aisle, trying not to burst into tears because I couldn’t decide which to buy.
It’s always stuck with me. Of all the things I’d written about, what about shampoo decision paralysis gave her the way in? Why did that resonate with her? But also, it hadn’t occurred to me there was any kind of power in my story until then.
I’ve been passionate about talking about depression for a long time now. Depression has always been a part of my life. Raising awareness and helping people access treatment are essential to me. Because stories have power, I have a vague plan to keep writing about depression here, but I make no promises. Even though I haven’t had a depressive episode in six or seven years, I have to be vigilant because of my type of depression. It will always be a part of my life. Part of that is tempering my commitments — to others and myself.
It’s another example of how depression profiles are different for everyone. Most people have one depressive episode, and it gets treated. They learn tools to manage things and are good to go. They are done with depression and have an excellent toolbox to draw on going forward. But for some of us, it’s a more complex illness.
But here’s the thing — there are loads of people out there telling their stories. And each of those stories has power.
If you want to learn about what depression looks like, it is worth seeking them out. People are writing comics, Medium articles, tweeting, on IG, FB and TikTok. They are everywhere. People who can tell you about their journey if you are willing to listen. I highly recommend seeking them out.
Standard PostScript for my posts on depression
Mental health resources vary depending on community and country. If you landed here hoping to learn how to get a diagnosis, or to access antidepressants, I’m sorry I wasn’t able to help.
Your best bet is to head to a medical professional. Nothing I suggest should ever take the place of medical advice.
In North America, the two major diagnostic tools for depression are ‘inventories’. Folks self-report what is happening with them on these questionnaires and being honest is vital. These days you can find these online if you want a headstart before talking to a doctor.
They are the Beck Depression Inventory-II (BDI-II) (you need to score by hand), and the PHQ9 (self-scoring). Self-scoring versions of the BDI-II are few and far between. But I found this self-scoring one based on the Beck Inventory if scoring separately feels too overwhelming.
