Myth Vs Truth #1
Depression; What It Is & What It Isn’t
Demystifying the urban myths
This is the first of a series of pieces on mental health. In each respective piece, I will discuss and explore a different mental health issue, disorder. The hope is to promote awareness of mental health. And demystify some of the urban myths.
What is Depression?
Depression is classified as a serious and very common mood disorder. Those affected by depression will feel persistent feelings of incredible sadness and hopelessness. Such individuals will also lose interest in activities they once enjoyed engaging in.
Depression can also affect our physical health. Those affected by depression can also experience chronic pain or digestive issues.
The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) outlines the following criteria.
An affected individual must experience five or more symptoms. This must be during a two week period. One of the symptoms must be either depressed mood or a loss of interest or pleasure.
Depressed mood most of the day, nearly every day.
Markedly 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 a decrease or increase in appetite nearly every day.
A slowing down of thought and a reduction of physical movement. This must be observable by others. Not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation. Without a specific plan, or a suicide attempt or a specific plan for committing suicide.
These symptoms must cause clinically significant distress or impairment to meet a diagnosis. Substance abuse or another medical condition must not be the cause of the symptoms.
(Source: The Diagnostic and Statistical Manual of Mental Disorders; Fifth Edition (DSM–5))
Depression may be diagnosed as mild, moderate or severe. An individual may also move across these parameters within the same episode of depression.
What Depression Is Not
Depression is not something those affected by it have control over. Depression is more than just a feeling of sadness.
Depression is not identified by attempting to quantify the level of low mood. Instead, it is a combination of the above factors and the duration of these negative symptoms. And also the severity of the impact of these symptoms, on an individuals ability to engage in activities of daily living.
Sadness is a human emotion. This emotion can be triggered by the death of a loved one, the end of a relationship or the loss of a job. But, depression requires no such trigger.
There is a clear distinction between sadness and depression. But, a major depressive episode can be caused by a significant loss or bereavement. This is sometimes referred to as reactive depression.
There is no robust evidence to suggest a correlation between depression and a lack of wealth, or non-attainment of success. In whatever way you define success.
Tragic examples of this are the relatively recent suicides of Chris Cornell and Chester Bennington of Linkin Park. Both by hanging. Keith Flint’s (founding member of The Prodigy) death was pronounced inconclusive by a coroner. Yet, he was also found dead as a result of hanging.
Different Types of Depression
There are several different types of depression. Some are connected and may be a trigger for another.
Dysthymia: This is a continuous mild depression that lasts for two years or more. It is also referred to as persistent depressive disorder or chronic depression.
Postnatal depression (PND): This type of depression can occur in the weeks or months after becoming a parent. Statistically postnatal depression is usually diagnosed in women. But it can also affect men.
Prenatal depression: This depression can present during pregnancy. Also referred to as antenatal depression.
Seasonal Affective Disorder (SAD): This depression occurs at a particular time of year.
A wealth of statistics inform us of the prevalence of depression.
Depression is the most predominant mental health problem worldwide (Mental Health Foundation).
Depression will be the second-leading cause of world disability by 2020 (The World Health Organisation).
Depression affects 1 in 10 people (The NHS Information Centre for Health and Social Care).
In 2013 depression was the primary driver of disability in 26 countries (Mental Health Foundation).
I live with depression. The terminology I use when discussing my own lived experience is important to me. It helps define my relationship with depression.
It is a relationship I cannot get out of. I live with depression, not out of choice.
Living with depression involves managing it. Depending on the severity of my depression at any given time I may be managing it well. Or I may be struggling to manage it.
Whether I am managing my depression well or not depends on the metaphorical dark cloud. The dark cloud that follows me around.
That is how I describe the lived experience of depression. It is like being followed by a dark cloud, constantly. When I am managing my depression well the dark cloud is still around. But it is a safe distance from me.
The Dark Clouds May Not Return
I remember a time, not too long ago when all I could see above were dark clouds.
When I am struggling to manage my depression this dark cloud looms over me with such dark intensity.
I have little to no control of when this cloud moves nearer to or further away from me.
The treatment for depression is as unique to the individual, as the illness is to the individual.
A combination of the following is well known to help treat depression to good effect.
Alternative treatments: such as art therapies; mindfulness; peer support
Electric Convulsive Treatment (ECT): Used only in cases of severe depression, catatonia or mania.
Medication: Always consult a qualified practitioner before commencing or stopping any psychotropic medication.
Self-help resources: An online CBT course; physical activity; self-help resources such as books, online resources
Support Groups: A support group can be directly for depression. Or it can be to support the affected individual to manage the stressors that are triggering the depression.
Talking therapies: such as cognitive behavioural therapy (CBT); family therapy; couples therapy; psychodynamic psychotherapy
Please note any and all advice is given in good faith as experience-based opinion or comment only. I am an experienced psychiatric nurse with a lived experience of mental health.