Amanda Swisher, LPC-IT
A Look At Clinical Depression
There is one good thing that has happened as a result of the Covid-19 pandemic: there has been an increased amount of attention to the importance of mental health. It is becoming more socially acceptable to seek help, and less acceptable to “grin and bare it.” Particularly, a lot of attention has been given to clinical depression and how it has been evolving over the years. While common, it is a very serious mental health condition, characterized by depressed mood, loss of interest in daily activities, and difficulty in completing tasks of daily living.
Effects On Friends, Family, and Coworkers
While depression of course has a tremendous effect on the individual who has been afflicted, what does it mean for those around them who care for them? Depression can look like a lot of different things, especially depending on age. In children and teens, depression can look like:
- Anxiety
- Feigning illness to avoid school
- Clinginess towards one or both parents
- Getting into trouble at school
- Easily frustrated with everyday tasks.
- Low self esteem
With adults, depending on where they are in the life cycle, depression can also look like:
- Irritability
- Negative view of life and the future
- Decreased libido
- Early morning waking
- Grief
While these are only some of the ways that depression can present itself in individuals, from the side of the friends, family, and coworkers, this can be a bewildering experience. Friends may wonder why their friend is no longer answering their calls, or why they are canceling plans. They may wonder, “Why is my friend avoiding me?” Families may be frustrated by a messy room, inability to complete chores, or them spending the day in bed. Coworkers may be concerned that their previous bubbly officemate no longer leaves their office, or works with the door closed, or is turning down lunch dates.
The hardest part may be that typically an individual suffering from clinical depression could be reluctant to share how they are really feeling, so loved ones are left to infer what their behavior means. It can look like rejection and avoidance. Shame and guilt can be a common emotion to feel as a loved one, as they may wonder what they have done to cause their family member/friend to suddenly dismiss them. Recognizing that they are more than likely dealing with something greater could be the first step in getting their loved one help in dealing with what they are going through.
Diagnosis
To be diagnosed with clinical depression, certain criteria need to be met. One of the symptoms needs to be a depressed mood or a loss of interest or pleasure in almost all activities. Common symptoms include:
- Persistent sadness, anxiety, or “empty” mood.
- Feeling hopeless or pessimistic
- Feeling irritable, frustrated or restless
- Feeling guilty, worthless or helpless
- Loss of interest in hobbies or activities
- Decreased energy and fatigue
- Difficulty concentrating, remembering or making decisions
- Sleep disturbance, including waking up too early or sleeping too much
- Changes in appetite or unexpected weight changes
- Body aches and/or pains, headaches, digestive concerns without a clear physical reason
- Suicidal thoughts or attempts, or a preoccupation with death.
For diagnosis, at least five of these symptoms must be experienced every day or nearly every day consistently for two weeks.
In the current age, depression can be difficult to diagnose, but this is not so in a lot of cases. Some of the difficulty in diagnosing depression can be that depression across the lifespan can present differently with different symptoms that could look like something else. As mentioned earlier, children can present as anxious or angry, which could look like an anxiety diagnosis. Teenagers who are getting in trouble at school could be mistaken for having a type of conduct disorder, or the depression could be missed because it exists with other diagnoses, such as eating disorders, ADHD or substance use. The largest trouble with diagnosing depression is the stigma surrounding not only the topic of depression, but of mental illness itself.
Stigma
Depression can happen to anyone at any time and unfortunately it happens a lot. The reality is that even though it is incredibly common, stigma surrounding depression and mental illness in general is still very much alive. It has survived partially because of the history of how mental illness has been treated and because of the perpetuation of public views.
The history of psychiatry is far reaching and can fill a multitude of books. There are many untold horror stories surrounding how those with mental illness were treated and how those receiving “treatment” were viewed. In looking over the literature, a case could be argued that individuals were trying to justify their treatment of those suffering from mental illness at the time by exaggerating the conditions they were facing, hence why terms such as “psych ward” and “institutions” have been phased out of the approved lexicon.
This history has bred a fear, not only of what will happen were someone to be judged as mentally ill, but of those who were sent to these places where they required such extreme treatment, such as isolation, locked wards, and straight jackets. Current media doesn’t help the situation, with attention to news stories featuring crime suspects suffering from chronic mental illness, and/or horror movies that exploit the stereotype of serious mental illness to mean that those individuals are violent, dangerous, or even evil.
While mental health and wellness has seen an increase in attention due to the Covid-19 Pandemic, with celebrities even coming out and sharing their stories, making it safer for others to feel they can do the same, the stigma is still very much present for millions of people. This stigma leads to feelings of shame and guilt and often to discouragement in seeking treatment. It’s not hard to see how this can lead to further isolation, a key indicator of some mental illnesses, like depression, which thus perpetuates the problem.
If you, or someone you know, is struggling with depression, do not hesitate to reach out. The courage it takes to overcome personal hurdles and societal ones is well worth the effort. Especially if it means finding some relief and hopefully some peace.