Happy Days Are Here Again! (But Not for Me, I’m Depressed) by Terri Marini, RNBC, CARN
I’m feeling depressed, blue, sad, disinterested, but I don’t know why. There are many reasons a person may feel depressed-personal problems, illness, conflict, abuse, grief or loss, substance abuse, to name a few. Other times it’s a feeling or state of mind that you can’t attribute to anything. You rack your brain trying to find the reason, so you can make peace with it, but you can’t identify the cause. Honestly, I’m more comfortable with my depression when I know why I’m depressed. At least when I know why or think I know the cause, I can experience and embrace my depression with a sense of entitlement. I can say “of course I’m depressed, my dog just died,” or “you’d be depressed too if you lost your job,” but what do you say when there doesn’t seem to be anything identifiably wrong? Not just to others, but even to yourself. Your mind runs an inventory of possible reasons-maybe it’s money, no I just got a bonus; maybe it’s my marriage, no we just went on a luxury vacation and things are great; maybe it’s something medical, but no I just had a complete physical and received the “awful” news that I was in great shape.
Feeling depressed is descriptive of our mood. There is a wide spectrum in feeling and describing moods. Our mood can be euthymic, which is a normal mood; euphoric, which is an intensely excited or happy mood; dysphoric, which is a feeling of dissatisfaction, anxiety, restlessness; melancholic, which is feeling no pleasure in almost everything, and on and on and on. However, changes in our mood or mood disturbances don’t always qualify as a diagnosable mood disorder or depression.
For example, in order to meet the criteria for Major Depressive Disorder five or more of the following symptoms must be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly attributable to another medical condition.
- 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 decrease or increase in appetite nearly every day
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- 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
The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The episode is not attributable to the physiological effects of a substance or to another medical condition.
This criteria is set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This manual has the criteria for every mental disorder, including every mood disorder-Disruptive Mood Dysregulation Disorder, Bipolar Disorder, Cyclothymic Disorder, Persistent Depressive Disorder, Premenstrual Dysphoric Disorder, Major Depressive Disorder, and then further classified mild, severe, with psychotic features, without atypical features, in partial remission, early onset, late onset, intermittent, substance induced, mood-congruent, mood-incongruent. This manual includes diagnostic features, associated features, comorbidities, risks and prognostic factors, prevalence, gender-related issues, culture-related issues, and a whole lot more. These writers thought of every possible scenario. It is like the Bible or Torah or Koran to psychiatrists!
This is heavy stuff, and right now it doesn’t really apply to me. I’m talking more about less intense depression. Symptoms that do not meet criteria for a diagnosable mental disorder. My symptoms are not interfering with my ability to function. The feeling is more of an annoyance, or a nagging itch. It is not at the level of needing medication. It more so could be “treated” with pound cake. I don’t mean a slice of pound cake, I mean “a-pound-of-cake,” it could be chocolate or angel food, I don’t really have a preference. It is the kind of mood where you don’t want to be around anyone because they are all smiling and laughing, as if they all know something that you don’t. It’s the kind of mood where you don’t want to put makeup on and you’d rather wear a Halloween mask to maintain anonymity.
Don’t despair. You can learn to foster happiness. There are simple things you can do that may help improve your mood.
- Think about activities that are most meaningful and pleasurable to you
- Think about how much time you spend doing these activities, and make an effort to increase your time
- Express gratitude and practice gratitude for yourself, focus on the amazing things you do and have to offer, keep a journal
- Learn to root for yourself-we speak to ourselves using harsh words, words we would not direct towards others, be kind and gentle to yourself, celebrate the better moments of the day
- Exercise, it is thought that for many people 30 minutes of exercise a day can be as effective as antidepressants
- Never let a crisis go to waste, learn from it, remembering difficult times can sometimes make you more appreciative of your life when things are going well
- Surround yourself with people who really care about you and your well-being
- Slow down, meditate, research shows that meditation can actually change the way your brain works and makes you more susceptible to positive emotions
- Embrace your uniqueness, be your authentic self, you are one-of-a-kind, there will never be someone just like you
Be vigilant in regards to your emotions. Don’t isolate. If you find facing the day is becoming difficult, and you can’t get yourself out of a funk, or you can identify with the criteria of a Major Depressive Disorder, seek help. Whether you have money, no money, insurance, no insurance there is always help available. Every county in New Jersey has a crisis center that is available 24 hours a day. Other states have equivalent services. Additionally there are a wide range of options: private treatment, community based not-for-profit treatment, faith-based treatment, clinical trials, and many other treatment alternatives. Don’t continue to suffer, and don’t keep your suffering to yourself. Reach out. Someone will be there.