What is Depression? Part 2: Simon DuBois, Psychologist

Differentiating between depression and sadness

A good way to think about the experience of sadness and whether that experience has become truly problematic is to consider the extent to which that sadness interferes with the capacity to maintain involvement in fundamentally important things that make up daily life. If you are unable to maintain your participation in work; if you are unable to maintain your involvement in important relationships, whether that be your marriage, family relationships or friendships; if you are unable to eat adequately to maintain your health, or you're eating too much of the wrong foods; if you are failing to maintain standards of dress and grooming; or if your beliefs about yourself and the world are much more negative than normal, then sadness has probably crossed the line into depression.  Feeling sad is an inevitable experience of being human. Feeling debilitated by sadness to the point that we are unable to care for ourselves adequately is when we have a problem.

It should be noted, however, that some life experiences can be truly depressing. Should someone have an experience that is incredibly difficult to cope with, we would expect that person to go through a phase of unhappiness, where they do not function as well as normal, and withdraw from the world to some extent. We wouldn't see this as unusual given the context of the situation. In some ways the depressive experience is designed to make us take a step back from our lives, sit with our distress, and in so doing help us re-emerge with a better understanding of our self, and the capacity to embrace our new life. Significant losses are cause for extended and deep periods of sadness. Again, we should begin to worry if this grief prevents us from making essential efforts towards self-care or accepting help from others.

So getting the blues may not be regarded as depression if it can be understood in the context of a distressing experience, providing the person still has a reasonable capacity to care of themselves, even though they cannot participate in life as fully as they once did. Another important factor is that we emerge from this dark time in our life after a reasonable period of withdrawal. An indicator that we may have become depressed after a distressing event is that we have become stuck in the sadness much longer than is beneficial. Remember that poor frog in the boiling water. There’s a time where we need to jump out. Knowing how long to be sad about something is a difficult experience to judge.

But the story of depression gets more complex still! Feelings of sadness or distress are often triggered by external life events. However, for some of us sadness can become depression because of our neuro-chemical makeup. A distressing event can become truly depressing because of the nature of the neuro-chemical response. For others, there may be no external trigger at all- the descent into depression may be simply caused by a neuro-chemical imbalance. So now we have more questions to ask ourselves. Am I feeling depressed because I am having understandably rotten experiences that my brain can’t quite negotiate?  Or is my life pretty good, but my brain only focuses on the difficult bits and exaggerates them? When we need to ponder this question we are usually in the midst of depression. These questions can be difficult and confronting to address. It is best to seek help and support rather than try to answer them alone.

Neuro-chemistry isn’t the only determining factor when it comes to processing or coping with challenging experiences. The way we tend to “think about our experiences” is another factor to consider. Two people are given a glass of water poured to the same height. One views it as half empty and as a result feels pretty unhappy about it. The other views the glass as half full and experiences happiness at having received it. A simplistic example but it prompts us to think about how our beliefs, values and thoughts impact on our ability to cope with distress. These thinking structures are often hand-me-downs from our family experiences.

So to recap, what is depression?

Depression is an emotional, cognitive and physiological experience that makes it very difficult if not impossible to participate in day-to-day life. We feel disconnected from ourselves and from others, and there is a lack of emotional and physical strength to participate in life and complete important tasks. Our belief in ourselves or the world becomes extremely tarnished. There appears to be little that can be gained from living, as there is nothing positive to be found in ourselves or in the world. At its worst we may believe that death is a better option. This is when sadness has truly crossed the line into depression. It is extremely important to seek help and support from family, friends, and health carers. There are a number of treatment options for depression, and these will be discussed in Part 3.