Am I depressed or just deep? This Emotional Life - PBS

Yes. I admit it. I am a recovering angry youth. The symptoms of this disorder include wearing a disproportionate amount of black, having an inner adolescent who still wants to sometimes flip the bird at people who tell me what to do and feeling like I can’t live without music. “Paula, why do you wear so much black” my older brother asked when I was 17. “It is not what I wear, it is who I am,” I answered dramatically.

I recently saw a patient, a young college student, struggling with her classes. Within the first few minutes she had called herself “lazy” and a “loser”. As she kept talking she described a classic depressive episode, which seemed to hardly be the first in her life. She’s isolating from friends, not picking up her cell phone, struggling with making decisions, can’t seem to eat or sleep. She denies feeling like killing herself but admitted frequent thoughts of “it would be a lot easier to just not wake up one morning.”  When I reflected to her that she sounded depressed she said “I don’t think so, that is just my personality.” So many people confuse depression with just being a lazy, unmotivated person.

You know the story of the frog? Supposedly, if you put a frog in boiling water it will jump out. However, if you put it in cold water and slowly bring up the temperature it will allow itself to be boiled to death. This happens with depression: you get so accustomed to living this way that it becomes normal: miserable, but normal. You may even think it is who you are.

Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear “I am not depressed, I am just realistic”, “Anyone who isn’t depressed isn’t paying attention”, or “Life has no meaning and I am going to die, how can I be happy?” I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.

There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.

We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.

Depression can range from mild to severe. People sometimes minimize how they are feeling by saying, “anyone would feel this way in this situation” or “it isn’t like I want to kill myself”. You don’t have to be suicidal to be depressed but is a symptom of depression. Thinking a lot about death or wanting or even planning how you might die is serious and needs immediate attention. Call a friend, a crisis center, your doctor, call 911 or even show up at an ER.

So, as I sit here at the coffee house in my black turtleneck and chunky black boots listening to Ani Difranco, Indigo Girls and The Cure on my ipod I am acutely aware that yes, one day I will die. Ultimately, no matter how close I am to any other person, in some ways I am alone. However, I realize that life is not meaningless: I love my husband, children, family and friends; through my work I get to help people help themselves and yes, most importantly, I blog. What could possibly be more meaningful than that?