When Blue Is Not a Color: Dealing with Depression

By: Jennifer Yen Clark, MD
For the past few weeks, I have been juggling so many projects that I feel like I’m drowning in them. It seems like every time I take care of one thing, something else takes its place. There were times when it was an accomplishment just to get myself out of bed and start the day. On those days, the only thing I wanted to do when I got home was get into my pajamas, eat junk food, and watch TV. There was a point where I even started to feel pretty low, wondering if the stress would ever go away and if I could survive another day of feeling overwhelmed. I’m sure that every one of you has gone through something similar, considering how hectic life is nowadays. For some of us (and luckily in my case), these moments will come and go and soon be forgotten, tucked away in the back of our minds like so many others. For others, however, they will blossom into something that turns their life upside down.

What Is Depression?
Depression is a term often used but rarely fully understood. It’s thrown around casually to describe a bad day, a case of the Mondays, or some big life change or event. All of these things can cause what most people call “the blues,” but they might not trigger a depressive episode. To complicate things, having depressive symptoms does not automatically mean you have depression or depressive disorder. Depression is a constellation of symptoms that includes feeling excessively sad or low and changes in sleep, appetite, thinking, or behavior. Some possible causes of depressive symptoms are a sudden or serious medical illness, the loss of a loved one, abuse or neglect, misuse or abuse of drugs or alcohol, and dealing with a separate mental illness. Other triggers for depression include being under a great deal of stress for long periods of time, having a poor emotional support system, or dealing with bullying or discrimination. In addition, if there are other people in the family who have suffered depression or other mental illnesses, that can increase an individual’s risk of becoming depressed. Whether or not it is considered depression depends on how long it lasts and how severe your symptoms become.

Is Depression Common?
Major Depressive Disorder (MDD), commonly referred to as “clinical depression,” is one of the most common mental disorders in the United States. In the 2014 National Survey on Drug Use and Health, an estimated 6.7 percent of the population age 18 or over (or 15.7 million people) suffered at least one clinically significant depressive episode. In addition, in the same study, an estimated 2.8 million adolescents ages 12 to 17 also had experienced at least one episode of depression in the past year, which amounts to 11.4 percent of the U.S. population in that age range. Depression also carries some of the heaviest burden both psychologically and physically. Of the 15.7 million people who suffered a significant depressive episode, 10.2 million of them (or 4.3 percent of all U.S. adults) had at least one episode of major depression with severe impairment. Of the 2.8 million adolescents ages 12-17 surveyed, 2 million (or 8.2 percent) of them had an episode with severe impairment.
How Do I Know If I’m Depressed?
MDD is characterized by the presence of depressed mood or a loss of interest in daily activities for at least two weeks. It should be accompanied by a change in the social, work, or school functioning, and not be something that is normal for the individual. In addition to the depressed mood and lack of interest, a person should also experience several of the following symptoms: change in appetite and/or weight, change in sleep, agitation, fatigue or loss of energy, feelings of guilt/worthlessness, and changes in focus and concentration. In addition, severity is assessed through thoughts of death, harming oneself, or suicide. In some cases, anxiety or moodiness can also be seen as part of the depression. Severe depression may cause someone to be unable to work or go to school and to stop caring for themselves.

Could It Be Something Else?
Yes, in fact, it can. Although many of the changes mentioned are typically linked to depression, there are other possibilities that have to be considered. For example, depressive symptoms can be the result of the loss of a loved one. This type of mood change is typically considered bereavement or grief, as long as it does not cause big changes in functioning or cause suicidal thinking. Drugs and alcohol can serve as substances that affect the parts of your brain that control mood, resulting in temporary feelings of sadness or hopelessness that go away if you stop. High levels of stress or major changes can result in something referred to as Adjustment Disorder, in which symptoms of depression can happen for a short period of time and eventually resolve. All these can mimic the symptoms of MDD and cause similar temporary dysfunction.

What Should I Do If I Think I Have Depression?
Ideally, it is helpful to get a comprehensive assessment through a mental health professional, such as a psychiatrist, as they are trained to distinguish between different mental disorders. They can also pick up on some of the other factors that might be contributing to the mood change and make suggestions on how to address them. If the diagnosis of MDD is made, treatment will likely be recommended, and may include medication, therapy, nutritional and lifestyle changes, or a combination of these. If the depression is more severe, sometimes a referral for more intensive treatment in a hospital setting may be made.

What Should I Remember About Depression?
Although there are many reasons why someone might become depressed, Major Depressive Disorder, or “clinical depression,” is something that needs to be addressed through a mental health professional. Untreated depression can lead to significant problems in your work, school, and home life. In addition, those who suffer depression are more likely to develop medical issues, including decreased immune function, heart disease, and complications or poor recovery from infection or surgery. Early diagnosis and intervention is key to both recovery and prevention of future episodes, allowing you to live a happier and more successful life.

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Jennifer Yen Clark, MD graduated from the University of Texas Medical School in Houston and went on to complete residency training in general psychiatry at UT Medical School. She then completed fellowship training in child and adolescent psychiatry from Baylor College of Medicine. She is currently splitting her time between her private practice, Serenity Behavioral Health, and academics as Clinical Assistant Professor of Psychiatry and Behavioral Sciences at Baylor College of Medicine.

Dr. Yen Clark is also the author of a young adult novel series entitled The Avalon Relics, under her pen name of J.L. Clark. The series follows a teenage girl named Sophia as she discovers a realm of magic, intrigue, and romance. She hopes to send a message of empowerment and acceptance through her writing, while entertaining her audience with a journey through a hidden world of wonder and fantasy.

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