When Down in the Dumps Doesn't Seem so Down

The girl in this picture is what we typically envision when we think of depression.  However, depression is so much more than just feeling sad.  It is a complex issue that may or may not look like sadness all the time.

“She can’t really be depressed; she isn’t crying all the time.”  Have you ever heard that statement or felt invisible because people don’t understand what you are dealing with every day? 
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A common misconception of depression is that we must look sad or cry all the time to be depressed- If we have happy moments, then we can’t be depressed.  Many people do not understand depression, which can lead to someone with depression feeling isolated and hurt even more because his or her illness is not recognized or validated by other people. 

Invisible illnesses are difficult to live with because the effects of the illness cannot be seen by other people and are often dismissed as invalid or seen as a figment of the person’s imagination.  The pain is inside rather than outside. 
 
“It’s a very lonely feeling because you’re hurting and yet people can’t see it so you’re battling it alone.  I would desperately want someone to reach out and notice that I was struggling, but it was like that part of me was invisible.”  Sophia (age 29)
 
The main symptom of depression is characterized by at least one of the following every day or nearly every day for at least two weeks:

• Depressed mood in adults
• Depressed or Irritable mood in children and adolescents
• Loss of interest or pleasure in most activities

Yes, you read that correctly.  Depressed mood does NOT have to be present in order for a diagnosis of depression to be accurate, which is why so many cases of depression are misdiagnosed by professionals and misunderstood by friends and family.  Depressed mood is only one symptom of depression and may not be the primary symptom for individuals.

Children and adolescents more often show irritable mood as their primary symptom rather than depressed mood, which is often interpreted as “typical teenage attitude” or behavioral problems.  A teenager with depression may be isolating and crying a lot, but she also may be having difficulties with anger and trouble maintaining relationships.  Parents, teachers, and doctors may attribute these behaviors to bad behavior, learning disabilities, ADD, or personality.  When we see a change in mood or behavior that seems to be lasting for several weeks and is out of character for the teen, we need to look more deeply for a reason for the change other than typical teenage issues.

"It’s like…like feeling as if I’m a second class citizen... like I’m not privy to certain emotions just because I’m not as sad as some other people.”  Natalie (age 18)
 

​Elderly people more often show loss of interest or pleasure in activities and are the group most often misdiagnosed for depression.  Elderly people tend to isolate themselves and may not be telling other people about their mood.  Additionally, as elderly people are becoming less mobile and may be losing friends, loss of interest or pleasure in activities increases. 

Many times the answer to the question, “Do you feel depressed?” is no because even the person experiencing the issues does not understand that depression is more than feeling sad.  If a person’s predominate mood is irritable or loss of pleasure, he or she may not think of being depressed. 

If you feel out of sorts and cannot seem to figure out what is happening with you, it may be worth talking to a counselor about your symptoms to determine if you may be struggling with depression.
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If you know someone who might depressed, encourage him or her to talk about the symptoms and seek counseling.  Friends and family can be a great source of support and encouragement-especially when we fully understand the symptoms.  Parents and teachers can watch for changes in behavior in children and adolescents and seek deeper explanations for changes in mood and behavior when those changes seem to be out of character for the child or teen or when the changes seem to lasting longer than expected for a typical adjustment. 

Additional symptoms of depression are:

• Weight loss or gain or change in appetite
• Insomnia or hypersomnia
• Feeling restless or slowed down
• Fatigue or loss of energy
• Feeling worthlessness
• Excessive or inappropriate guilt
• Difficulty concentrating
• Indecisiveness
• Suicidal thoughts

 
Depression is treatable and you can feel better.  If you or someone you love needs to talk to a counselor, Dr. Christine Belaire works with adults, adolescents, and children dealing with depression.  Get more information or schedule an appointment on our website www.BelaireCounseling.com.

Christine Belaire, Ph.D, LPC, LMFT, NCC