We all have experienced times in our life when we feel sadness. Sadness can result from a breakup, a poor grade on an exam, or the disappointment of not getting that dream job. Sadness is usually short-lived, lasting a few days. It is a normal reaction to disappointment, stress, loneliness, and a host of other negative events in life. But sometimes sadness persists and begins to interfere with the rest of life. This is the key difference between sadness and a psychiatric or clinical disorder that requires treatment. When the symptoms interfere with performance at work or school, negatively affect relationships with loved ones and friends, or prevent someone from enjoying activities that have been enjoyable in the past, that calls for an evaluation for depression.
Other symptoms of depression might include a depressed or sad mood; issues with weight, sleep, and activity level; extreme fatigue; trouble with concentration and attention; and recurrent thoughts of death. Someone does not need to experience all of these symptoms to be diagnosed with clinical depression, which is characterized as major depressive disorder in the DSM-5, the handbook of psychiatric diagnoses used by mental health workers in the United States.
No two presentations of depression are the same. Imagine depression on a severity dimension, from mild to severe. Everyone’s level of depression can be different, and the number and combination of symptoms can vary as well.
The phrase, “time heals all wounds,” is true for sadness. Without any kind of intervention, just the passage of time is usually enough to have feelings of sadness dissipate. This is not the case for a major depressive disorder, which can last for months. Not only does it last longer than sadness, it is generally more severe, and it can be life threatening. People who experience a major depressive episode are at increased risk for suicide, engaging in harmful behaviors, chronic health problems, substance use, relationship issues, and other co-occurring psychiatric disorders.
There are other types of depressive disorders as well. When a person has a depressed mood that lasts for 2 years or more, it is called persistent depressive disorder. The symptoms of depression in this disorder are similar to major depression, but are present nearly every day. Also, depression can be part of other disorders, like bipolar disorder, substance use disorders, and others.
Unfortunately, sometimes people experiencing depression think they can get better by themselves and don’t seek help from a mental health professional. If someone woke up with a terrible cough, headache, and flu-like symptoms, they likely would immediately make an appointment with a physician.
Why are some people reluctant to seek help for mental health issues, when they readily seek help for other health problems? While 1 in 5 Americans will suffer from a mental illness each year, many will go untreated for a number of reasons that include lack of access to mental health treatment, the stigma some attach to seeking help for mental health issues, and generally inaccurate stereotypes about the mentally ill. This is very unfortunate because without proper treatment, individuals are at higher risk for additional problems, including the worsening of symptoms, the development and exacerbation of health problems, substance use, suicide, victimization, accidents, and other problems. So when you hear someone say, “suck it up,” don’t buy into that. Get the help you need.
If you are suicidal, or know someone who is, call the National Suicide Prevention Hotline at 1-800-273-8255 or visit https://suicidepreventionlifeline.org/ and hit the “chat” button for immediate help.
Editor’s Note: Carolyn R. Fallahi, Ph. D., the faculty liaison to Student Disability Services, is a professor and chairperson of the Department of Psychological Science at Central Connecticut State University.