“John I’m feeling depressed.”
In my line of work, I often hear those words. Having experienced major depression two decades ago, when someone tells me they’re feeling depressed, I wonder: are they having a couple of bad days in a row—or are they dealing with depression for real?
According to the World Health Organization, and the National Institute of Mental Health, here are some of the most common forms of depression:
Major Depressive Disorder (MDD)
Major depression is characterized by an overwhelming feeling of sadness or a loss of interest and pleasure in most usual activities. Other associated symptoms include decrease or increase in appetite, insomnia or hypersomnia, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and/or suicide, and cognitive difficulties, such as, diminished ability to think, concentrate, and make decisions. Any combination of at least five of these symptoms persisting for two weeks or longer may indicate major depression.
Persistent Depressive Disorder (PDD)
The essential feature of PDD is a low, dark, or sad mood that is persistently present for at least 2 years. For the individual to receive the diagnosis of persistent depressive disorder they also have to be experiencing two of the following symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration, difficulty making decisions, or feelings of hopelessness. The symptoms of PDD are not as severe as with major depression.
Depressive disorder related to a medical condition
Endocrine and reproductive system disorders are commonly associated with depressive symptoms. For example, people with low levels of the thyroid hormone (hypothyroidism) often experience fatigue, weight gain, irritability, memory loss, and low mood. When the hypothyroidism is treated it usually reduces the depression. Cushing’s syndrome is another hormonal disorder caused by high levels of the hormone cortisol which can also cause depressive symptoms.
Seasonal Affective Disorder (SAD)
People with SAD suffer the symptoms of a Major Depressive Disorder only during a specific time of year, usually winter. Every February here in Michigan, I wonder if I should move to a warmer, sunnier climate. SAD appears to be related to the shorter daylight of winter, and the lack of sunlight in many parts of the country.
So: how do you know if you’re just having a few bad days in a row—or struggling with one or more forms of depression? (NOTE: If you’re dealing with suicidal thoughts, stop reading and go get help right now! See your doctor, get to a counselor, reach out for help without delay).
Here are eight easily-overlooked indicators of depression that can help you determine if you’re heading toward a depressive episode or in the middle of one:
- Fatigue – Not just garden-variety fatigue. Rather, chronic fatigue—physical, mental, and emotional tiredness. If you always feel tired, even though you are sleeping well at night (most adults need 7-9 hours per night), it’s possible you’re suffering from depression
- Rapid weight changes – When I was suffering with major depression, I lost my appetite—and 30 pounds within 3 months. Other depression-sufferers respond by overeating in an attempt to find some sort of pleasure in life.
- Insomnia or hypersomnia – In other words, difficulty sleeping, or sleeping too much.
- Difficulty concentrating – Dr. Norman Sussman describes it this way: “Depression is like a form of reversible brain failure. It’s like your CPU isn’t working properly.”
- Phantom physical symptoms – In my struggle with major depression, I experienced numbness in my arms and legs. Neurological tests ruled out any physical explanation for those sensations. I also suffered with a persistent feeling of choking coupled with difficulty breathing. An ear, nose, and throat specialist confirmed there was nothing physically wrong, even though the choking sensation felt real.
- Increased irritability – Irritability is often mistaken as a character flaw. While it may be that—often times it’s an indicator of looming depression.
- Anxiety – I experienced the twin challenges of major depression and crippling anxiety at the same time. Nasty combo.
- Indecisiveness – Depression may can cause you to have difficulty making decisions that you used to make easily.
So what can you do if you suspect you’re suffering with one or more forms of depression? I want to encourage you to apply a full court press strategy:
Get to your doctor immediately
It’s possible that other medical conditions are contributing to your depression. Your doctor may prescribe antidepressant medication for a while. This type of medicine helps stabilize you so you can work on those things fueling your depression.
Schedule an appointment with a qualified therapist
Therapists know how to scrub out emotional wounds. Talk therapy can be extremely helpful in correcting thought processes and interpreting feelings, as well as setting strategies for healthier emotional hygiene.
Get your body moving
Regular exercise does emotional wonders for most people. Research suggests exercise releases feel-good chemicals in your brain that lift your mood. Check with your doctor before you start.
King Solomon wrote: “A cheerful heart is good medicine.” Regular doses of laughter are a strategic part of the full-court press.
Find a supportive community
The last thing you need if you’re depressed is to be alone in your depression. The second-to-last thing you need is to be around the wrong kind of people. You need to be around friends who love you, are committed to you, who replenish you, and like to laugh. Schedule healthy community into your weekly rhythm.
Revisit/reset your workload
If you’re working 55-60 hours every week, blowing by Sabbath rest on a regular basis, and can’t remember the last time you took a vacation—no wonder you’re struggling with depression! Take charge of your calendar or it will take charge of you.
Work toward 7-9 hours of sleep each evening
Your brain repairs itself when you sleep. It flushes toxins when you sleep. Cutting corners on sleep over the long haul usually intensifies depression. Sleep is an important part of the full court press.
Listen: If you’re having a couple bad days in a row, welcome to the human race. It happens to all of us periodically. But if you’re legitimately suffering with depression, take it seriously and apply the full court press. Depression is not a life sentence. It doesn’t have to be the final chapter in your story. But it won’t magically disappear on its own. Hopefully the outline I’ve sketched out above will get you started in the right direction.
I’m rooting and praying for you!
P.S. – A full discussion of depression and how to deal with it is outside the scope of this post. I highly encourage you to check out my book Unshakable You: 5 Choices of Emotionally Healthy People. It will provide more detailed strategies for building an approach to life that will help you get and stay healthy emotionally.