The Depression Trap

The word depression is used to describe feeling a bit sad for a day or two and a medical condition that can result in death. We seem to lack the language to really express the range of negative feelings that we suffer from. Does this really matter? I think it does for a number of reasons.

Firstly it can lead to a lot of misunderstandings. We all have periods in our life when we are unhappy, perhaps due to bereavement, or a relationship break up. It is natural in such circumstances to go through a period of feeling really down. We may feel as though things will never get better, our life is over or just incredible sadness. In such circumstance we may well describe ourselves as depressed, but most of us are not actually clinically depressed. We are going through a natural, healthy period of sadness or mourning and we will recover on our own in due course. However, if we think of this as depression and call it depression then this can lead to us misunderstanding true clinical depression. This can be very painful for those who are clinically depressed.

Many people with clinical depression suffer from well meaning friends and relatives telling them to snap out of it, think positive, or try taking up a new hobby. These tactics may have worked for people who were just feeling down, but they don’t work for those who are truly depressed. If we had different words to express feeling deeply sad and being clinically depressed then we might avoid some of these misunderstandings.

As a counsellor I try not to ‘misuse’ the word depression, but then I sometimes find myself struggling to describe how I’m feeling. Sometimes when I’ve been going through difficult periods in my life I have felt tremendously sad, as though my life had no purpose and I was just waiting to die. In the moment I can see no purpose, no reason to go on and it feels as though the sun will never shine again. However, I don’t feel that I can say I feel depressed because I know I’m not clinically depressed. These bouts don’t last long enough for me to qualify, plus I usually only have 3 or 4 rather than 5 of the required symptoms (see below for DSM4 definition of depression). So I am left feeling that I must in some way minimise the importance of my feelings, as I can’t use the only word I know that ‘feels’ right.

So do we need to invent a new vocabulary? There is already enough confusion about clinical depression, non clinical depression, major depression, atypical depression, dysthymia, weepy depression, anxious depression etc. This ever increasing list of types of depression seems to me to have more to do with the human obsession with categorising things than with the condition itself. What I’m thinking of here is new word for the type of ‘depression’ that doesn’t need clinical intervention. The sort that we all go through, that’s a natural part of being human. So that we can express how bad we feel without stepping on the toes of those who are clinically depressed. What do you think? Any suggestions?

The official definition of clinical depression is given in the Diagnostic and Statistics Manual-IV (DS4), as:

‘Five or more of the following symptoms present during a two week period (at least one of the symptoms is either depressed mood or loss of interest or pleasure):

• depressed mood
• loss of interest or pleasure
• poor or increased appetite/weight loss or gain
• insomnia or hypersomnia
• psychomotor agitation or retardation
• loss of energy/fatigue
• feelings of worthlessness, guilt or self reproach
• poor concentration/indecisiveness
• thoughts of death or suicide attempts’