I have come across threads where people say they have been hospitalized for depression. I know other people who insist that their depression is serious enough to warrant the same sympathy that hospital patients receive. I am ignorant on this subject so I would like to know what a serious depression is like. What are the symptoms and how sever of an illness is it? Is it just unhappiness, or is it something much worst?
Well, it does manage convince a lot of people whose lives are otherwise great (decent job, loving family, etc) that everything is horrible, nothing will get better, and they should kill themselves… and that their loving parent/child/friend/significant other will actually be much happier if they do. Almost a cliche, local man with wife-career-car-kids-future kills himself, obit on page ten.
Just think about what an absolutely STUPID idea that is for a moment. Assume no terminal illness, no crippling chronic pain, no huge debts, lots of friends and loved ones… how dumb would it be to conclude that both you and everyone else would be better off if you died?
Now think about how messed up someone’s brain would have to be to actually believe something like that.
You could ask 20 people who have suffered from clinical depression what their symptoms were and you would probably get 20 different responses.
For some it is indeed an intense sadness that does not reflect the day-to-day reality of their lives (as elfbabe noted).
For others it is a complete absence of any feeling, good, bad or otherwise.
Some become almost psychotically depressed, resulting in an inability to react to the outside world in any way, while others are able to maintain some semblence of ‘normality’ and keep up working and family committments even though they feel like automatons.
Although suicide is the main fear for depression sufferers, there are other common features including self-harm activities, self-medication (with alcohol and other prescription/non prescription drugs) and the effect depression has upon immediate family members (esp. children).
It is not a nice disease, and one that is oftentimes difficult to treat, despite all the wonderful drugs and treatments on the market. With physical disorders (say, a broken leg) it’s going to hurt and it’s going to be a pain in the arse to treat, but it will get better.
But the problem with depression is that there appears to be NO light at the end of the tunnel, and when one is in the midst of an episode, death can seem like the only way out. It’s not a rational disease.
Samuel Johnson suffered from what we now call depression, what he referred to as “morbid melancholy”, which is a rather good description, I think. Since both Dr Johnson and his biographer James Boswell were so on the ball in their description of the problem, and of the possible remedies, and since they were so up front about discussing it (and yet without boring the pants off everyone), and since they were gloriously jargon-free in those days about mental afflictions, I’ll quote from the book (Boswell’s ‘Life of Johnson’) directly and liberally. It really is difficult to better, I feel. I’ve taken the liberty of italicising those parts which I believe show special insight into the condition. (Page references are to my library’s Everyman edition; but probably useless to anyone else since there are almost more versions of this classic than years since it was first published, 1791.)
30-31: 'The “morbid melancholy”, which was lurking in his constitution [as an undergraduate at Oxford], and to which we may ascribe those particularities, and that aversion to regular life, which, at a very early period, marked his character, gathered such strength in his twentieth year, as to afflict him in a dreadful manner. While he was at Lichfield, in the college vacation of the year 1729, he felt himself overwhelmed with an horrible hypochondria, with perpetual irritation, fretfulness, and impatience; and with a dejection, gloom, and despair, which made existence misery. From this dismal malady he never afterwards was perfectly relieved; and all his labours, and all his enjoyments, were but temporary interruptions of its baleful influence. He told Mr. Paradise that he was sometimes so languid and inefficient, that he could not distinguish the hour upon the town-clock.
Johnson, upon the first violent attack of this disorder, strove to overcome it by forcible exertions. He frequently walked to Birmingham and back again, and tried many other expedients, but all in vain. His expression concerning it to me was “I did not then know how to manage it.” His distress became so intolerable, that he applied to Dr. Swinfen, physician in Lichfield, his god-father, and put into his hands a state of his case, written in Latin. Dr. Swinfen was so much struck with the extraordinary acuteness, research, and eloquence of this paper, that in his zeal for his godson he shewed it to several people…
But let not little men triumph upon knowing that Johnson was an HYPOCHONDRIACK, was subject to what the learned, philosophical, and pious Dr. Cheyne has so well treated under the title of “The English Malady.” Though he suffered severely from it, he was not therefore degraded. The powers of his great mind might be troubled, and their full exercise suspended at times; but the mind itself was ever entire. As a proof of this, it is only necessary to consider, that, when he was at the very worst, he composed that state of his own case, which shewed an uncommon vigour, not only of fancy and taste, but of judgement. I am aware that he himself was too ready to call such a complaint by the name of madness; in conformity with which notion, he has traced its gradations, with exquisite nicety, in one of the chapters of his RASSELAS. But there is surely a clear distinction between a disorder which affects only the imagination and spirits, while the judgement is sound, and a disorder by which the judgement itself is impaired…
To Johnson, whose supreme enjoyment was the exercise of his reason, the disturbance or obscuration of that faculty was the evil most to be dreaded. Insanity, therefore, was the object of his most dismal apprehension; and he fancied himself seized by it, or approaching to it, at the very time when he was giving proofs of a more than ordinary soundness and vigour of judgement. That his own diseased imagination should have so far deceived him, is strange; but it is stranger still that some of his friends should have given credit to his groundless opinion, when they had such undoubted proofs that it was totally fallacious; though it is by no means surprising that those who wish to depreciate him, should, since his death, have laid hold of this circumstance, and insisted upon it with very unfair aggravation.’
277: ‘He mentioned to me now, for the first time, that he had been distrest by melancholy, and for that reason had been obliged to fly from study and meditation, to the dissipating variety of life. Against melancholy he recommended constant occupation of mind, a great deal of exercise, moderation in eating and drinking, and especially to shun drinking at night. He said melancholy people were apt to fly to intemperance for relief, but that it sunk them much deeper in misery. He observed, that labouring men who work hard, and live sparingly, are seldom or never troubled with low spirits.’
A few points I’d make: a) many depressed people are more intelligent than average; b) many depressed people tend to be compulsive/obsessive; c) depressives often don’t feel at home in this world; d) there is no cure; but e) wholeness is what a depressed person most craves; f) for reasons c-e, many depressives are Christians, believing in a better world.
Best book by a health professional I’ve read on depression: The Drama of the Gifted Child: The Search for the Trus Self, by Austrian psychoanalyst Alice Miller. Don’t let that put you off, though - she’s no Freudian.
Thread perfectly placed in this forum, by the way.
Thanks roger, wonderful quotes.
Oliver Sacks made the distinction between diseases that feel, to the sufferer, like an “it”, and affect the sufferer from the outside. A broken leg is one example, but there are also mental afflictions, lile epilepsy, that don’t affect the 'I".
Depression, in contrast, is an disease of the “I”; disease and personality interact much more closely, and as a result, as kambuckta noted, 20 people will yield 20 different depressions.
Psychology has made an attempt to objectively describe different types of depression in the DSM-IV,, the Diagnostic and Statistical Manual. DSM_IV gives lists of symptoms to differentiate between the many different types of depression.
In my own experience with depression it expressed itself as, more than anything else, a sense that I couldn’t improve my situation - and then exacerbated by a complete lack of energy. We’re not talking about staying in bed for a few extra hours - we’re talking about not being able to stay awake for more than two or three hours a day.
For a lot of people with depression the lack of energy can get so dramatic that they won’t shower or bathe for weeks on end, because destinkifying themselves is too much effort.
I thought of running my car off of an overpass or into a wall. The new baby and my other son were typically in the car; that fact was many times the deterrant to acting on my woeful despair.
Then some of us are bi-polar. I have at times gone for days or weeks on end wanting do to nothing more than curl up in a corner and cry, often for no real reason. And sometimes I would do just that, call off work, not talk to anyone etc. Other times it’s just an overwhelming feeling of hopelessness. That no matter what you do, you will never mean anything and the world would be better off without you in it. This despite the fact that I have a wonderful longterm relationship, a great job, a nice place to live in a beautiful city etc. As was said, it’s not a rational condition.
Then there’s the up times, boundless energy, an unrealistic optimism about anything and everything, “Let’s go party till dawn!”, etc etc. I won’t lie, the ups are a blast to experience. This is a large part of why many bipolar people refuse medication, they don’t want to lose the ups.
It can be hard to describe it to people, but it’s not a fun way to live. Without the support system I have, I would probably not be here today.
Way different than sadness.
The summer after my mother died I was (understandably) extraordinarily sad. I couldn’t remember anything from one minute to the next, as if my brain, not wanting to remember she was gone, refused to remember anything. In fact, to this day I remember nothing of that summer. The grief took over everything for a while. After some time, though, I could go a day or so without thinking of my grief, until finally I could remember her without wanting to cry, rejoicing that she had lived, and feeling glad that we’d had her if for too short a time.
Depression was, and is, different. At the worst of my depression, I was afraid ALL THE TIME. I wanted to cry most of the time. Frequently, at work, I would have to go into the ladies’ room, hide in a toilet stall, and cry as quietly as I could. I found no joy in anything. I would look at something beautiful and intellectually realize that it was beautiful and that it might be possible to enjoy that, but was completely unable to do so. Which made me even more depressed. I would feel like there was a dark grey veil over everything, or like I was at the bottom of a deep dark pit, being sucked into a black whirlpool, clinging to the sides of the pit with my fingernails, but tired of the effort. For a time, I wished I could just be done with everything, but realized my children needed me, so I set myself a specific date in the future upon which it would be acceptable to end my life. Fortunately, I got professional help before that time came. For me, a single pill per day gave me myself back. I still get sad sometimes. I was really sad, for example, when my young nephew died unexpectedly last summer. I’d be a monster of some sort if I weren’t sad in such a case. But I am no longer clinically depressed. I can enjoy life again.
Big difference.
Kambuckta makes several very good points. Depression affects different people differently. Some lose weight and can’t sleep, I personally gain weight and sleep all day when I’m in a depression (though a recent diagnosis of narcolepsy may explain some of the latter 
). While I can’t say for certain that I’ve ever been suicidal I have definitely been at points where I could understand suicide, not so much for “I can’t take it anymore” feelings as “I just have no interest in or desire to see tomorrow or do much of anything else” sensation that lasted indefinitely. Imagine the Buddhist ideal of complete detachment from everything, but the dark ugly side of that- the not in a good way side.
Some people you can see at a distance of 100 yards and regardless of their actions you can tell they’re depressed (especially if you know them). Some are agressively depressed- they share their status with all and bring down everybody around them. I try to hide mine and in fact have left people crying with laughter while I was morbidly depressed and they never suspected and didn’t believe me when I told them about it later. Aristotle even commented on how in his experience the wittiest and funniest of people were frequently the most serious and melancholy.
Or you see it but you just remember that so did Princess Diana. 
One of the many horrible things about depression is that so many people don’t understand it. It’s not a matter of “go out and buy yourself a new shirt” or “look on the bright side”- you KNOW it’s irrational and you KNOW that things could be worse (but then again, for people in concentration camps things could be worse- I’m sure that didn’t buck their spirits up) but it doesn’t matter. It’s about like saying “You’re having a diabetic seizure, go watch a Chris Rock concert video and you’ll feel better”. It’s not a lack of self-control or a lack of willpower or a lack of wanting to feel better or a spiritual void (that’s a BIGGIE down here- “go to church and read the Bible and you’ll feel better”- well, you’ll be a depressed Christian but not that much changes) but an INABILITY to do these things.
What disgusts me are people who refuse to treat their depression. Probably half my family suffers from it and I am the ONLY ONE who takes medication for it even though all of them know about the disorder and the treatment but stubbornly refuse to take pills for one asinine reason or another. Even with medication I have lows, but they’re more manageable, and I’ve accepted that I’ll probably never not be on anti-depressants and I’ve tried to proselyte for their effectiveness because I know the befores and after feelings of them and, once you find what works well for you, the effectiveness far surpasses the side effects. Unfortunately my relatives and friends who’ve had textbook cases of the disorder simply think they can trudge through without them whether this cycle takes hours to pass or a year to pass and it drives me bonkers(er). It’s as silly as a severe diabetic refusing to take insulin because “it’s habit forming”.
Of course to answer your question as to what it’s like, listen to Lou Reed and the Velvet Underground’s Venus in Furs about 421 times on a loop. The way you feel after the 232nd time- that’s depression (but far from my record number of listenings to that song :D).
I’m not sure if treatment should be synonymous with taking drugs, as you appear to make it. Treatment also includes talking with others (whether “professionals” or not), and most importantly “talking” with yourself, i.e. being honest. Your comment about being in a place where you understand suicide is very well expressed.
For me, it was an almost total absence of self-worth. I was stupid, boring, ugly, and useless, and there was no way to ever change that, so why bother even trying? In fact, why bother doing anything? Go out and meet people? Who would ever want to spend any time with me? (This, despite the fact that I had lots of friends who were always willing to hang out with me.) Go to a party? Why, when I’m such a loser that I’d just drag the whole party down? (Again, despite the fact that the aforementioned friends were always inviting me to parties.) Date? Who would ever… well, I think you see the pattern here. I was lucky in that it eventually went away more or less on its own. I never tried to seek treatment because, to my mind, there wasn’t anything wrong with how I felt. Someone who was as big a loser as I was should feel that way, right? It was my just dessert for sucking so much. In the final tally, I ended up missing out on the bulk of what should have been the best decade of my life. How many other people out there remember high school more fondly than college? And I had relatively light depression. I was never suicidal, for instance. As horrible as I felt on more or less a daily basis, what’s really scary is looking back and realizing how lucky I was, compared to other people with the same disease.
What MLS and Sampiro said. Imagine that all of a sudden, everything is numb and colorless. Your favorite foods don’t taste as good. You can’t enjoy your favorite movies, or your favorite songs sound blah. Even when you’re out with friends, and everyone around you is laughing, you feel like you’re outside of it, just observing.
And that’s when you’re not hiding away, unable to talk because you’re crying all the time, when you’re at work and desparately trying to hide the fact that you can’t stop sobbing, when you have to claim “allergies”, and no one believes you, when you’re not just wishing you could just lay down and go to sleep and never wake up again.
That’s why when people start in all this bullshit about how we’re lazy, and “medicating all our problems away” that I just see red, because for me, it’s not an option to NOT take my meds. My problem is depression which is caused by an anxiety disorder, so I’ll probably be on meds until I die. Believe me, I’d LOVE not to have to take them. The side effects have pretty much gone away, for the most part-I’ve learned how to manage them, and how to fix them.
“Better living through chemistry?” You betcha. If that’s what it takes for me to feel NORMAL, not happy, but just NORMAL, well, I’m willing to take meds. If you don’t like it, too damned bad. It ain’t your life.
I didn’t see this when I posted-to be completely fair, I’m NOT saying meds are for everyone, just that for me, they are a must. (Like I said too, it’s more for the anxiety disorder than just the depression).
But yes, counseling is definitely important. Sometimes counseling alone doesn’t do it, sometimes it does.
For me, it was just like I was on drugs all the time. I never saw anything clearly. I never had a good handhold on reality. I felt like I was seeing the cracks in the world. Things can suddenly stop making sense if you stop trying to make them make sense. And this was freaky and scary adn there was nothing I could do about it. I didn’t believe in life, I didn’t understand it. So I couldn’t really do anything except wail at the meaninglessness of it all because nothing was appropriately real for me, and I couldn’t imagine a future where it could be.
Here is a journal entry from a bad day:
And here is one from a good day when I went on a walk in a nearby town, that shows how much reality I was losing, and yet how seductive and magical that loss could be:
I somehow got better without drugs, by slowly learning to trust in the world and reinvest in life, in sanity. And by cultivating the braveness to face all the work it’d take to get better and deal with the rest of my life. I felt like I’d finally found that liff- the one that you go completely nuts and lose all touch with reality if you go off it- and I backed away. Sometimes I miss all the rawness of it. But it’s an amazing blessing every day when I wake up and can think straight.
Although I’ve never been hospitalised for depression, I have suffered from it on and off for years. I am presently unmedicated because I prefer to cope with it to the best of my ability without drugs. Having an understanding of the disorder has made it easier for me to cope with it. There have been times when I’ve had to resort to medication because I have been unable to get through it. While there is nothing wrong with taking medication if you need it and it helps, I feel better about myself when I deal with it and although medication may help me through a rough patch, it leaves me feeling that I have “failed” in some way.
Usually, I can bluff my way through depression and casual acquaintances would not know that I suffer from it (I believe that I am perceived by most as an upbeat individual). I do not have complete control over it all the time though, and it tends to be my nearest and dearest who have to deal with my sudden outburts of temper, my inability to get motivated to do anything, my excessive sleeping and my irrationality. Depression becomes a self-perpetuating cycle for me: I become tired and lack motivation, I fail to keep up with my housework, I find my untidy home depressing, I sleep more, I do less, the house gets worse… and on it goes. Depression and fatigue are so closely intertwined in my life that it’s hard to separate them and each makes the other worse. I have a lot of trouble holding down a job because when I get tired, I get depressed, and when I get depressed I need more sleep, and when I can’t get more sleep I get even more depressed and once again we have a self-perpetuating cycle.
Anti-depressants helped me when my depression was at it’s worst - a situation I’ve only been in once - but they were not enough to help me cope with the strain work puts me under and I had to quit my job in the end or I would not have been able to go on.
Depression makes me feel paranoid and isolated. I have trouble getting myself together to go to events that I’ve known about for some time in advance because it gives me time to convince myself that it’s a bad idea, that I will not enjoy it, that I will be unhappy and that everyone will have a better time without me. Most of the things that would help make me feel better - getting out of the house, socialising, eating well, keeping on top of the housework - are the things that depression makes it harder for me to face doing.
The discription that fit me was a complete inability to experience joy. Those things in my life that used to bring joy were no longer able to do so.
I get hypersomnia – not because I want to sleep, so much, but because getting up and doing anything is just overwhelming effort. There are days in a depressive episode where I check off major accomplishments like “Found clean underwear” or “remembered to eat”; when I’m coming out of it I have wildly productive days in which I do a load of laundry or maybe empty the dishwasher.
The inability to get tasks done haunts me at these times: there’s no reason behind it, just my own deficiency at being unable to muster the capability to do something so simple and so basic that any even remotely competent person should be able to handle. Not only do I wind up feeling unable to act, but that my inability to act is a personal failing, something that I should be ashamed to even contemplate. “Making excuses”, I expect people to say. If I could just sleep – go into that nullstate where I’m not supposed to be doing anything – until it stops.
When it’s actually bad, I get anxiety responses. Not only is the awfulness of my life and my ineptitude stacked up in great tottering piles around me, the slightest disturbance will bring them all falling down on my head, crushing me. (I haven’t had a bad episode since I went on B vitamins, though; the clearing up of the anxiety symptoms is what motivates me to keep on the damn things.)
OtakuLoki, Sampiro (who also noted a major reason that my studies of Buddhism have always been academic), Miller, and even sven have all written things that I can relate to deeply. It’s like that, yeah.
For me, it was lying on the couch, not being able to sleep, but unable to concentrate on anything. Like I lost attention in a daydream, except you’re aware of a crushing blackness. I remember once the Olympics were on, and I remember looking at the TV, but my mind couldn’t comprehend what was going on. Like being a sleepless zombie.
Now, let me tell you, depression plus anxiety is EVIL. Same symptoms as above, but combined with being too anxious to sit still, eat, or do something to calm the anxiety. Instead of just floating in the blackness, you’ve got a worried mental energy. You’re anxious you’ll never get out of it. You can’t stop moving, but you’re too sad to turn that exercise into something positive. You’re doing laps around the yard while crying.
I’ve never heard the way my mind works during my “bad periods” described so succinctly.