Am I Sad or Clinically Depressed?
David is off. His moods consist of feeling blue, sad, empty and irritable. He eats little and lost 10lbs; he can’t stay asleep- wakes up frequently and starts to experience intrusive sad, dark thoughts; remains tired thru the day. He has stopped going to the gym, or meeting friends. He spends all evenings and weekends at home lying on the couch or in bed going through the motions of watching the TV screen. He goes to work but his performance has plummeted and barely gets through his daily assignments.
The brain is like an orchestra every moment with its conductor balancing a multitude of emotional and thought signals (instruments). It decides the sequence and combinations of signals that makes it to conscious perception (music). This perception may be peaceful, pleasant, or jarring, anxious or one of many combinations. Think in one day how many different moods and thoughts you experience. Each experience is generated from signals combined from internal sources (your body, memories, and ideas) and from the external world.
In an adaptable and stable brain no matter what the temporary experiences are, the brain returns you to a baseline stability — from which the next series of signals arise. The circuitry that makes such a process possible, are the millions of neurons with their trillions of interconnections using chemical signals (neurotransmitters). These circuits are organized into a multitude of brain systems that generate our experiences. These brain circuits never stop; they continuously pulse with activity to constantly adjust the brain’s systems activities. Examples of some systems are moods, concentration, self perception, outlook, body controls and many more.
Now getting back to David. At this point in his life, his brain has lost the ability to return itself to baseline stability. His brain’s conductor has lost the ability to keep all various systems in harmony. The resultant disorder has produced these multi brain systems malfunctions (symptoms).
Each one of us has been in David’s shoes in our lives for short periods of time. The cause in most cases was from a stressor. The most common stressors: loss of a loved one thru separation or death; the loss of possessions that have a strong symbolic and emotional meaning to that individual- property, job, money, reputation; physical injury or illness. Each individual’s collection of symptoms may be different but the end result is the same — not being able to “bounce out of it.” A gay individual if vulnerable to depression may be at a greater risk due to the additional life stressors they may have to manage — from relationships, to family, job and environmental issues.
So if such a state for David lasts from a few weeks to a month and by then he has started to bounce back, i.e. started returning to his usual state of stability (sleeping better, improved work performance, return of interest in his life) then we would label it as a state of sadness (in psychiatric terms- an adjustment disorder). David may need some help to get better such as social support from his friends and employer, perhaps temporary sleeping medication. However his brains circuits will have started to or have returned to synchronized harmony within the 1 to 2-month period. A gay individual especially when just starting out in life in their late teens or 20’s with possible fewer social supports and navigating the coming out process may have even a harder time returning to a stable state.
If David however is doing as poorly by month 2 or later; or if he actually has deteriorated to let’s say missing work; feeling life is hopeless; not even trying to keep up an external appearance then we are dealing with more than sadness- the brain circuitry has become “stuck” in disharmony; loss of intercommunication between its systems. This is called clinical depression.
Clinical depression does not mean one is weak, broken or not good enough to live life to the fullest. What makes an individual vulnerable to clinical depression is a combination of nature and nurture. Some major identified factors are: genetics (family history); early childhood hard drive programming on how stress is handled; the quality of one’s current life; the use of mind altering chemicals (drugs, alcohol).
Clinical depression most often appears in teens to early 20’s. We have strong research evidence that the longer a depressive episode lasts or the more frequent number of episodes and individual experiences in their lives leads to a significantly higher probability for more frequent and deeper future depressive episodes; and these then can appear spontaneously without an external stress trigger.
The good news is that this brain malfunction, can be reversed and future risk can be reduced with proper treatment. We will examine in the next article some of the most successful treatments we have: specific types of talking therapies and certain types of medications.
For David it’s important for him to overcome the fear, prejudices of seeking treatment (if has them) and not risk further suffering and disorder of his brain and his life. As a gay individual who may have less supports and more life stressors it especially urgent to seek treatment that will support the healing of his brain and self.