We are fortunate to be living in a society that is striving towards making mental wellbeing as important as physical wellbeing. This is a huge step in the right direction. Mental health awareness and education is at the forefront of many media campaigns and is being championed by celebrities and influencers. This movement has enabled those suffering with mental illnesses, such as depression, to unashamedly seek help - which hopefully we’d all agree is pretty darn great! However, as with all great things, there are a couple of caveats...
The increased coverage of depression within the media has made our society hyperaware of mental illness. This isn’t inherently bad, however, just as googling the symptoms of a cold can end up with the incorrect self-diagnosis of pneumonia, you can also google the symptoms of sadness, for example, and end up misdiagnosing yourself with depression. That isn’t to say that having a cold or feeling sad isn’t difficult, painful and worthy of care and attention... it’s just not pneumonia or depression.
The difficulty lies with the definition and symptoms of depression and sadness. Both depression and sadness are associated with low mood, changes in appetite, disturbed sleep patterns and loss of motivation, to name a few. You can see why telling these two experiences apart can be difficult for both the individual and outsiders. Clinically the ‘two-week’ diagnostic criteria is used to distinguish between depression and sadness, meaning that if you experience these symptoms for more than two weeks then you may be diagnosed with depression. In many cases, this cut off point will indeed flag up depressed patients.
That being said, I’m pretty sure we’ve all had one or even two of those months where everything seems to be going against you. Money is tight, you’re going through bumps in your relationship, you’re lucky if you manage 5 hours of sleep and to top it all off your boss seems to have it in for you. If anyone manages to get through a month like that without showing symptoms of sadness and depression then they must be superhuman!
If you’ve ever lost someone very dear to your heart or even gone through a difficult relationship breakdown then you’ll know that the healing process takes months and sometimes even years. Sadness is inevitable in situations like this and the feelings of sadness, lack of motivation and disturbed sleep may linger for extended periods of time. This is a natural reaction.
Symptoms of sadness and depression in these situations aren’t due to illness or dysfunction they’re healthy human responses. This is not to say that those suffering with these difficult life events and subsequent sadness are not as worthy of love, care and healing as those suffering with clinical depression - they absolutely are. However, treating a clinically depressed patient as if they were experiencing sadness and equally treating a patient struggling with intense sadness as if they were depressed can prolong the recovery process and can, in some cases, be damaging.
So, how can you tell the difference between experiences of sadness and clinical depression?
It’s tough. However, a good place to start is by looking at your environment. Do you hate your job? Is your relationship on the rocks? Have you lost someone you love or been rushed off your feet to the point of exhaustion? If so, the low mood you’re experiencing might be a result of these factors. Sadness is a normal healthy response when times get tough. If however all your basic needs are being met and you’re supported and loved by your family and friends, yet still feeling low and unmotivated then you may be depressed. Depression can strike at the best of times - you can appear to be thriving, achieving your goals and investing in meaningful relationships yet nothing seems to make you feel happy… or even ok.
Another key indicator of clinical depression is thoughts or actions of self-harm and/or suicide as a form of relief. We’ve all wished away time when life throws us a challenge, and we've all experienced wanting to bury our heads in the sand. These feelings can be intense, painful and unpleasant and it’s important to seek help or chat to a friend when these emotions come up. These experiences are, unfortunately, part an unpleasant part of life… they can totally suck and seeking help from friends or talking to a counsellor or life coach might help you to figure out your next mode of action.
Thoughts of suicide and self-harm however, are a different kettle of fish. If an individual is feeling suicidal they’re in a state of no hope and it can be difficult for these individuals to logically break down their emotions, subsequently perceiving suicide to be the only form of relief. Not all clinically depressed patients experience intense suicidal thinking, however in most cases suicide isn’t a foreign concept. Self-harm can be used as a coping mechanism by depressed individuals as the temporary physical pain may provide a moment of relief from their mental turmoil.
If you are experiencing suicidal thoughts or engaging in self-harm please seek help immediately by calling the Samaritans on 116 123, visiting your local A&E or booking an appointment to see your local GP.
Sadness and clinical depression are both unpleasant experiences and they both deserve to be treated with love, kindness and compassion - neither of these experiences make you weak or unworthy. They’re simply different, neither better or worse, and may suit different healing approaches. For instance, someone with depression may find yoga or meditation destructive, being alone in their mind and focusing inwards can be very scary and sometimes detrimental. Whereas for someone experiencing sadness, yoga might provide a supportive and social outlet whilst finding some inner stillness.
There is a frequent misconception that to benefit from therapy or similar formal help you have to diagnosed with some form of mental illness, but this is not the case. If you have been struggling with sadness and feel as though your environment is negatively affecting your mental wellbeing, reach out and talk to someone. Book in to see your GP, as they could help you find a therapist or counsellor or may make other suggestions that could aid your recovery. Clinical depression may be unresponsive to therapy alone and medication in these cases can provide a life-line to these individuals. The combination of talking therapy and medication may be required. For severely depressed patients that have been unresponsive to previous treatment, there are other options such as EMDR (eye movement desensitisation and reprocessing) which might be appropriate. This should always be discussed with a qualified psychiatrist.
The line between normal sadness and depressive disorder is fine; so fine that it can be difficult to know when to be concerned and when to seek help. As a general rule of thumb, if you have any doubt in your mind and think you might be experiencing depression, book an appointment with your GP as soon as possible. If you’re on the fence, look at your environment, explore your feelings either by yourself or with a friend or family member that you trust. Would you expect someone else to feel the way you do if they were in your shoes?
Either way, whether you identify yourself with feeling sad or think you are experiencing clinical depression, talk to someone and seek help. Just because you don’t think you’re clinically depressed doesn’t mean you don’t deserve the time, love and compassion of others; you absolutely do. However, being able to distinguish between sadness and depression will help you figure out which recovery path is right for you.
If you’re feeling suicidal or just need to talk, call the National Suicide Prevention Lifeline for free at 1-800-273-8255. And for more information on depression and other mental illness, head to Mind's Website.
This blogpost was written by Yoga Teacher, Neuroscience & Neuropsychiatry Student & Mental Health advocate, Ella Stanley.