Nobody welcomes feelings of sadness or dejection, but feeling down is sometimes part of life. Sadness is a normal, healthy emotion, and a natural response to loss or disappointment. Depression is a mental health issue, and a treatable illness.
While it may not seem to matter what you call it when you or a loved one is hurting, it is important to understand how these conditions are different.
When untreated, depression can raise the risk that more harmful behaviors will become established. Millions of people struggle with untreated depression each year. This also impacts friends, family and work relationships. The better we can recognize when someone needs help, the more we can reduce depression’s impact and support those we care about. Depression is treatable and people can recover to enjoy more positive, healthier lives.
The Difference Between Sadness and Depression
Sadness is a low mood of short duration. It’s a normal emotional response that everyone experiences after disappointment, hurt, or a personal loss.
When you feel a sense of sadness, you can usually trace the cause back to a particular life event. You may have lost something or someone you love, or regret a missed opportunity. While you feel this sadness, moments of laughter can co-exist. You don’t feel that your world is all or mostly negative. Sadness eases at some point; it will pass.
Depression is life altering and more complicated. People experience it differently, and sadness is just one component.
Depression saps life’s energy, and wreaks havoc with a person’s hopes and desires to do good things and enjoy life. People with depression may want very much to feel better and be more fully present to those they love. But when fatigue, numbness, or apathy take hold, some may feel desperate and do destructive things to feel less bad.
People with depression may stop exercising, even when the body needs the natural stress fighting, mood lifting boost exercise offers. They may stop reaching out to their friends, or they may isolate themselves. They sometimes don’t get enough sleep or can get too much. They may binge-eat or do the complete opposite and may starve themselves, sometimes without even realizing it. Depression can alter the way the body functions. Stress hormones increase, digestion slows, and changes occur in the interactivity among connections in the brain. Some people may turn to alcohol or drugs, hoping to find relief.
Depression Types and Symptoms
Depression is a general term for a group of disorders that includes several forms. Some of these are (according to the National Institutes of Health):
- Major depression — the form that people most often think of when symptoms are noticeable. During bouts of severe depression, people lose sleep or are sleeping more, miss school or work, appear unable to enjoy life, and even may be at a point of suicide.
- Persistent depressive disorder — a low mood lasting more days than not for 2 years or more. Severe bouts may occur during the course of less severe symptoms.
- Postpartum depression (PPD) includes debilitating symptoms that occur for about 10 to 15 percent of new mothers, up to 18 months to 2 years following childbirth. Symptoms can overwhelm the ability to care for a newborn or maintain self-care, and can raise risk of suicide or harm to the child. Women who experience PPD and postpartum mood and anxiety disorders (PMAD’s) have a critically important need for understanding, support and treatment (to be addressed more fully in a future article).
- Seasonal affective disorder (SAD) includes debilitating symptoms that follow seasonal cycles, usually bringing out depression in the cold, gray winter months.
Everyone Feels Sadness; Depression May Go Unrecognized
Sadness occurs for everyone. Depression is widespread and often goes undiagnosed:
- Untreated depression is the number one risk factor for suicide among youth (Depression and Bipolar Support Alliance)
- Suicide is the 2nd leading cause of death for those aged 15 to 34 (CDC).
- Major depressive disorder is the leading cause of disability for people aged 15 to 44 (ADAA)
- Depression is one of the top 3 workplace concerns, topped only by family crisis and stress (DBSA)
- About 6.7 percent of Americans over 18 are diagnosed with major depression, says the National Institutes of Health (Huffington Post)
Each person with depression may experience it differently. In general, symptoms include:
- Feeling helpless or hopeless, like giving up – Nothing makes life feel better, there is no hope things will improve; a sense of emptiness makes it hard to get through each day.
- Little or no interest in activities or others – Little enjoyment comes from doing things that brought pleasure before; few good feelings come from relationships with caring friends and family.
- Trouble with sleeping and eating habits – You find you can’t sleep, or you oversleep; you find you always want to eat, even when you’re not hungry. You may be skipping meals, or feel apathy about eating. Your weight changes more than 5% each month, up or down.
- Irritability – Men, in general, often experience depression as a quick temper, loss of patience, or a short fuse. Women may tend to feel overwrought and driven to tears. Both may feel more agitated, annoyed or intolerant, like everything just grates on their nerves.
- Feeling worthless, self-loathing – Inability to see one’s own good points, berating one’s self as “dumb, ugly, stupid; ” feeling others only judge them and find fault with them; difficulty being influenced by caring and outreach from others.
- Being absent-minded – A person may seem forgetful, distractible or indecisive, or have trouble concentrating or paying attention. Some may even say these are symptoms similar to ADHD, inattentive type.
- Unexplained physical pain — Headaches, body aches, or stomachaches may occur without clear cause.
No matter the type or what the symptoms are, it is important to get help to treat and address depression, especially to avert the risk of problems that develop during the struggle to cope. While people can usually stop feeling sad on their own, it is possible for sadness to turn into depression.
Treating and Healing Sadness and Depression
Depression and sadness are both treatable with therapy.
When clients first seek help, my role as a therapist is to determine the nature of the difficulty and what kind of support is needed.
The first step is to explore — safely and gradually — where the need for healing is. With a trauma-informed approach, we remain mindful that larger issues may lie beneath the more visible symptoms. Often clients care most about immediate issues — they can’t get out of bed in the morning, they have no energy, or they just feel numb. Sometimes they can point to the source of their sadness; other times this takes more time and effort to uncover.
Sadness usually happens for a reason: “I’m sad we had to move,” or “I’m sad because my friend died.” There’s a defining moment for sadness.
Those struggling with depression may not know why they feel so low. They may even point out positive events such as a promotion at work, welcomed wedding plans, or a relationship with a safe, supportive partner. The debilitating symptoms are confusing: “Everything in my life is basically good. Why am I sad?” It may seem the symptoms do not make sense.
Creating a Safe Place to Face Personal Challenges
Treatment begins with building a safe, supportive environment. Trauma-informed therapy occurs within an empathetic, therapeutic relationship. Emotional safety is our primary resource, like a protective force field around everything we do. This provides a secure feeling that: “I can tell my therapist what is on my mind, they are not going to judge me, dismiss me, be angry with me or shame me; they are going to walk alongside me.”
Taking Time for Sadness
Recovery from sadness is fairly simple. We take time to notice and experience the grief or disappointment. As the popular movie “Inside Out” dramatized so well, sadness enables empathy. Sadness can deepen our capacity to honor all of our emotions, and even integrate them.
Sadness is necessary to restore emotional balance after difficult losses and changes. Allowing it to run its course also opens the heart to deeper self-awareness, acceptance and joy.
Recovery from depression is a different process. It will require more time, hard work, and courage.
Taking Small Steps to Treat Depression
Once it is grounded in safety and trust, therapy for depression helps build a stable foundation for lasting healing. Healthier life habits and good self-care are a big part of establishing stability to support recovery from depression.
Small changes can make important improvements. You and your therapist may decide to start with better sleep, for example. You may talk about turning off the screen or putting the phone away an hour before you go to bed. If the struggle involves overeating, therapy may touch on what else you might do when feeling depressed. Could you go for a walk? Could you call a friend? Could you write down what is going on for you?
Sometimes depression may make even small changes seem like too much. It may take special effort to work on them. You and your therapist may consider antidepressant medication to help you care for yourself the way you want to.
Beneath this foundation is the principle of self-care. Depression can make it hard to imagine positive change, let alone make it happen. Opening up to self-care and self-compassion through therapy allows hopelessness and self-criticism to move aside so that alternative views can form. Kind, gentle curiosity allows new ways for the mind to think things through.
Addressing Underlying Issues
The work of therapy involves learning to notice. Therapists will draw upon extensive training, experience and therapeutic approaches to help clients notice their thoughts, feelings and experiences in ways that may feel difficult, but that are also safe.
Depression can be a huge challenge to a person’s ability to observe, notice and honor what lies beneath the sense of emptiness and despair. In the interim, while someone is learning how to take notice, the therapist is noticing. Work in therapy helps establish a gentle process of bringing attention to sensations in the body, memories, thoughts and feelings, and how they may impact the way a person goes through life, because so much of this inner activity has been happening outside of awareness.
Refocusing Attention to Empower Change
We know from neurobiology that the brain has plasticity, which means it is open to change, even in adulthood. Therapy helps us empower ourselves to move from unhealthy to healthier ways of functioning, mentally and emotionally. One key to helping the mind make positive change is to focus attention on how we make sense of our experience. As author and neurobiologist Dan Siegel describes it:
When you learn to focus your attention on the nature of the mind itself, you actually can rewire important parts of the brain that help regulate how your entire nervous system functions – so, for example, how your body regulates itself, how you balance your emotions – and also how you engage in relationships with other people. It also changes the way you relate to someone very close to you, how you relate to yourself.
By noticing deeper emotions and thoughts in therapy, we may find unresolved feelings that still need to be seen and held with compassion.
“Name it to tame it” is a phrase Daniel Siegel coined to promote wellbeing by calming emotions with awareness. When we “name and tame” the thoughts and feelings we are experiencing, we can begin to see their role in our behavior and relationships. If old reaction patterns have been “calling the shots” up to now, noticing and naming them allows us to recognize them and re-direct their energy, instead of being driven by them.
What Recovery From Depression Looks Like
It may take great effort for people with depression to learn how to integrate new ways of seeing themselves and the world. Small steps are a good way to make changes that build on each other. Healing happens slowly, one change at a time. At first suggestions may come from therapy. Later, you may find yourself ready to consider one improvement at a time, for example:
- Could you do one social thing this week?
- Could you reach out to one friend this week?
- You once enjoyed hiking; could you go again?
You know you are seeing recovery begin when you look back on a week and realize you had coffee with a friend, or that you got more sleep three nights in a row, or that you did actually go for a walk. As you recover, you learn how to manage your symptoms so that they no longer feel overwhelming.
With recovery, a person with a depressive disorder will feel like they can see the light at the end of the tunnel – that there is a glimmer of life again.
Healing from depression takes great strength and persistence. Reaching out for support is a sign not of weakness, but tremendous strength and courage. Facing depression and learning to manage and heal from debilitating symptoms is admirable and deserves our utmost respect.
Many of us face life’s challenges unaware of each other’s struggles. By understanding how to recognize the difference between sadness and depression, more of us can help and encourage each other to find the support they need.
- Tara Brach: Meditation, Emotional Healing, and Spiritual Awakening
- Health Journeys
- Sounds True
- Postpartum Support Virginia
- Postpartum Support International
- Depression and Bipolar Support Alliance
- Breathe2Relax (free)
- Universal Breathing, Pranayama (Under $10)
- Yoga Nidra Lite (Lite version is free)
- Calm (free)
- Letting Go of Self Destructive Behaviors, a Workbook of Hope and Healing by Lisa Ferentz (includes details about the CARESS technique)
- The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment (Norton Professional Book) by Babette Rothschild
- Mindsight: The New Science of Personal Transformation by Daniel Siegel
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