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When Depression Hits
The Differences Between Sadness and Depression
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AnnaMarie Houlis,
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Journalist & travel blogger
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If you're feeling depressed, you're far from alone.

Major depressive disorder affects approximately 17.3 million American adults, or about 7.1 percent of the U.S. population ages 18 and older, in a given year, according to a 2017 National Institute of Mental Health “Major Depression” study. And, major depressive disorder is more prevalent in women than in men, according to the "Journal of the American Medical Association." In fact, women are almost twice as likely as men to have had depression, according to the Centers for Disease Control. 

But how do you know if you're just sad or if you're actually depressed? After all, what's the difference between sadness and depression?

What is depression?

Depression is nuanced, and it takes form in a variety of different ways.

"Depression (major depressive disorder or clinical depression) is a common but serious mood disorder," according to the National Institute of Mental Health. "It causes severe symptoms that affect how you feel, think and handle daily activities, such as sleeping, eating or working. To be diagnosed with depression, the symptoms must be present for at least two weeks."

That said, some forms of depression are different, as they may develop under unique circumstances. Here are a few examples.

  • Persistent depressive disorder (also called dysthymia): Persistent depressed disorder is "a depressed mood that lasts for at least two years," according to the National Institute of Mental Health. Someone living with persistent depressive disorder may experiences episodes of major depression, as well as periods of less severe symptoms.
  • Postpartum depressionPostpartum depression refers to, essentially, a more severe form of the "baby blues." New mothers may experience postpartum depression (extreme sadness, anxiety and exhaustion), which makes it difficult for them to care for both themselves and their new babies. Unlike the baby blues, postpartum depression doesn't sizzle out when new moms get adjusted to motherhood in a few weeks' time.
  • Psychotic depression: Psychotic depression occurs "when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations)," according to the National Insitute of Mental Health.
  • Seasonal affective disorder: Season affective disorder happens during the winter months, when there is less natural sunlight, and it typically lifts during the spring and summer. It's characterized by social withdrawal, increased sleep and weight gain, and it predictably returns every year, according to the National Insitute of Mental Health.

All in all, depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease, according to the World Health Organization. In fact, depression usually accompanies other illnesses, like the following, according to the National Institute of Mental Health:

  • Cancer: 25 percent of cancer patients experience depression
  • Strokes: 10 to 27 percent of post-stroke patients experience depression
  • Heart attacks: One in three heart attack survivors experience depression
  • HIV: One in three HIV patients may experience depression
  • Parkinson’s Disease: 50 percent of Parkinson’s disease patients may experience depression
  • Eating disorders: 50 to 75 percent of eating disorder patients (anorexia and bulimia) experience depression
  • Substance use: 27 percent of individuals with substance abuse disorders (both alcohol and other substances) experience depression

What are the symptoms of depression?

The symptoms of depression vary from person to person. Not every person who is depressed will experience every single symptom associated with depression. That said, typically, depression manifests as such:

  • Persistent sadness
  • Continuous anxiety
  • Feelings of emptiness, hopelessness or pessimism
  • Extreme irritability
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest or pleasure in work, hobbies and other activities
  • Decreased energy and increased fatigue
  • Restlessness
  • Difficulty concentrating or remembering
  • Indecisiveness
  • Difficulty sleeping or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Physical aches or pains, headaches, cramps or digestive problems without a clear cause and/or that do not feel better with treatment

How does depression differ from sadness?

Depression differs from sadness in that sadness is a side effect of depression. While you may feel sad one day, perhaps following an upsetting experience, you may not actually be depressed. It's important to note that, in order for a person to be diagnosed with depression, their symptoms must subsist for at least two weeks.

What are the treatment options for depression?

There are several treatment options for depression. Some treatments work well for some people with depression, while others do not. The side effects of these treatments will also vary from person to person, so it's important that, if you're depressed, you consult your doctor about all of your treatment options.

In short, depression is usually treated with medications, psychotherapy or a combination of the two.

Many types of antidepressants are available, including the following:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants
  • Monoamine oxidase inhibitors (MAOIs)
  • Other medications added to an antidepressant to enhance antidepressant effects

Meanwhile, psychotherapy is a "general term for treating depression by talking about your condition and related issues with a mental health professional," and is also known as "talk therapy" or "psychological therapy," according to MayoClinic.

For others, doctors may recommend other procedures such as brain-stimulation therapies like the following:

  • Electroconvulsive therapy (ECT): The use of electrical currents passed through the brain to impact the function and effect of neurotransmitters to relieve depression
  • Transcranial magnetic stimulation (TMS): The use of a treatment coil placed against the scalp to send brief magnetic pulses to stimulate nerve cells in the brain involved in mood regulation and depression

Up to 80 percent of those treated for depression do indeed show an improvement in their symptoms generally within four to six weeks of beginning their medication, psychotherapy, support groups or a combination of those treatments, according to the National Institute of Health.

Again, different treatments affect different people in different ways, and the side effects can sometimes be worse than the symptoms of depression itself. For that reason, it's hugely important that you consult your doctor about all of your treatment options in order to pick the best treatment for you.

What resources are available for the depressed?

If you or someone you know is experiencing depression, reach out for help. There's a wealth of resources available to you to learn more about depression, research your treatment options and find doctors and support groups to help you get through it. Here are just a few to get you started:

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AnnaMarie Houlis is a feminist, a freelance journalist and an adventure aficionado with an affinity for impulsive solo travel. She spends her days writing about women’s empowerment from around the world. You can follow her work on her blog, HerReport.org, and follow her journeys on Instagram @her_report, Twitter @herreportand Facebook.

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