Depression is the most common form of mental illness. Millions upon millions of people suffer from it. First, we must distinguish between bipolar depression and unipolar depression, which is what most people have. Bipolar depression is far less frequent, but exponentially more severe. People with unipolar depression are more or less depressed all the time—but the risk of suicide is much lower. I have no personal experience with unipolar depression, but I have many friends who do, so I think I can speak with authority on it.
most clinical depression is chronic, like most adult diseases. we get the wrong idea when we are little kids or have little kids. we think illnesses are like strep throat or middle ear infections: take the meds 5-10 days and you're done.
adult diseases like high blood pressure, diabetes, cardiovasular disease, are chronic and require chronic treatment. if you have a single episode of clinical depression you might get off antidepressants and stay off them. once you've had 3 episodes, accept that it's chronic and stay on the meds that helped you. 2 episodes: depends on how severe, how quick in onset, how dangerous, personal preference.
sometimes i tell people that part of my job as a psychiatrist is telling if they're depressed [clinically] or just miserable. don't mistake situational suffering for clinical depression. the former might trigger the latter, however, so it might take a professional to really tell the difference.
unipolar depression is more likely accompanied by diminished or disturbed sleep, while bipolar depression often has excessive sleep. bipolar mixed states - excess energy usually in the form of irritability, agitation, raciness, and diminished sleep accompanied by depressed mood, is really uncomfortable and really dangerous. this is the state that is most likely to lead to suicide.
if you can exercise yourself to a better mood, good for you. but there's no shame in getting checked out by someone who understands these things. getting checked out doesn't commit you to meds or treatment of any kind. so don't make a big deal of getting checked out if you're suffering. maybe you're just miserable.
Thanks for this very good piece of advice, Jared. I have a daughter who is close to a depression so I will share it with her.
One additional piece of advice is to have a pet in particular a dog or a cat and I know how much you are in love with cats, I think you have 5 of these. Now I am at a risk of getting depressed these days as my only cat that I love a lot, is probably dying. He is suffering from kidney failure and the treatment does not seem to work anymore. I am at a loss on how to deal with this situation as it makes me extremely sad and I wish I could help the cat effectively. I thought writing down these things is one way to address the issue and that is one reason why I am doing it. And I believe in your advice that this too shall pass.
Excellent piece here Jared: Well written with practical advice. Depression is complex and difficult to discuss due to definitions and a lot of variables. One think that factors in is reactive vs endogenous. The former is mood impacted by external 'bad stuff' (abuse, trauma, loss, etc.); The latter is more medically driven (med side effects, endocrine disorders, etc.) An over simplification and often co-existing but a factor that helps sort things out.
Glad to see you get both positive feedback and good clinical info in Comments. BTW, your 1st statement is incorrect: The most common mental disorder (according to most experts) is anxiety, not depression. Keep up the great work; I enjoy DDN and the free stuff but have some confusion due to the transition to the web site.
I was very depressed when I was young. I bottomed out and decided I wanted to be a happy person. I studied what happy people did. Went to some therapy sessions and worked at it. It took 2 years to be happy more often that not. That was decades ago and I still have my periods of depression and went through a period of health related chemical depression. I agree with everything in the essay. Anyone can be miserable, being happy takes work.
This is good stuff - practical, helpful, and written with your usual clarity and style.
most clinical depression is chronic, like most adult diseases. we get the wrong idea when we are little kids or have little kids. we think illnesses are like strep throat or middle ear infections: take the meds 5-10 days and you're done.
adult diseases like high blood pressure, diabetes, cardiovasular disease, are chronic and require chronic treatment. if you have a single episode of clinical depression you might get off antidepressants and stay off them. once you've had 3 episodes, accept that it's chronic and stay on the meds that helped you. 2 episodes: depends on how severe, how quick in onset, how dangerous, personal preference.
sometimes i tell people that part of my job as a psychiatrist is telling if they're depressed [clinically] or just miserable. don't mistake situational suffering for clinical depression. the former might trigger the latter, however, so it might take a professional to really tell the difference.
unipolar depression is more likely accompanied by diminished or disturbed sleep, while bipolar depression often has excessive sleep. bipolar mixed states - excess energy usually in the form of irritability, agitation, raciness, and diminished sleep accompanied by depressed mood, is really uncomfortable and really dangerous. this is the state that is most likely to lead to suicide.
if you can exercise yourself to a better mood, good for you. but there's no shame in getting checked out by someone who understands these things. getting checked out doesn't commit you to meds or treatment of any kind. so don't make a big deal of getting checked out if you're suffering. maybe you're just miserable.
Bang on the money with this. I only read your free stuff but I think your writing is excellent. And keeps getting better. 👍
Thanks for this very good piece of advice, Jared. I have a daughter who is close to a depression so I will share it with her.
One additional piece of advice is to have a pet in particular a dog or a cat and I know how much you are in love with cats, I think you have 5 of these. Now I am at a risk of getting depressed these days as my only cat that I love a lot, is probably dying. He is suffering from kidney failure and the treatment does not seem to work anymore. I am at a loss on how to deal with this situation as it makes me extremely sad and I wish I could help the cat effectively. I thought writing down these things is one way to address the issue and that is one reason why I am doing it. And I believe in your advice that this too shall pass.
Excellent piece here Jared: Well written with practical advice. Depression is complex and difficult to discuss due to definitions and a lot of variables. One think that factors in is reactive vs endogenous. The former is mood impacted by external 'bad stuff' (abuse, trauma, loss, etc.); The latter is more medically driven (med side effects, endocrine disorders, etc.) An over simplification and often co-existing but a factor that helps sort things out.
Glad to see you get both positive feedback and good clinical info in Comments. BTW, your 1st statement is incorrect: The most common mental disorder (according to most experts) is anxiety, not depression. Keep up the great work; I enjoy DDN and the free stuff but have some confusion due to the transition to the web site.
WWWinn (Psychiatrist)
Thanks for writing this. It means a lot.
Such wise words. Thank you.
I was very depressed when I was young. I bottomed out and decided I wanted to be a happy person. I studied what happy people did. Went to some therapy sessions and worked at it. It took 2 years to be happy more often that not. That was decades ago and I still have my periods of depression and went through a period of health related chemical depression. I agree with everything in the essay. Anyone can be miserable, being happy takes work.