By Marc Wolford, CFMHE Marriage and Family Therapist Trainee
Understanding Depression: More Than Just Feeling Sad
The depression obsession
I feel like I can’t go more than a day without hearing the word “depressed” or “depression.” Granted my vocational path has something to do with it, but the rampant use of the word over social media and on reality television makes me think that I’m not alone. Unfortunately, this is for good reason. At least 8% of Americans experience diagnosable Major Depressive Disorder each year (Quick Facts and Statistics About Mental Health, n.d.), and the frequently accompanying self-harm has made recognizing depression symptoms a mainstay of clinical training. Major Depressive Disorder is a mood disorder, which includes some other well-known mental health conditions such as Bipolar one and two, Persistent Depressive Disorder (formerly dysthymia), and many others (American Psychiatric Association, 2022). This post will help you understand what depression can look like, some basic self-care strategies for mood improvement, and how to seek professional help. This blog post is intended to provide information to augment professional therapy and is not intended as medical advice, or a replacement for therapy.
What is depression?
Before we go any further it’s important to ask, “what is depression?” The answer is somewhat complex, so feel free to skim this section. Colloquially the term “depressed” is often used to mean “sad,” “melancholy,” or “despairing”, but when a therapist or health professional uses the term “depression” it often has a more specific meaning. At its most basic level, professional use of the word “depression” is close to its common usage. It refers to a lower mood, often characterized by lessened arousal and negatively valenced emotions such as loss or fear (Jackson & Robinson, 2022). More commonly, a mental health professional will use the term “depression” to describe a diagnosable major depressive episode. A major depressive episode is a two-week period with symptoms such as decreased mood, or loss of interest or pleasure that impact the ability to function (American Psychiatric Association, 2022). There are other criteria for this as well, but I will omit them for the sake of time.
The different “flavors” of depression
The presence of a ‘major depressive episode’ is the hallmark feature of Major Depressive Disorder or MDD. MDD is possibly the most common depression diagnosis (Quick Facts and Statistics About Mental Health, n.d.), but there are other depressive disorders as well, such as Persistent Depressive Disorder (PDD), where symptoms span years, and are sometimes more innocuous. Substance/Medication-Induced Depressive Disorder is another, and Premenstrual Dysphoric Disorder which is an escalated version of premenstrual syndrome (Clay, 2023), is also included in the depressive disorders. Confusing, right? To make matters more complex, it is possible to experience a Major Depressive Episode during Persistent Depressive Disorder. When this happens, a therapist or healthcare provider may give both MDD and PDD as a diagnosis. This is sometimes referred to as “double depression.” The last term I’ll cover here is “treatment-resistant depression.” This is a specific term to denote a depressive disorder that affects roughly 30% of those suffering from MDD. Treatment-resistant depression is generally understood to be a depression that persists through treatment with two classes of antidepressants (Treatment-Resistant Depression, 2023).
The Power of Self-Care in Mental Wellness:
What is self-care? And why does it matter?
Self-care is becoming a more popular term and is a useful tool in the toolbox of mental wellness against mood disorders. Self-care strategies are varied. It can be something simple, like taking a shower, or as complex as a game of chess. A self-care activity is generally understood as intentionally setting aside time to do what you need to improve your mental or physical health (Caring for Your Mental Health, n.d.). I think of it as any activity that will give you strength. Some of the more common forms of self-care are proper sleep, eating well, catching up with a friend, exercising, and spending time with family. However, there are many many more! While self-care alone is not usually enough for depression treatment, it is a protective factor against depressive symptoms (Di Benedetto et al., 2019).
Self-care for mental wellness
Mood disorders in general are somewhat difficult to treat, but there are many things you can do to augment treatment as well as increase your mental wellness. Some of the best self-care strategies for mood improvement share the concept of winning easy battles. This (usually) does NOT mean attacking the biggest thing on your to-do list, or embarking on an arduous task that you feel like you should do. Self-care generally does not leave you overwhelmed or feeling unpleasantly depleted (I add ‘unpleasantly’ to allow for my fellow vigorous physical activity enthusiasts). For someone suffering from severe symptoms of MDD, just opening a window and taking time to feel the breeze can be very productive self-care. For someone experiencing different symptoms, self-care could be a movie night with friends. In all cases, taking a moment to check in with yourself is essential. Even if you struggle with meditation, pausing for a few moments to ask, “What do I need right now?” can be all it takes. Once you have an idea of what sounds good, ask yourself further, “Will this leave me better off once I’m done.” For example, if you ask yourself “What do I really need right now?” and the first thing that comes to mind is “I would like to sleep for an entire day,” unfortunately, not many people can sleep for an entire day and feel great when they wake up (although maybe there are exceptions out there). Taking a second to check if your self-care idea will actually add to your mental wellness once it’s over can help screen out unproductive impulses or stress responses.
If you’re having difficulty coming up with some self care-activities here are some suggestions:
- Going for a walk
- Enjoying a favorite snack
- Playing a game with family
- Listening to a song or album by an artist you love
- Spending a few minutes in a quiet place with your eyes closed
- Catching up with/reaching out to a friend
- Watching a relaxing YouTube video
- Journaling
- Attending a religious service
- Going for a drive with the windows down
- Taking a long shower/bath
- Cooking a well-balanced meal
- Going to the gym
- Reading a good book
- Spending some time meditating
- Letting yourself spend some time on a hobby you enjoy
- Going to the beach and soak in the sensations around you (warm sand, the sound of the waves, the taste of salt, etc.)
- Going out with friends
- Doing some gentle stretches or physical recovery activities (roll out with a foam roller or tennis ball)
When self-care isn’t enough for depression treatment
As I mentioned earlier, self-care has been shown to be a strong protective factor against depressive symptoms. It alone isn’t often suggested as a treatment for depression, so remember that if you recognize depression symptoms, it is often best to consult a professional. Licensed therapists can help you better understand where your symptoms are coming from and what you can do about it. Fortunately for anyone who is experiencing depressive symptoms, there is plenty of research around what interventions work best for depression.
Possibly the most studied is cognitive behavioral therapy or CBT. Cognitive behavioral therapy for depression usually involves your therapist asking you questions to understand how you view the world, and why you see it the way you do. Therapists using CBT might encourage you to be aware of your thought life, as CBT holds that thoughts give rise to feelings. Identifying unhelpful beliefs and the thoughts that they create can help alleviate some of the unpleasant feelings of worthlessness or loss that often appear with depression. Mental wellness is complex, and the right treatment for depression can often involve medication, therapy, your physical health, and unsurprisingly, self-care.
Seeking Professional Help for Depression
If you or a loved one are experiencing symptoms of depression, remember that professional support can make a difference. The Center for Mental Health Excellence (CFMHE) is committed to providing accessible, evidence-based mental health care for all.
We offer free fifteen-minute consultations for anyone interested in learning more about therapeutic support. This initial conversation can help you understand how our personalized, culturally sensitive approach might be beneficial, whether for yourself or someone you care about.
If you’re considering professional support or have any questions about our services, we encourage you to contact us. Our team is here to provide information and support for those exploring options for depression treatment and enhanced self-care. We’re ready to assist you on your journey to better mental health.
About the Author:
Marc Wolford is a Marriage and Family Therapist Trainee at the Center for Mental Health Excellence (CFMHE). He specializes in Substance Use, Spirituality and Weight Loss. To learn more about Marc or to schedule a consultation, visit his profile.