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Is it depression or normal sadness?
The Atlanta Journal-Constitution
Critics of psychiatry claim that doctors these days are too quick to diagnose patients as being depressed.
They say psychiatry has ‘medicalized’ normal sadness by failing to consider the social and emotional context in which people develop low mood — for example, after losing a job or experiencing the breakup of an important relationship.
This diagnostic failure, they say, has created a bogus epidemic of increasing depression. But psychiatrist Ronald Pies in a recent article suggests that diagnosing depression is a lot more complicated than it might seem.
What do you think? How can you tell if what you’re going through is just a case of sadness based on sad circumstances or depression?
Permalink | Comments (21) | Post your comment | Categories: Mental Health




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Comments
By ga girl
September 22, 2008 5:12 PM | Link to this
I can only answer to what I have gone through. I have had depression for 10 or more years and have being on meds. for it since. When it started I did not know what to think as it was news to me, a feeling I had never had before. It is really hard to explain except to say you are down and I mean down. You feel like you do not have a friend in the world and such a feeling of dread, sadness,don’t care, leave me alone and let me sleep. There is no energy to be had, just mope around. I had family and friends come to try get me out of house, talk to me and try to cheer me up, just to talk. In the beginning my Dr. put me on Prozac which was a miracle drug for me until It didn’t work for me anymore. To make a longer story short, I still take anti-drpressants daily and I still have days of sadness, but thats a lot different than depression. Sadness can go away,for me, by stimulation, and by that I mean a phone call,a good laugh, something exciting to do, and most of all praising God. God is our only refuge.
By Ann
September 24, 2008 8:59 AM | Link to this
We are living in a world of whiners. Pick yourself up and look at people in worse circumstances when you are feeling blue. Buck up. I lost my job because of a hand problem (I was a musician), six months into a pregnancy a year later I lost our child, and four months afterward my 37 year old husband died of a massive heart attack. I was sad and “down”, but never used the word “depressed”.
By Anita Jefferson
September 24, 2008 9:12 AM | Link to this
Sadness after a painful event, be it divorce, death, or downsizing, is a natural response which should not be medicalized unless the sadness becomes a prolonged life altering episode.
Depression is still stigmatized rather than accepted as a probable event since more and more people are emotionally jarred by the disastrous news about the economy, war, politics, pump price pain, calamities, or environmental threats. These real news items can and do influence our mood and outlook.
Thus, it may take more stimulation to have a “good” day, to climb these obstacles.
Normal sadness can become depression if the cumulative emotional reaction lingers and suppresses a joyous, hopeful state of mind.
Physicians should take into account the scale of devastation, the context around the sadness, and other precipitating factors presented by the patient. In essence, get to know who she or he is in multiple sensitive engagements before prescribing medication. This is what my doctor did for me when my sadness became depression and I needed a lift.
By ida
September 24, 2008 9:52 AM | Link to this
This is to Anita. You are so right and so strong. Sometimes we have to pick ourselves up by the bootstrap and go on. God is our strengh and source. I too have loss a child. And yes I have sad times, but I still can find beauty in life and something to smile about.
By CS
September 24, 2008 10:10 AM | Link to this
From my experience, there is a clear difference between being sad and true depression. Sadness and many other emotions are a facet of being depressed, but when in depression, despite what many who have not been there think, there is no thinking your way out of being depressed. Sometimes, it may not be deep but other times, depression can be debilitating. Only those trained to deal with it can help and my experience was that they were careful in using meds but at least in my case, that was the only resolution.
By Ann
September 24, 2008 10:29 AM | Link to this
I know when I am sad vs depressed. At this point in my life, I realize that there is so much depression in America. As a middle-age female, who has experienced one loss after another, so much to the point, that I feel totally helpless and at the mercy of society as a whole. I am so afraid of the side-effects of medications, however, I do know that they can be helpful.I am concerned about counseling because I have seen so many women stigmatized after they had been diagnosed and then counseled and provided medication. Does anyone have any advice for me?
By Matt
September 24, 2008 10:45 AM | Link to this
Ann,
You are an idiot. Did you even read the article? You say that you were “sad and down,” but you had tragic events in your life that caused you to feel that way.
Depressed people are depressed because they are depressed. There is no “bucking up” to do for us, it comes without warning. It can come because it’s raining outside, because a favorite TV show isn’t on, because you remember a time in your past and friends you haven’t seen in years…..
People like you calling depressed people whiners? Thanks for doing your part to be callous and helping ensure the suicide rate in this country remains high.
By Wanda
September 24, 2008 10:58 AM | Link to this
I wanted to respond to what Ann said. When you are in depression you can’t look beyond but what is going on with you. It doesn’t matter to you what is happening to other people that are worse off than you. Everyone handles things differently. They are not being winers. There is a big difference in being sad and being in depression. You need to think before you speak.
By Karen
September 24, 2008 11:00 AM | Link to this
As one person said, for those who have not been clinically depressed, it is difficult to explain the extent to which the deep sadness, sleepiness, overall debilitating effects of the disease affect several or many aspects of your life; this is something a physician should be trained to assess.
As for the “stigma,” there are always going to be persons who will not understand. I just would be careful about whom I tell and know that if they find out they might not understand the depth that the disease truly can “cripple” one. I’ve heard negative remarks now for 16 years, but the counseling and medication have made my life so much better, I would never consider going off the medicine. It is a disease that is genetically predisposed. Again, some people will never understand. But the important thing is for you to care for yourself as you would a daughter or son who had the disease.
By itpdude
September 24, 2008 11:25 AM | Link to this
I would say Americans are depressed because we are at the point, societally, that most of us are not with want. Sure, we want a vacation, we want that new car, we want that new gadget, but we are not wanting for food or shelter or protection from our “enemies.” The human basics, things the vast majority of humans struggled for and rarely achieved until the last 300 years, are now satisfied for the vast majority of Americans. And now what are we looking for that we really need to struggle for? We are now looking for things, that by and large, are easy to come by (look at the stuff we can now get online from sex to intoxicants to gadgetry that makes life “easier”) or take years to develop (relationships that are satisfying with spouses, partners, children, etc). We are in a paradox that leaves us in between things that are too easy to accomplish and too difficult to accomplish for many of us. Couple this with our increasing secularization and it is no wonder many of us are depressed: We simply cannot find meaning right here and right now.
By lizzylove
September 24, 2008 11:39 AM | Link to this
Ann
This is why in this day and age people are still pre-judging/not accepting of others who might actually have this disabilitating disease. Your remark is very ignorant. People with depression still do not seek treatment for the very reason you stated. Dumb people like you will tell them to “buck up” “suck it up”, etc. when in reality they are actually in need of stabilizing medications.
By Nurse Ratchet
September 24, 2008 12:05 PM | Link to this
In the last 8 years, here’s the rota:
1) head & neck cancer - ‘04 (survived - duh!) 2) lost 3-4 professional positions (software engineering) 3) bankrupted due to #1
In a nutshell, directly or indirectly due to cancer I’ve lost health, wealth, family and all sorts of other ancillary things along the way…
Am I depressed? You betcha (imagine that!)… but is it the end of the world? Nah… I’ve learned at some point, Father God continually comes along and His love covers me like a warm blanket. I understand (truly do) most of what I’m reading here on this blog, and empathize with each and every one of you. It sounds trite, but just hang in there - cause in the Bigger Picture of things, it’s not about life and adversity per se, but how you gracefully deal with the adversity while you’re here that counts…
No meds… just mind over matter. Eat right and do what you can to change the world around you. Be the change you’d like to see with the rest of the world…
Thanx for hearing me out, y’all… God’s Peace…
By whatever
September 24, 2008 12:22 PM | Link to this
Buck up?!?! Yeesh!
One thing I know is that I am not qualified to tell if someone is sad or depressed. On the one hand, there are those who are too quick to say, “I’m depressed. Medicate me.” On the other hand, there are those who say, “there’s no such thing as depression. You’re a weak loser. Suck it up.”
Cancer leaves a tumor, or two, or ten. Depression doesn’t. Depression may feel like cancer to those who have it, but too many people believe that if you can’t see it, it must not exist.
How can you tell if what you’re going through is just a case of sadness based on sad circumstances or depression? That’s a good, fair question. My answer would be to try something different, a new activity. Volunteer. Exercise. There are many options. If this new activity can help take your mind off of circumstances, then I think you’re said. If it can’t, then I think it’s worth spending a couple of bucks on a doctor, or a counselor, or a psychiatrist, and tell them what’s going on. You may still not be depressed. But at least you’ll know that you did something about it.
By jakesdad
September 24, 2008 12:25 PM | Link to this
depression is every bit a “real” disease as diabetes but unfortunately you can’t measure serotonin (/dopamine/etc) by pricking your finger. people w/clinical depression can no more “pick themselves up” than a diabetic can during a sugar drop or an asthmatic can just “gut it out” during an attack. everybody knows no oxygen in blood->drop dead and lots of people understand insulin but it’s amazing how many people want to deny that their brain’s function(s) depend on a proper balance of a small # of chemicals even though this is well-known/accepted in the scientific/medical communities. now that said there is some analogy to diabetes (/blood pressure/cholesterol/etc) in that there is a spectrum of severity with several non-drug things people can do to help themselves (exercise being near the top) and I don’t deny for a minute that there’s a lot of people taking a lot of pills out of convenience before exhausting their non-pharmaceutical options…
By UC
September 24, 2008 12:36 PM | Link to this
Some of these comments are truly heartless. It is obvious that anyone that has never experienced true depression knows what someone with depression is going through. Let’s be a little less judgmental and a little more sympathetic especially if we don’t know what we’re talking about. I also find it very sad that people in general are less accepting when it comes to mental illness.
By dondee
September 24, 2008 12:59 PM | Link to this
I pray that none of you are ever truly depressed. My mother has suffered with depression off and on for years. The attitude of “buck up” works in instances where you are not actually depressed or maybe have the strength to pull out of it. For many others, that is impossible. Society as a whole is still very uneducated about depression and what detrimental and long lasting effects are associated with it.
By Sonya
September 24, 2008 2:00 PM | Link to this
I am a member of the ‘sandwich’ generation. My parents and grandparents rely on me more, and my husband’s children and grandchildren know that we are always just a phone call away from solving the latest disaster. I grew up doing it all for everybody, all the time, and coupled with a career, planning for a retirement that keeps moving farther away, etc. the stress sometimes becomes unbearable. For me this sometimes translates into anxiety attacks. I had one on a street downtown last week, and a homeless girl/woman comforted me enough to get to my office building.
My doctor (a PCP) immediately wanted to medicate me - (Cymbalta). He said that it would make me feel more like ‘me’. After extensive study of the tiny writing on the patient info sheet, and a bit of internet research, I could not reasonably expect to feel anything like ‘me’ with the side effects that the information admitted to. I did this dance before a year or so ago with Lexapro, and I did not like it - I certainly didn’t feel like myself.
I can only speak for myself, because I do believe that depression is very real, and pharmaceutical remedies can be useful. But, the rub for me is that even though I think that my doctor knows me, he like a lot of other physicians are caught in symptom treating as mandated by HMOs.
After a few days of soul searching, and long conversations with my husband, I realized that, once again, ‘for me’, I just needed to slow down, rest, reprioritize, and take care of me first. The masses would get their piece of me in due time.
By Matt
September 24, 2008 2:02 PM | Link to this
Great comment jakesdad……..that’s exactly how to think of things. For a clinically depressed person, you can learn how to deal with things, but there’s no way to just snap out of it.
By Jason
September 24, 2008 2:47 PM | Link to this
Studies (Alloy and Abramson, 1979; Dobson and Franche, 1989) have shown that “depressed” people have a more accurate view of reality than “happy” people, who tend to have inflated self-images. So I’m not convinced depression is anything more than a term invented by people in denial of their own mediocrity to describe those who are honest enough to acknowledge—and in some cases lament—their limitations.
By lizzylove
September 25, 2008 3:31 PM | Link to this
So what happens to the person who seemingly has everything? The person that to the outside world would seem to have it all? ex: mother with beautiful healthy kids, husband, PTA member, nice home, and yet she has a hopelessness inside her, a feeling of worthlessness. What about her? Guess you would tell her to suck it up too, huh? Like one of the posters mentioned, depression is real and just because you can’t see it, doesn’t mean it doesn’t exist!
By Steve Lloyd
September 29, 2008 2:55 PM | Link to this
I have had depression all of my life. You do not “buck it up”. Depression is physical and mental. Everything can be right in your life, and you still feel like you wish you were dead. You always feel like you “are on the outside lookin in”. It does not take much at all to trigger an episode, that can last for days or weeks. Even when you are not having an episode, you still feel pretty down. The way society in general views depression seeme to me, to be incorrect. We are not losers, whiners, or nutcases. Most people with depression have alot to offer in life. We just have that chemical Imbalance