Separating Sadness From Depression

Sad movies are popular. People read sad novels and get in touch with the feeling. However, in our daily lives, sadness is a bittersweet memory of what once was.

This normal and natural emotion accompanies a loss of something or someone you value. It can be brief. It can linger. Sadness can reappear on the date of a loss, from looking at a picture, a situation, a passing thought—practically anything that you associate with the loss that holds meaning for you.

It is because we form attachments with people, with animals, and with ideals and places, that sadness carries through our lives. The size of the loss doesn’t matter. A child who experiences the loss of a goldfish weeps at a loss that others might find trivial. It’s not trivial. This loss is as real as any other is.

Losses come in different ways at different times. The loss of a tradition can evoke sadness. You may miss and feel sad when your children grow to adulthood and leave home to live on their own. The death of a close friend may leave you with a lingering feeling of loss. All sad. All inevitable.

When my childhood friend Al’s teen-aged daughter died, I saw my six-foot-five, 350-pound friend collapse in sadness and despair. He asked, “How will I ever get through this?” There was no answer. There was only time. I supported him as best I could. I wrote a poem in her memory. I wished I could have done more.

Within the year of his daughter’s death, Al died from cancer. I felt a great loss. Sadness still awakens within me when I think of happier times. When I visit his grave, I bury an old coin in the ground. Silly? Perhaps. Al loved to collect old coins. There is nothing wrong with feeling sentimental.

Sadness is a tribute. If there were no meaning to our relationships, there would be no sad feelings. There are sad times because there were once happy times, cherished times, and valued attachments.

Sadness reminds us that we are human. It is part of our biology and our heritage. If you accept that reality, you may find that you don’t go through phases of denial, anger, and resignation following a major loss. You may avoid depression. Acceptance of sadness is enough. Meanwhile, write poetry. Organize a march to raise money for a cause. Paint. Walk. Solve a problem.

Loss. Sadness. Time to grieve. Time to heal. Time. Time. Time. It can go so slowly. There is acceptance. There is allowance. There is working through the process of loss. However, in situations where the loss came from a tragedy that is followed by depressive thinking and depression, it can take considerable time and work to come to grips with the experience.

Bob’s fiancée, Jane, died hours before their wedding. It was a tragic automobile accident. Bob felt numbed and grief stricken. Three years after this tragic event, Bob continued to feel great guilt and depression. He told himself, “If only I had phoned Jane before she left, she would have gone through the intersection at another time.” He told himself, “I can’t live without her.” He believed, “I will never find anyone like Jane.” A cloud of hopelessness covered his life, and his depressed mood was both deep and painful.

Bob stopped doing what he once enjoyed. An avid tennis player, Bob let his racquet gather dust. There were no more dinners with his friends. As he drew within himself, he withdrew from his family. Previously a successful accountant, Bob quit. Thereafter, he mostly did odd jobs, such as buffing automobiles.

Bob felt overwhelmed by the details of daily living. His mood was despondent. He awakened in the middle of the night with a frightening image of the accident that took Jane’s life. He compounded his profound sadness with defeatism, pessimism, and self-loathing.

As he learned to defuse the negativity in his thoughts, and to accept his lack of control over Jane’s tragic death, Bob’s inner turmoil softened to sadness. Months later, he resumed his accounting career. At the time of this writing, he is happily married with three children. His family is a source of great joy. Has he forgotten about Jane? Jane lives on as a cherished memory.

Loss is inevitable. Sadness is inevitable. But, depression is not inevitable. Sadness, you accept. You deal with depression.

When sadness changes to depressive darkness, it’s time to look for a flashlight.

By Bill Knauss, Ph.D.

Singin’ the Blues

Depression isn’t about feeling sad and blues music isn’t about depression.  A great piece by lawyer turned therapist Will Meyerhofer.  Read the Blog

Adventures in Depression

From the blog Hyperbole and a Half, an well-written take (including cartoons!) about one person’s experience with depression and feeling bad for “no good reason”.  Read the Blog

Lawyer Blues or Depression?

The opposite of depression is not happiness, but vitality – the ability to experience a full range of emotions, including happiness, excitement, sadness, and grief.  Depression is not an emotion itself; it’s the loss of feelings, a big heavy blanket that insulates you from the world yet hurts at the same time.  It’s not sadness or grief, it’s an illness. –Richard O’Connor, Ph.D.

I can spot sadness on lawyer’s face.  Like a craggy poker player reads dog-eared cards in a smoke-laden backroom bar, world-weary drooped eyelids, even on young lawyers, which suggests a great weight borne, a solemnity.  To others, their expressions may seem like a seasoned lawyer’s humorless, steely resolve. But, I know better.  Their faces a subtler shade of grey, the somber hue of a 1L’s textbook on Contracts.

Their humorous repartee among each other, if any, can be deeply cynical and sarcastic. It is a tough life for many in this boat; many dream, sadly, of a different life.  “Every man has his secret,” wrote the poet Henry Wadsworth Longfellow, “which the world knows not; and often times we call a man cold when he is only sad.”

It’s normal to “feel the blues”, a sadness that colors our lives from time to time like the reds of anger, the greens of envy.  Sadness is the price we pay to experience its opposite: happiness.  Carl Jung, a protégé of Sigmund Freud, wrote, “Even a happy life cannot be without a measure of darkness, and the word happy would lose its meaning if it were not balanced by sadness”.

Sadness

Sadness is not clinical depression – – not by a long shot – – because while sadness is an emotional response to a loss, depression is a loss of feeling; the absence of a wide array of emotions replaced by psychic pain.

There are two major differences between the blues and depression: the length of time the sadness endures and whether or not there are other symptoms associated with depression which are tagging along with the perpetual sadness. “I think the difference between just having the blues and depression lies in the symptoms,” said Raymond Crowe, M.D., UI professor of psychiatry. “If ‘the blues’ persist for more than a couple of weeks and are accompanied by trouble eating, difficulty sleeping, or suicidal thoughts, you should see someone.”

J.K. Rowling, the creator of that mischievous and bespectacled wizard Harry Potter, makes this distinction:

Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.

Psychiatrist Peter Kramer, author of Against Depression, underscores the point that depression is a serious illness and not ordinary sadness:

For the psychiatrist, then, depression becomes an intimate.  It is poor company.  Depression destroys families. It ruins careers. It ages patients prematurely. It attacks their memories and their general health. For us – for me – the truth that depression is a disease is unqualified.  Depression is debilitating, progressive and relentless in its downhill course, as tough and worthy opponent as any doctor might choose to combat.

It’s important to recognize the difference between sadness and depression because a suffering lawyer will not be able to resolve the depression by himself; talking it out with a group of work pals over some Old Milwaukee’s after work just won’t get to the bottom of the problem.  This person will need a mental health professional to help evaluate him to see if he has depression, and, if so, to get him the serious help he needs.

Others simply do not have a reference point for depression unless they have been through it before.  Have they known loss and sadness? Yes.  The deep psychic pain of depression?  No. So they misidentify a person with depressive symptoms as having the blues which can have severe consequences because the more people do so, the greater the isolation, the greater pit of desolation the depressive falls into because no one understands and because they do not understand, it becomes hard for them to seek out help.

This commingling of sadness and depression is confusing – – and dangerous.  This is so because a sufferer and those around him may underestimate the gravity of the situation: “Bob is just sad, going through a tough patch at the law office.  He’ll get over it.”

But, Bob might not.  He may get worse.  The depression may deepen.  He may need medication that he’ll never get. He may need to talk to a therapist to address the distorted thinking that goes on during a depression. He may need medication to lift himself out of the darkness. Absent such help and hope, he may commit suicide.  As much as 80% of suicides are committed by those struggling with depression and lawyers have much higher suicide rates than the general population.

Not only do others misunderstand and mislabel a depressed lawyer’s symptoms as regular sadness, the depressive himself often does not know what is going on inside him or herself.  He himself may be confused because while he knows what sadness is, he senses something bigger than sadness – – and much worse – – may be happening to him.  He senses something is deeply wrong, but might ignore the red flags, or symptoms of depression, because he doesn’t know what they mean. If he’s never experienced major depression before, he doesn’t know that they’re harbingers of something awful, a turbid wave about to hit his bow.

Grief

Grief, a close cousin of sadness, has several symptoms in common with major depression because its symptoms are more layered than everyday sadness: the sadness is accompanied by sleep problems and poor appetite, for example.

Another significant difference between the two is that grief tends to be trigger-related:  People that are grieving tend to feel better in situations where they have heart-felt support, but have their grief triggered by things that remind them of their deep loss such as their wedding anniversary which they no longer enjoy because their spouse has died.  Andrew Solomon sums it up best, “Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.”

The reason for the differences between sadness and depression is because with the former we are dealing with a normal human emotion which is transitory – – it will change, subside and be replaced with other emotional experiences.  Depression is not transitory because it is an illness going on in the brain, a system unable to ward off serious psychic pain.

These losses are stressful, but not, in themselves, necessarily depressing in a clinical sense. Peter Kramer, M.D., writes:

Depression can be set off by a variety of stressors: sexual abuse, housing problems, illness in one’s child, and the other common problems you might imagine. To suggest that depression arises from loss is to skew the argument in the direction of the metaphor . . . , the one that likens apparent depression to ordinary bereavement. Likewise, “sadness” does not capture the essence of depression, which is a marked disruption of brain and mind characterized by painful apathy. Not only in degree but also in quality, sadness and depression are different.

So, look at the nature of your pain and others.  Is it something you can relate to some loss?  If so, it’s probably sadness. If not and there are a few symptoms of depression, bereavement that will pass at some point after a major loss.  If not, the culprit is probably depression.

 

 

 

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