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Feeling Down in the Dumps
Everybody gets the blues. It’s natural to feel sad when you’ve experienced a loss—a friendship ends, a family member gets sick, a pet dies or you lose your job. Usually, these feelings are nothing to be concerned about. They’ll pass naturally.
But if you feel sad or down for most of the day, nearly every day, or you stop getting pleasure from activities that are normally enjoyable for you, and it’s been going on for at least two weeks, you may be depressed, according to psychologist Landau. Other symptoms of depression may include:
- enduring changes in eating or sleeping habits
- lack of energy
- feelings of worthlessness or guilt
- hopelessness or helplessness
- trouble concentrating or making decisions
- feeling empty or irritable
- thinking about your own death or suicide (If you have suicidal thoughts or feelings, especially any plans, see a mental health professional immediately.)
Even clinical depression can lie along a spectrum from mild to major. “Mild depression can be like the common cold—energy-draining and annoying—but not life-threatening,” says psychologist Ellen McGrath, Ph.D., founder of the Bridge Coaching Institute in New York City and chair of the American Psychological Association Task Force on Women and Depression. “But major depression is like a mood cancer: It can go into spontaneous remission, but it can come back, and it’s often a progressive illness for many people.”.
There’s an even trickier form of depression: dysthymia, which literally means “bad state of mind” or “ill humor.” It’s a chronic, but less severe, form of depression that’s been ongoing for at least two years. Because it’s so long-lasting, some people think this state of mind simply reflects the way they are (irritable or low in energy) or that it’s part of their personality (somewhat gloomy or pessimistic), rather than recognizing it as a mood disorder. “Dysthymia is so internalized that it almost approaches a personality issue,” Landau says. “Some women run around for years with a suitcase of sadness, always feeling negative or down.” Besides raising the risk of getting major depression on top of it—a phenomenon called “double depression”—dysthymia can increase your chances of developing substance abuse, heart disease and other health problems.
You can seek professional help. There is talk therapy, in the form of cognitive behavioral therapy, which focuses on changing your thoughts and behavior, or you can try interpersonal therapy, which focuses on improving your relationships. Antidepressant medications also are used to treat both major depression and dysthymia. “In neither of these situations is medication the only answer, but that’s what most people get,” Landau says. With the right combination of medication, therapy and lifestyle measures (like regular exercise), many people with major depression or dysthymia will feel better, so it pays to be persistent until you find the right mix for you.