Is it Depression — Or Just the Blues?

Even the happiest among us know what it’s like to feel down. The loss of a loved one, getting fired from a job or even a dear friend moving away can cause us a great deal of sadness. Sometimes those feelings can be overwhelming and last for days, weeks or even months. But there’s a difference between the kind of sadness that hits us when we experience a loss and the overwhelming malaise that signifies clinical depression.

“The blues will go away,” says Sally Winston, PsyD, Co-Director, Anxiety and Stress Disorders Institute of Maryland. “Depression feels as if you are stuck.”

While it might not be easy to distinguish between the two when you’re the one experiencing that pain, there are some very clear signals that can help us to determine whether it’s a normal case of the blues, or something requiring medical attention, says Dr. Winston.

“Depression is an illness,” she says. “It may or may not involve the feeling of sadness, but often it doesn’t. There are all kinds of other feelings involved: guilt, hopelessness, feelings of being worthless, or having no meaning in life.”

Depression can include physical symptoms as well, she says, such as sleeplessness, loss of appetite, headaches, loss of libido, aches and pains, and fatigue.

“But the signature aspect of depression is anhedonia — the loss of ability to feel pleasure. Things that would normally give you pleasure just fall flat when you are depressed,” she says.

Winston cautioned that people experiencing what they believe to be symptoms of depression should immediately be seen by a physician — not just because depression requires treatment, but because the symptoms could be caused by another illness making itself as depression.

“Many illnesses also cause this type of fatigue,” she says, “such as pulmonary disorders, cardiovascular disease and cancer. Practically every system in the body could have a disorder that could provoke depression-like symptoms.”

According to the National Institute of Mental Health (NIMH), depression can also co-exist with other illnesses, such as heart disease, stroke, cancer, HIV/AIDS, diabetes and Parkinson’s disease. It’s important to see a physician to seek treatment for both conditions, because research shows that people who suffer a medical illness along with depression will experience more severe symptoms of both. Likewise, treating the depression can help improve the treatment outcome for the medical illness.

There are many things a person can do to counter the feelings of depression, says Dr. Winston. For example, exercising or forcing yourself to stay active, even when you don’t feel like it, will activate endorphins — chemicals within the body that reduce the perception of pain and improve mood. Numerous studies have shown that a regular exercise program improves mood in people with mild-to-moderate symptoms of depression and may even benefit those who are severely depressed.

Just the act of getting up and out of the house and forcing yourself to stay connected to people can help, says Dr. Winston. “The worst thing you can do when you are feeling depressed is to stop moving, or withdraw from people,” she says. “Get in the shower and go out, even though it feels like a huge effort.”

But taking steps on your own may not prove sufficient, she says. Many people require psychotherapy or antidepressant medications, such as SSRSs or MAOIs, or a combination of both therapy and medication.

The good news? NIHM reports that the majority of people with depressive disorders improve after receiving appropriate treatment. If you or a loved one are experiencing depression, be sure to seek medical attention to determine what’s best for you.