Shedding Light on Depression

Depression is a serious, but highly treatable disease.

Illustration by Brittany Inglese

In a casual sense, many of us claim to be depressed pretty often. We say we’re “depressed” after a bad day at work, for example, or after taking in a tear jerker at the local multiplex. If we grumble excessively about feeling low, a friend or family member advises us to snap out of it already, and after a bit of distraction and attitude readjusting, we usually can.

But for the truly depressed, it’s not that easy. Depression is not a temporary downer or the result of a lousy day. It is not grief, either. It’s a persistent and lingering frame of mind that permeates every aspect of life. If a normal outlook enables us see to each day through at least somewhat hopeful, if not rose-colored, glasses, depression saddles us with dirty, gray lenses — ones that we don’t seem to be able to take off.

“Depression is a state that interferes with people’s ability to function, and makes it difficult to work, interact with family members and simply get out of bed in the morning,” says Jeanne Courtright, PhD, a clinical psychologist at LaMora Psychological Associates in Nashua. Clinically depressed people find it “difficult to do the most basic things of life on a regular basis for at least a couple of weeks, all day, every day,” Courtright says.

Typically, depressed people find that activities that once brought them joy — such as playing with their children or going for a bike ride — no longer hold any allure. They might sleep or eat significantly more or less than they used to, and lack the energy and motivation to do just about anything. A feeling of hopelessness commonly dominates their mood. They feel that they are worthless failures, and that life is meaningless and unlikely to ever feel good again, says Courtright. “And even if they themselves know that those things are not true, they feel true,” she says.

Depression can bring physical symptoms, too, such as chest pain, blood pressure changes and headaches, says Michael R. Kandle, PsyD, a licensed psychologist in Durham. As a result, “some people go to the doctor complaining of various physical symptoms without recognizing the underlying cause of depression,” Kandle says.
The origins of depression can be difficult to pinpoint, but it’s clear that biological and environmental factors can play a role. “It runs in families but it usually requires some kind of environmental or experiential trigger that will interact with a person’s predisposition to depression,” Kandle says. “It’s the interaction of nurture and nature that can cause it.”

However, not all cases of depression stem from biological underpinnings, Kandle says. The groundwork for the disease is often laid when an individual experiences some sort of loss — a divorce or a death, moving, separation from family and social connections, financial losses and pressures, the loss of a job — or any kind of significant trauma, abuse or assault. Sustained exposure to hostility, either in the workplace or at home, and stubborn relationship conflicts can also brew emotional trouble that can lead to depression, Kandle says.

In addition, hormonal changes, such as the fluctuations that occur during puberty, pregnancy and menopause can trigger depression, Courtright says, as can major illness or any significant life change — even if it’s for the better — such as a new job, marriage, retirement or setting off for college. But sometimes “depression can occur when there’s been no major change and there’s no clear identifying factor at all,” she says. Even if “everything in your life appears to be going great … it can just happen.”

Fortunately, depression is a very treatable illness. Most often, patients receive a two-pronged treatment approach of medication and therapy. Therapeutic models vary, but one of the most common approaches, cognitive behavioral therapy, helps patients recognize negative thoughts and regain “a more balanced, realistic way of thinking,” Courtright says, while they “work on directly changing behaviors and self-defeating patterns.

To avoid depression in the first place, take preventive steps that fortify your emotional health, such as creating and maintaining “good emotional connections and relationships,” Kandle says. “Social connectedness with family and friends is often a good buffer to depression,” he says, whereas isolation increases our vulnerability. Try to practice good communication habits, particularly as they relate to managing conflict, and be sure to strive for equilibrium between physical and mental activity. “In this day and age, we are all absorbed by our computers and our video games and our smartphones, and we’re sitting idly in front of electronic screens, including the television,” Kandle says. “We need to stay in motion. We need adequate exercise and social interaction to maintain a healthy emotional balance.”  

Are the kids all right?

If you follow the news at all, no doubt you have heard about anti-bullying efforts in schools, and you sense the growing attentiveness to the emotional health of kids. Awareness of depression among the younger generation has grown, spurring more treatment in kids and contributing to a drop in suicide rates among youth, which “have gone down substantially in the last 20 years,” says Michael R. Kandle, PsyD, a licensed psychologist in Durham.

What can parents do to help bolster kids’ emotional health? For starters, limit electronics time—surely a bone of contention in many households—since excessive time spent engaged with a screen increases the risk of social isolation and depression, Kandle says, and kids and teens who are prone to depression are particularly likely to “escape into these virtual worlds more and more because they’re so safe and entertaining and fascinating,” he says.