“The Big Sad” – Major Depressive Disorder

People think depression is sadness. That it’s crying and dressing in black, but people are wrong. Depression is the constant feeling of being numb. It’s being numb to emotions, being numb to life. You wake up in the morning just to go back to bed again.” – Unknown

I want to make sure I reiterate – before I go into talking about what Major Depressive Disorder is and the symptoms, know that I am not diagnosing you. If you feel you may have MDD after reading most post, please contact a health care professional, preferably a psychiatrist.

I am not going to talk as much about mental health with men, or postpartum depression because I am going to give those their own posts. The reason for that is, there is such a strong stigma around men and their mental health and not being able to talk about it freely. As with postpartum depression, there is an upsetting amount of people who just don’t believe it’s real. I want to bring light to both of these awful types of depression. I want everyone to know. I want to make sure that everyone is getting the help and knowledge they need.

Major Depressive Disorder is one of many silent killers. This disorder can also be called “Clinical Depression” or “Depressive Disorder”. MDD is a mood disorder that “causes distressing symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working” (National Institute of Mental Health). Different from the previous disorder we have talked about, this does not have any ups, or manic/hypomanic episodes. In order to be diagnosed with MDD, you must have symptoms present most of the day, nearly everyday for at least two weeks.

Like other mental illnesses, this isn’t something you can just “snap out” of. Having depression puts so much of your life at risk as well as others connected to those people, like spouses or family. Most people with it need to have treatment to feel better.

When it comes to what causes depression, research suggests it is a combination of genetic, biological, environmental, and psychological attributes. This disorder can occur alongside other serious illnesses. This includes cancer, diabetes, heart disease and Parkinson’s disease, making these worse or vise versa.

Some think depression is just sadness. What some don”t understand is that being sad is only one small part of depression. Most people don’t feel sad at all, but numb. Of course, everyone is different.

Some of the signs and symptoms of depression are:

  • There is a decrease in energy, fatigue, or feeling “slowed down”
  • Persistent sad, anxious, or “empty” mood
  • Feelings of guilt, worthlessness, or helplessness
  • Appetite and/or weight changes
  • Restlessness or irritability
  • Loss of interest or pleasure in hobbies or activities
  • Feelings of hopelessness or pessimism
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease when treated
  • Thoughts of death or suicide or suicide attempts

There are two types of depression. Well, these are the more common or “well-known” ones:

  • Major Depression – Having symptoms of depression most of the day, nearly every day, for at least 2 weeks. These symptoms interfere with your ability to sleep, eat, work, or just enjoy life. One thing I did not know was that an episode can occur only once in a person’s lifetime, but more often, people have multiple episodes.
  • Persistent Depressive Disorder (dysthymia) – Having symptoms of depression that last over at least 2 years. This person may have episodes of major depression along with periods of less severe symptoms.

“Smaller” types of depression, or as the National Institute of Mental Health says, forms of depression that are slightly different or they develop “under unique circumstances”:

  • Seasonal Affective Disorder (SAD) – This type of depression comes and goes as the seasons do. It typically starts in late fall/early winter and goes away in the spring/summer.
  • Perinatal Depression – This type of depression only occurs in women. They experience full-blown major depression during pregnancy or after delivery.
  • Psychotic Depression – This type of depression occurs when a person has a severe depression as well as some form of psychosis. This can mean having hallucinations (hearing or seeing upsetting things that others cannot hear or see) or delusions (disturbing false fixed beliefs).

There are other examples of depressive disorders, such as:

  • Disruptive Mood Dysregulation Disorder is diagnosed in children and adolescents. This condition is of “extreme irritability, anger, and frequent, intense temper outbursts.” (NIMH)
  • Premenstrual Dysphoric Disorder is an extremely severe form of PMS, also known as premenstrual syndrome.
  • The depression side of bipolar disorder would be considered another type of depression, but as you have read in previous posts about bipolar disorder, it is very different from major depression. Bipolar disorder has manic or hypomanic episodes which make it different.

Depression looks very different from person to person based on gender and age.

  • Younger children, according to the NIMH, may pretend to sick, refuse to go to school, cling to a parent, or worry that a parent could die.
  • Older children and adolescents may become more irritable, have trouble behaving right in school, and sulk. Teens with depression may experience symptoms from other disorders, such as anxiety, eating disorders, or possibly substance abuse.
  • Older adults have less obvious symptoms of depression. They may also be less likely to admit to any feelings of sadness. Older adults are more likely to have medical conditions that could contribute to their depression.
  • Women have depression more often than men (NIMH). A possible link for the higher depression rate may be due to a women’s biological, life cycle, and hormonal factors. The symptoms a woman with depression usually has are sadness, worthlessness, and guilt.
  • Men are more likely to be very tired, irritable, and angry if they have depression (NIMH). They may lose interest in the things they have once enjoyed, have sleep issues, and behave recklessly, such as using drugs or alcohol. Men sometimes do not recognize their depression and fail to seek help for it.

So, how can we treat this ugly monster called Depression?

Obviously the first thing that needs to be done is to talk to a medical professional in this field of care. You can go through your primary care doctor to see who is in network with your insurance. They will send out a referral for you to get an appointment. If you don’t want to go that route, you can also Google psychiatrists in your town and give them, or your insurance a call to make sure you are in network with them. When you get to your first appointment, it’s basically a get-to-know-you session. You’ll have your exam, they will ask a lot of questions, and depending on if they don’t need to make a follow up appointment, you might discuss medication options. There are a few different options to treat depression:

  • Medications are usually tried first. Psychiatrists prescribe antidepressants based on diagnosis. Unfortunately it can take a few weeks to start seeing any changes in what you are feeling. Also unfortunately, there could be side effects with some medications. – MAKE SURE YOU LET YOUR HEALTHCARE PROFESSIONAL KNOW IF YOU ARE HAVING ANY SIDE EFFECTS.
  • Psychotherapy is therapy. I highly recommend you do therapy. According to NIMH “it teaches new ways of thinking and behaving, and changing habits that may be contributing to depression.” Therapy can help you understand and work through feelings.
  • Brain stimulation therapies Electroconvulsive therapy (ECT) and other brain stimulation therapies may be used if the patient has severe depression and it is not responding to antidepressants. “ECT is the best studied brain stimulation therapy and has the longest history of use.”

My psychiatrist suggested I try ketamine to help treat my depressive episodes. I believe it was due to my suicidal ideation. It was very tough to keep trying new medications and waiting for them to work while feeling and thinking the way I did. If you want to know a little more about ketamine treatments and my experience with it, I have a post called Where I’ve Been that goes into more detail. Also, speak to your doctor if you are curious about ketamine.

How can you help yourself if you are depressed?

As I said above, antidepressants can take a few weeks to kick in. So you might need to try a few different things to help you cope. Try doing things that you used to enjoy. Be easy on yourself. That is the most important. Here are a few different things you can try:

  • Avoid self-medication with alcohol or with drugs not prescribed for you. I have a small issue with that because I believe cannabis is a very good thing to use when feeling down. I only mention that because some people still think of cannabis as a drug, it is not. The “drugs” they mean here are the illegal ones such as meth, cocaine, etc.
  • Spend time with other people and confide in a trusted friend or relative.
  • Try to be active and exercise often
  • Postponing any important life decisions until you feel better. You are going to want to discuss any important decisions with people who know you well
  • Breaking up large tasks into smaller ones, setting priorities, and just do what you can as you can

How can you help others when they are depressed?

Depression is very difficult to live with, but it makes it easier when you have friends or family who are there for you in your dark time. If someone you love has depression and if going through a bad time, you can do some of these things:

  • Remind them that the depression will lift, with time and treatment
  • Invite them to go for walks or come out for outings
  • Offer support, understanding, patience, and encouragement to them
  • Help them stick to a treatment plan, such as setting reminders to take their medications
  • Ensure that they have transportation to their psychiatrist and therapy appointments
  • NEVER ignore any comments about suicide, and report them to their health care provider or therapist

I didn’t get anyone who wanted to share their stories, and that’s just fine! Some people are uncomfortable with sharing. I will, however, have some to share on the next post. 🙂

Please make sure that you are mindful of those who are not as peppy or happy as they usually are, they could be going through a low period. It is important not to make them feel badly about not being as outgoing as normal. Make sure they feel important and cared about. I’m going to post this again, here are some helpful things to do in case of an emergency:

If you or someone you know is in crisis, get help IMMEDIATELY.

  • Call you or your loved one’s health care professional
  • Call 911 for emergency services
  • Go to the nearest hospital emergency room
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-8255. TYY: 1-800-799-4889

Thanks for reading! Love you all!

-Bipolar Weirdo

****Disclaimer: I am not a healthcare professional. My blog is used to discuss mental health in a way that is easier for people to understand. My information comes from a wide variety of books by trustworthy authors, my personal healthcare providers, and reputable online sources. If you have mental health related questions, I highly recommend you seek a healthcare professional.”

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