Major Depressive Disorder can be one of the most debilitating and frustrating hands that life can deal you. In the United States, the lifetime prevalence of Major Depressive Disorder is around 20%, meaning that 20% of people will at some point experience Major Depressive Disorder, and at any given point the number is around 1 in 10 are presently experiencing it.
These numbers go up for younger adults as well, who are the most likely to experience it. However, these numbers are for depressions that meet a certain threshold of symptoms that make it “clinical,” but so many people will experience depression in response to events, life stages, or grief and loss.
Combining all of these, there exists a very significant portion of our population that experiences depression at any given time! My goal here is to illustrate what the symptoms are to look for and describe what the experience of depression actually is, then to give you some resources to begin getting help if that is you.
Imagine standing at the base of a wall. It’s a very tall wall that you have no hope of climbing over. It goes on and on into the distance, so there’s no going around it either. It’s impossible to dig under the wall as well. On the other side of the wall exists the life you want of joy, happiness, and fulfillment. On your side of the wall, however, is despair, loneliness, and isolation.
It feels near impossible to ever get to the other side of that wall. You might have an idea of what is over there, but if feels a Sisyphean task to climb that wall. Depression is that wall and this is what it can feel like to live with depression. You know you want to be on the other side, but it seems impossible to get yourself there.
What are the Symptoms of Depression?
For many, we think of depression as synonymous with sadness. While a lot of people who experience depression also experience sadness, it is so much more. Sadness is a symptom of depression and a hallmark symptom at that. However, the other hallmark symptom of depression is a lack of interest or pleasure in things.
This symptom is often one of the most demoralizing because even if you make strides in improving your situation or try and do what you used to enjoy, often you just do not experience the same pleasure.
According to the Diagnostic and Statistical Manual (DSM), from which we derive diagnoses, Major Depressive Disorder can exist without the experience of depressed mood if there exists a lack of pleasure or interest. I highlight this because it is important to remember that Major Depressive Disorder can look different for everyone.
Beyond just sadness and a lack of interest there exist a few other symptoms that go into a diagnosis of Major Depressive Disorder. These include significant unintentional changes in weight, a slowing down of everyday movements, feelings of fatigue, feelings of worthlessness or guilt without merit, difficulty concentrating, and finally thoughts of death or suicidality.
For a clinical diagnosis of Major Depressive Disorder, someone must have five of the above symptoms, with either sadness and lack of interest as one of them. I list these so that they may be on your radar, but this is not meant to be a checklist to self diagnose. There exist other criteria for a formal diagnosis, such as time and frequency of symptoms and a ruling out of other disorders and effects of substances. If you notice these symptoms in yourself, please reach out to a therapist and work with them to create a formal diagnosis.
While what is listed above constructs the formal, medical diagnosis of Major Depressive Disorder, I would like to take some time to talk about the Christian and spiritual impacts of depression that I have seen. Since depression often causes us to lose motivation, we lose our ability to interact with people.
Religion is such a social experience that often individuals with depression will pull away from church activities and other events where they might experience the community of God. This compounds the feeling of loneliness and can cause individuals to experience spiritual isolation.
Further, on the more individual level, feelings of depression can cause one to feel “further” from God. Remember, one of the symptoms of depression is guilt without merit. As this pertains to spirituality, we can begin to forget that we have salvation and feel inappropriate guilt. I try to not over-spiritualize mental health issues because I believe they are usually medically and physically created.
However, I do from time to time like to remind clients suffering from depression that this can be a spiritual attack as well. Remember, the Devil doesn’t just want us to sin, he wants us to be apart from God and sin is one of his tools. He can also trick us into believing the lie that our depression makes us unholy or that God has removed his favor from us.
He can use the depression and tell us lies such as, “If you were really praying enough you wouldn’t be depressed.” Unfortunately, many have reported hearing these exact words from members and leaders of the church.
Treatment for Symptoms of Depression
If this describes you, the good news is that you have some options for how to go about treating your depression. What is most often understood to be the best approach is a combination of medication and counseling. I know many people are hesitant to take medication and are often scared by potential side effects, however, the benefits can greatly outpace the risks.
It is important to understand how these medications work, though. If you have pain, you might take Tylenol or Advil to make the pain go away, and usually, you’ll have some relief in a short amount of time. Antidepressants do not work this way. They impact neurotransmitters in your brain and take some time to build up in your bloodstream to what is called a “therapeutic” level.
This process usually takes 4-6 weeks of taking the medication before you feel the benefit of it. Unfortunately, side effects sometimes come on in just the first couple of weeks too. Even then, finding the right medication is a bit of trial and error. Most doctors might start you on something common like Prozac or Lexapro, but for some, it takes trying a few different medications to find one that works, and that means this process can take a painstakingly long time.
The other component of treating depression is therapy, and that’s where I come in. Depression speaks lies to us and convinces us of things that aren’t true. Depression gets us to stop doing things that make us feel better and do more things that make us feel lonely and isolated.
By working with a therapist, you can begin to work through the unhelpful thoughts and actions you have been having and come up with new ways of thinking and behaviors to help you to feel better. Remember that wall I spoke about earlier?
Sometimes it seems that medication ties a rope for you to climb up that stops a couple of feet short of the top of the wall. It may not make everything better, but through therapy, you can get the tools to pull yourself up and over that last little bit. You might have not gotten there without medication, but you weren’t getting over it without some hard work and doing some things differently yourself.
Depression is a significant mental health issue that affects many people and often makes us feel alone and incapable of working through it. However, this does not have to be the case. Depression sucks. But it doesn’t have to last forever. Start today by reaching out to a therapist and a doctor and get the ball rolling on your treatment. It will take some time and hard work, so don’t delay any longer and get yourself the help that you deserve and need.
“Sad”, Courtesy of Pixabay, Pexels.com, CC0 License; “Brick Wall”, Courtesy of Frans Van Heerden, Pexels.com, CC0 License; “A Hand Up”, Courtesy of Samantha Garrote, Pexels.com, CC0 License; “Laughing”, Courtesy of Bruce Mars, Pexels.com, CC0 License