Most people have strongly held beliefs about the validity of mental health disorders and in particular depression. Maybe that’s the reason we throw around the word depression fairly casually to mean a more general sadness or malaise but major depressive disorder is not as simple as that. The idea of depression in our society seems to change from generation to generation. The word inevitably means different things to different people, depending on their history and context. Some people believe that depression is something people can and should opt out of. Before real research was done on the subject sometimes people believed that depression was simply a feeling of unhappiness and negativity or deeply selfish self pity. They sometimes thought that it someone had to choose to be sad, depressed, or negative. This was a particularly common disposition toward depression in early parts of the 20th century.  Many people believed that if you only smile through the sadness and pain, you’ll be able to live a fine life. It turns out depression is much harder to treat than with just a smile. There is absolutely nothing simple about this major depression. Scientifically depression is a mental health disorder that results from, “a combination of genetic, biological, environmental, and psychological factors.” According to the National Institute of Mental Health, depression is by no means a choice made by the person who suffers from it. 


Depression Is Not A Choice

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.”


It is a scientifically factual statement that “depression” has a very specific definition, one that is demonstrably different from the more superficial idea of depression that has sometimes been embraced by our society in years past. Depression comes with a myriad of complicated and dangerous symptoms that can even sometimes, tragically, lead to death by suicide if the disorder goes untreated.


Symptoms of Major Depression

Discovery InstituteFeeling empty or hollow inside – Someone who is suffering from major depressive disorder, otherwise known as clinical depression, sometimes experiences a feeling of emptiness, like they are hollow inside. They may feel like they are completely disconnected from themselves due to this feeling of emptiness, and in turn disconnected from those around them.


Persistent sadness – Though sadness is a word often used to mock depression, the kind of sadness that someone with depression experiences and suffers from is not only persistent but pervasive. It can sometimes last for months at a time, plaguing their everyday lives.


Worthlessness – People suffering from major depressive disorder often suffer from a near constant feeling of worthlessness or uselessness. These feelings can permeate the life of someone suffering from major depression and make their lives significantly more complicated by stealing their self confidence.


Guilt – If someone suffers from clinical depression they may suffer from a heavy guilt complex. Guilt is something that can at times feel so overwhelming as to drive a person to suicidal thoughts. Guilt is one of the most difficult symptoms of major depressive disorder for someone to overcome.


Hopelessness – People dealing with major depression may feel an occasional to consistent sense of hopelessness. This feeling can sometimes lead to a lack of self reliance, or an inability or unwillingness to care for oneself. This can sometimes feed the other difficult symptoms that come along with the disorder such as a deviation from good hygiene, doing daily tasks, or taking advantage of opportunities when they come along.


Loss of interest in normal life activities – Someone suffering from major depression may experience a significant loss of interest in the subjects that the person is passionate about.They may stop participating in their hobbies and no longer pursue their favorite activities which may otherwise fill their lives


Lethargy – A person who is depressed may feel genuinely dragged down. This feeling that sometimes comes with major depressive disorder may cause the afflicted person to literally move more slowly than usual and speak slower than usual. Depression can bring with it a literal loss of energy, and replaces that energy with a deep and enduring fatigue.


Insomnia – Insomnia is when someone has a difficult time sleeping, or when someone wakes up in the night and cannot return to sleep for a long time. The person with depression may also experience their insomnia by waking up, wide awake, very early in the mornings.


Oversleeping – On the other side of the line from insomnia is another common symptom of depression, oversleeping. This inability to get out of bed in the mornings often plagues people suffering from depression and may make them feel like they cannot sleep enough no matter what they do. This sleeping too much is a result of the lack of energy being replaced by fatigue.


Substance Abuse – Major depressive disorder, or clinical depression is one of the most common mental health disorders that is co-occurring with substance use disorder. A person suffering with depression may be more likely to develop a chemical dependency and psychological addiction to a drug or alcohol in order to try and numb some of the shame or worthlessness that depression causes them to feel. Of course, it is also possible that the person suffering from drug or alcohol abuse and addiction may develop major depressive disorder or clinical depression, as a trigger or result of the addictive behaviors, or it could be they physical symptoms of the chemical itself. It is not usually possible to really pinpoint which came first, the major depressive disorder or the addiction to drugs or alcohol. The two disorders frustrate each other’s symptoms and can become extremely dangerous if they go unrecognized and untreated.


Suicidal Ideation – The most dangerous symptom of all of those that come along with major depressive disorder is suicidal ideation. This is a symptom that especially haunts those who suffer from dual diagnosis of drug or alcohol addiction.  Some of the people suffering from this heartbreaking disorder do indeed go through with a planned suicide. Depression is a mental health disorder that affects the more than just the person afflicted with the disorder if also affects their family and the community they engage with daily.


Types of Depression

There are several different types of depression the following are a few:

Persistent depressive disorder: Persistent depressive disorder is also commonly known as dysthymia. This form of depressive disorder is the type of diagnosis that someone who suffers from a severe depressive episode lasting for a substantial period of time, over two years, might receive. The depressive symptoms may vary in severity throughout the lengthy depressive phase, however the depression will be continuous, even when symptoms are less aggressive.


Postpartum depression: Postpartum depression is a kind of depressive disorder that occurs after a woman gives birth to a child. The disorder has sometimes been referred to as “the baby blues”. The stigma around postpartum depression didn’t begin to crack until an acclaimed actor, Brooke Shields, came out as getting treatment and taking medication to treat her postpartum depression. She received a significant amount of judgement from the media and fans.  In spite of the controversy that Shields started, she also began the much needed conversation about the disorder. These days doctors are treating the disorder as a legitimate disorder, diagnosing and treating women with as needed.


Psychotic depression: Psychotic depression is a comorbidity. This is when two different disorders come together such as psychosis and major depressive disorder. For example, if someone has delusions or hears and sees things that are not real, those delusions or that psychosis may show it’s form in hallucinations that can cause or trigger feelings of sadness or despair in the person suffering from the comorbidity.


Seasonal affective disorder: Seasonal affective disorder, or SAD generally occurs during the winter season. People complain about a general feeling of malaise when there is less natural sun. When someone suffers from seasonal affective disorder, or SAD, they may seclude themselves away, but then begin  to re-engage, as if they were hibernating, during the spring and summer months. Some people treat SAD by using lights that are meant to mimic the sun’s rays.


Dual Diagnosis and Treatment at Rehabs in NJ & Detox Centers in New Jersey

Major depressive disorder is a real and chronic mental health disorder that can lead to, or be aggravated by any form of substance abuse and chemical dependence.  When drug or alcohol substance use disorders and a mental health disorders co-occur in a patient at the same time this is called a dual diagnosis. Someone with this diagnosis has a much more difficult treatment road to walk for either disorder more because it requires treatment of both disorders simultaneously in order to have any hope for success in the treatment of either one. Call Discovery Institute If you are looking for a program for depression and addiction treatment. New Jersey’s top rated addiction treatment program at Discovery Institute takes an holistic approach to alcohol and drug addiction recovery.


Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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