Is Depression just sadness in disguise?
This is a question I have pondered for some time. The push to diagnose and pathologize human emotions is a topic that I feel strongly about. Having been a therapist for over 15 yea4rs, 13 of which were spent working in healthcare, I saw a huge shift over time towards quick diagnosis and treatment of symptomology of which the origin is often complex and unknown.
Let’s look at the definition of depression in the American Psychological Assocation DSM V (basically the shrink’s Bible so to speak. The criteria for Major Depressive Disrder are the following:
- the depressive state must be at least two weeks long.
- must cause significant distress and severely impact social, occupational or other areas of life.
- Not be precipitated by drug or alcohol use, not meet the criteria for another major mental illness such as schizophrenia or bipolar.
- Not be better explained by bereavement.
I know I have seen many people who have been diagnosed with depression who have been going through grief from the loss of a loved one, a job, marriage, or various other major life events. I have also seen people diagnosed and on meds who were diagnosed when either under the influence of drugs/alcohol or in early sobriety from such.
I hear a lot about how great it is that the stigma has been lifted on mental illness and what I am left pondering is….
Yes, it has and it seems like we just call the general public mentally ill and medicate them.
How did we get here?
We can blame managed care and greedy insurance companies. Or we can blame Big Pharma with the push towards medicating our every ailment in an effort to make money. There is a push to view all disturbances arising in the body and mind as symptomology of one disease or another.
We could also then blame the fact that healthcare is run by both Big Pharma and the insurance companies thereby decreasing the amount of time your physician/clinician is allowed to spend with you and at the same time decreasing the amount of the reimbursement rate they are paid.
It is also true that insurance companies only primarily only pay for services that are based in the illness model. Insurance does not pay for wellness. Once a person is no longer deemed ill, their services are not covered.
Says my mind as we talk about all of this.
Just laying it all out would make anyone “depressed”
But instead of focusing on the blame game…what if we talked about how we might empower ourselves to look at what we can control instead of what is clearly out of our control.
About a decade ago a New York Times article by Ronald Pies Redefining Depression as Mere Sadness published in 2008 discussed this topic. This is interesting as according to a CDC report between the years 1988 and 2008 prescriptions for anti-depressants went up by 400%. A Journal of American Medicine (JAMA) study released in March of 2013 stated that ant0depresants are no more effective than placebo in cases of mild to moderate depression.
It would seem that the increase in diagnosing and prescribing of medications has not exactly helped people become happier.
Technology has changed everything. People are managing a lot more stress than they were just a decade ago. There is not only a push to do more but to also do it better. People no longer feel that they have time time or energy to deal with their emotions. Most people are moving at such a rapid pace that stopping to grieve could mean that they simply can not move as fast as they are used to moving. The push-pull of the state of our healthcare, the pace at which we are living and the limited capacity for the human body to keep up is a serious problem.
Is there a different way to understand and heal our emotional instability?
I would say
In our discussion Gut-Brain Connection: How the Gut Affects the Brain we talked about the research on the gut microbiome and how it shows that the our diet plays a crucial role in how we feel emotionally. The gut knows what it knows. You feel anxious, your gut feels it. You feel sad…often the gut feels that too.
The research shows that actually emotional states are often caused by disturbances in the gut more often than the emotions are causing said disturbance.
Is Depression Just Sadness in Disguise?
Quite possibly yes. There is no getting away from the fact that we are human beings, not machines, and our emotions are complex. It is not as simple as saying that we have a disease, taking a pill and moving on.
But depression is also inflammation of the gut in disguise. In December 2015, the Journal of Psychopharmacology and Neuroscience published the article The Gut-Brain Axis: The Missing Link in Depression. The article discussed a theory which has more recently become more publicized; that depression is caused by inflammation in the gut.
It is also worth noting that sometimes depression may actually be mental illness. Some people are at a point of risk and definitely need medications to get through.
My issues is not necessarily the diagnosing and treating of depression as illness but more in the fact that we don’t have the time to discuss whether a person is actually ill. It also feels that those in the mental health and healthcare field become uncomfortable with even having this discussion. It is almost like new information and ways of thinking come in direct conflict with our attachment to already knowing the answer to the problem.
The healing is not in turning away from our sadness or any other physical or emotional sensation.
Healing comes through dealing.
We must be willing to turn towards our pain and embrace it if we are ever to be able to transcend it. As we bring our attention to what ails us we are more capable of embracing the present moment and moving through it rather than avoiding it. There is no getting over or under what is ailing us. The only way is through.
We are all stronger than we believe ourselves to be. As we turn towards our pain and embrace it, we are able to see our innate capacity for resilience.
Is Depression Just Sadness in Disguise? Quite possibly yes. If this is true for you, know that through turning towards that which feels dark allows you to find your own inner light.
Cheers to embracing your own inner light!
Want more info on how you can work with me to help increase your own health and happiness? Contact me to discuss further.