Depression false myths

Despite the fact that depression will be the second most disabling illness by 2020 (WHO, 2012), it still causes wrong beliefs and false myths, interfering with the act of seeking and receiving appropriate treatment.

Let’s look at a few of them.

1. Depression doesn’t exist, we are all a bit depressed 

Many people think that depression is nothing but sadness and that everybody can experience it every once in a while.

Well, this is definitely false. Depression and sadness are very different in terms of intensity, duration and the impact they have on our daily lives. While sadness is a temporary feeling, as it doesn’t prevent us from experiencing positive emotions nor has it a significant impact on our daily life, depression can significantly account for changes in functioning and mood.

To be diagnosed with depression, the symptoms must be present for at least two weeks, most days and for most of the time.

Sadness and low mood are only some of the symptoms experienced by depressed people (beside lack of interest in the usual activities, diminished energy, feelings of worthlessness or guilt, change in sleep patterns and appetite, thoughts of death and difficulty concentrating).

2. Depression is all in our head and it does not have any biological root

Once again, false: nature and nurture interact to trigger and cause depression.

Genetic liability and life events play a role in this. As far as biology is concerned, a specific variation of a serotonin transporter gene seems to increase susceptibility to depression.

Besides, depression doesn’t only affect our thinking, but our body as well. Depressed people can experience different changes in their physical habits: some may experience a significantly increased or decreased appetite; some may have trouble sleeping while others may oversleep; some may go through motor retardation as opposed to agitation. This means that depression comes with a varied constellation of several different symptoms.

3. Depression is related to creativity and sensitivity

Since many gifted artists, scientists and musicians of the past suffered from mental disorders, one may tend to believe that suffering from a mental condition relates to being creative and sensitive. Well, this doesn’t apply to depression as a condition. There are so many creatives who have never suffered from depression and conversely, lots of depressed people whose nature is not particularly creative.

 4. Depression is always triggered by specific events

Specific events may sometimes trigger depression, such as the loss of a beloved one or a trauma.
As previously mentioned though, nature and nurture intimately intertwine and it’s not possible to pinpoint a single cause of depression.

5. If I start using antidepressants, I’ll be hooked forever

Taking medication for mental health treatment may be scary, because of the possible side effects as well as the fact itself of being on medication.

In the case of depression, depending on the severity of the specific case, a psychiatrist may deem clinically appropriate to prescribe medication. A combination of medication and psychotherapy is often recommended, especially in severe cases.

The length of antidepressant treatment usually depends on the case severity and the number of depressive episodes experienced.

Despite the abundance of false myths, depression is a severe and disabling condition that should never be underestimated.

If you think you are suffering from a depressive episode, consider talking to a specialist to receive appropriate treatment as soon as possible.

References:
World Health Organisation, http://www.who.int/mental_health/management/depression/wfmh_paper_depression_wmhd_2012.pdf

“False beliefs: the current treatment of patients with depression”, Lecrubier Y; Current Psychiatry Reports 2003, vol 5(6): 419-422.

Sadness or depression?

Nowadays the word ‘depression’ has been so fully absorbed into our daily language that it is often incorrectly used to describe normal sadness.

Sometimes it may occur that intense sadness makes us wonder whether it is a normal and transitory feeling or there is more about what is perceived as sorrow, such as real depression. In this instance, it is important to be aware of it and in case the boundary is crossed, seek appropriate help as depression is an actual disease which should be dealt with as soon as possible.

Let’s have a look then at the differences between sadness and depression.

The differences between sadness and depression

Sadness is an emotion that we often experience in our everyday life and that is usually categorised as a ‘negative’ and ‘unwanted’ feeling. Sadness is generally caused by missing out on our aims or goals which seem no longer achievable. Depending on how important the goal is and its specific meaning to us, we may experience a more or less intense feeling of sadness. For example, the intensity of the sense of sadness will be very different if applied to an unsuccessful application for a temporary and maybe not-so-wanted job as opposed to the instance of not getting our dream-life position.

Usually sadness is linked to specific events or thoughts, is time-limited and doesn’t prevent us from experiencing positive feelings if happy and joyous events occur. Furthermore, it doesn’t have a significant influence on our biological rhythms and daily functioning.

On the contrary, depression brings consistent and identifiable changes and symptoms in our habits and lasts for longer. First of all, a wake-up call related to a depressive episode occurs if the symptoms and low mood persist for at least a period of two weeks, in which they manifest most of the time and most of the days.

The core symptoms are severely low mood and lack of interest in the activities that used to stir up a positive response within ourselves, such as a sense of interest and engagement. When depressed, we are no longer interested in and motivated to undertake activities or hobbies as they no longer bring us any sense of pleasure. We may also feel like we have no energy for them at all. We may not care at all about going out, hanging out with friends, spending time with our partner (engaging in sexual activity as well), going to work, playing our favourite sport, etc. It may even occur that we neglect self-caring tasks. Low mood and a lack of interest will make us perceive the world as emotionally dull and grey, as though colours no longer exist.

As mentioned above, depression brings changes in our biological rhythms as well.

Different types of change in sleep habits, appetite and motor activity are reported. As a matter of fact, sleep problems or a tendency to sleep in can be observed as well as significantly increased or reduced appetite (and therefore weight gain or weight loss) and retardation or agitation related to motor activity.
Cognitively speaking, we may suffer from concentration problems, have trouble making decisions and often feel guilty, unworthy and hopeless about the future. In particular, the future may be perceived as an infinite extension of a worthless today. Several cognitive biases tend to maintain this hopelessness-related point of view.

As you can see, depression manifests in different ways with different symptoms, but the common denominator is a significant change in the functioning of the person, intense, strong and long-lasting symptoms and a significant impact on everyday life.

What to do

If you have the feeling that your low mood may not be linked to momentary sadness, keep an eye on it and if you recognise yourself in the aforementioned symptoms, consult a specialist. A psychotherapist, and in mild or severe cases a psychiatrist, can help you understand and tackle the issue.

Anxiety

We all agree that being anxious and suffering from anxiety is something that we would rather avoid in the first place.

Anxiety is an annoying condition and if its intensity raises, its symptoms may scare the person and bring forth the sensation of not being in control of our body reactions. Experiencing very intense anxiety symptoms in our body may be so terrifying that for many people it may become itself an experience to be very scared of.

In these instances we are talking about what is so called “fear of fear” itself. Fear of fear can bring more intense consequences than anxiety itself, leading the person to avoid any possible situation where they may feel the unwanted anxiety symptoms.

Fear of fear is a very powerful and delicate mechanism that in most cases maintains and/or worsens the initial situation.

The first step to overcome fear of fear is getting to know the enemy.

Let’s try to understand together what is happening to our body when we are so anxious and why.

Understanding the symptoms of anxiety

The first thing that is important to know is that anxiety is an emotion that in our evolutionary history derives from the most primitive emotion of fear, but it has appeared in the history of the human being only after the development of our superior cortical functions. Anxiety is indeed linked to the complex ability of our brain to make long-term plans and assumptions about what could possibly happen in the future; on the contrary fear is a more primitive and archaic instinctive that implies an immediate reaction to a threat in the “here-and-now”.

Secondly, anxiety, like fear, is related to the perception of a threat, and it activates the same brain pathways that are activated by its fellow emotion of fear. In both situations, the automatic reaction that is induced in our body is the fight-or-flight response: our body prepares itself to fight the threat or to run away to ensure survival.

Each symptom that is experienced when we are anxious can indeed be explained and understood in the fight-or-flight perspective.

Let’s see the most commons symptoms that we experience when we are anxious and their physiological explanations:

• Muscle tension: usually we feel our muscles contracted and rigid; if the anxious condition becomes prolonged in time, we may even feel some sort of pain. This happens because our body is preparing itself to fight the threat or to run away; as a consequence our muscles are in tension and ready to react immediately if it is necessary.
• Tachycardia or heart palpitations: our heart rate tends to increase so that our heart may pump more blood to our muscles and send more oxygen. This helps our muscles to be better prepared to react to the danger.
• Tingling or torpidity in our body’s extremities: we may feel tingling in our hands or feet. This happens because the majority of our blood flow becomes concentrated in our main muscles (for the reasons explained above) and not in the extremities. As a consequence this may be experienced as tingles, torpidity or cold hands and feet.
• Difficulty breathing: we may experience the sensation of having trouble breathing. This happens because the contraction of our muscles may counteract the expansion of our lungs.
• Air hunger: we may have the feeling of needing air. Very often during anxiety we experience hyperventilation; this means that we increase the number of breaths per minute but the quality our breathing worsens, as we tend to breath using only the higher parts of our lungs (thoracic breathing) and not our diaphragm. Hyperventilation introduces too much oxygen in our body, and the consequence is a worsening of the intensity of anxiety symptoms.
• Goose bumps: muscle contraction involves as well the skin, causing goose bumps.
• Stomach ache: very often we may experience stomach ache, as if someone punched us in our stomach, nausea or gastrointestinal problems. This happens because when the fight-or-flight response is activated, all the energy of our body is suddenly concentrated in facing the danger and digestion is interrupted, as it consumes a lot of energy that needs to be used to deal with the threat.
• Blurred vision: we may have the feeling that our vision is blurred during intense anxiety episodes. What happens is that pupils dilate in order to let more light come in the eye and have a better sight of the danger. Our eyes focus better on details and peripheral vision worsens, giving us the feeling of blurred vision.
• Dizziness and giddiness: we may experience those symptoms as a consequence of hyperventilation. As written above, hyperventilation brings more oxygen in our body. The consequence is the vaso constrictions of some brain blood vessels, so even if more oxygen is introduced in our body, our brain receives less of it and the consequence may be dizziness.

These are the most common symptoms that we may experience when we are anxious. As you can read, each of them has a specific physiological explanation related to the physiological reactions caused by the perception of a threat.

Taking care of your emotional states is a very important way of taking care of yourself.

Anxiety treatment

If you suffer from a serious anxiety condition, gathering information about what is going on is the first step but it doesn’t substitute specialist help. Psychotherapy and counselling can help you in better handling anxiety symptoms, dealing with hyperventilation and facing the perceived threats that foster your anxiety.