Ep. 355 The Difference Between Sadness and Depression (rerun)

Terry [00:00:04] Hello and welcome to the Giving Voice to Depression podcast brought to you by Recovery.com, a free online resource created to make it easier to find addiction and mental health treatment and resources. Each week we profile a guest here who shares intimate details of their mental health journey. They share because they understand that when people don't talk about their depression or other mental health conditions, those of us who struggle with them can feel like we're the only ones, that there is something wrong with us,  and that no one understands. We understand. I'm Terry, the creator and co-host of this podcast. You have my promise that we'll keep it real here. Depression is real and we're not going to sugarcoat our discussions about it. Hope is also real and you'll get a dose of that here, too. Thanks for joining us. 

Terry [00:01:00] We record a couple new interviews each month and also replay some of our best ones from the archives so that newer listeners don't miss out on those. This episode is from our earlier years when I co-hosted with my sister, Bridget. 

Bridget [00:01:14] Hi, Terry. (Hi, Bridget.) Today we're going to talk about the difference between being sad or down versus being depressed or having depression. We're actually going to ask a couple experts to weigh in on it in hopes of giving those of us with depression some affirmation and maybe even some language to talk about it and those seeking understanding to get some credible information so that they perhaps can be more compassionate. 

Terry [00:01:38] And speaking of credible, I am looking at an article in Psychology Today by a licensed psychologist who I like, Guy Winch, and he says that many of us struggle to tell the difference between these two common psychological states, as you just said, sad or depressed. And he says it's a huge problem that there's confusion because it can lead us to neglect a serious condition that requires treatment, which of course is depression, or on the other end of the spectrum, we can overreact to the normative emotional state of sadness. 

Bridget [00:02:05] Hm. Today we're going to start with talking with Dr. Robert Duff, or Duff the Psych, as he's known online, and in his hardcore self-help series of books on anxiety and depression, which are fabulous, even if you're sensitive to the F-bomb. We recommend them. He's a psychologist in Southern California. He has a private practice. 

Terry [00:02:24] He describes himself as having the specialty of taking complex psychological issues and breaking them down into plain language. (Thank you. Thank you!) Some of it's quite plain, but that's why we called him and why we asked him to explain for us the difference between, again, what I always call Big D and Little D depression. 

Dr. Duff [00:02:49] So depression is frustrating in some ways, in terms of the word, because it is a word in common language. You can feel depressed without being depressed, right? Without being clinically depressed. Depression is a feeling that everybody has of being sad, of feeling like the wind's taken out of your sails, maybe being lethargic, things like that. But with clinical depression, it's a pattern of those feelings. So, the real difference is that practical impact and the fact that it's an extended period of time. And for many people, it's also recurring. It looks a bit different for each person. 

Bridget [00:03:24] But it's not affecting us more because we're weak or overly sensitive or unable to handle life as well as other people. It's because there's an actual mental illness in play here, right? 

Dr. Duff [00:03:35] Sure, absolutely. I mean, that's one of the reasons that medication and other more physiological interventions work is because there actually is a difference that happens in the brain when someone's depressed. And, you know, there's a little bit of chicken and egg going on of is the brain different and that's what makes you depressed or is your brain different because you're depressed. But either way, there is a difference and that's why when you're depressed it can feel like such an uphill battle. And no, it's not because you're weak. 

Terry [00:04:02] And when you realize that this is like a battle you're having with your own brain, I think of what would know our weaknesses or our buttons better than our own minds. 

Bridget [00:04:10] Oh, is that ever well said, Terry? (It's an unfair battle.) Totally. You can't win —or it feels like you can't win. Well, I would even go so far as to say you can win until it shifts or thins. 

Terry [00:04:22] I like the way Dr. Duff describes it. Listen to this. 

Dr. Duff [00:04:25] I like to think of depression kind of as a parasite because it does all of the things to you that it needs to keep itself strong. It saps your energy, so it makes you feel more lethargic, which makes you not do things, which makes you feel more guilty, which make you feel more depressed, and so it goes in a cycle and it builds itself up and up. So it's really ... it can be something that's really hard to deal with without some sort of outside intervention or without something to just really get you on the path of trying to make a difference for yourself. It makes us come to this quote-unquote realization that, oh, this whole time I thought I was actually an okay person, but I'm not, which is totally backwards from, you know, often the reality and often where you would want to be. But it plays that trick on you, and it plays a lot of tricks on you. 

Bridget [00:05:09] He says it plays tricks on you, and I would say it lies unrelentingly to you. (Unrelentedly and convincingly.) Mm-hmm. Next, we're going to speak with Dr. Margaret Rutherford, who's also a psychologist and has a private practice in Arkansas. We asked her, where's the line? Where is that difference between really feeling bad because something is depressing, something is happening, and being depressed? 

Dr. Margaret Rutherford [00:05:40] We do all get down. We all have situations that are frustrating or we get despondent sometimes but the difference is, one, there's usually a specific trigger that we can recognize, two, it ends. It has a beginning, a middle, and an end. Depression does not. Depression can come on very, very gradually or sometimes very acutely with a loss or some kind of trauma. But what happens with depression is you wake up with it, you're eating lunch with it, and you go to bed with it. It does not remit. Depression can look a lot of ways. It can look like agitation and anger, it can look melancholy, it can look like the guy in the commercial that doesn't want to walk the dog, who's sitting on the bathroom floor. It can be perfectly-hidden depression and you don't look like that at all. And so when you have stepped over from being down into depression, it's something that greets you every day when you put your feet on the floor. And actually, in classic depression most of the time, the work is getting re-engaged outside of yourself. 

Bridget [00:06:55] I would say it consumes you every day when you put your feet on the floor. 

Terry [00:06:59] In one of Dr. Margaret's blogs, she said that people with depression, she said it's almost like you forget how to be happy. That it's not a choice. 

Bridget [00:07:07] It's so true. (Right). It's so true. It's like my brain goes into that place and it can't get out. I'm not trying to be mean. I'm not trying to be irritable. I'm not trying to not be grateful and notice all the beauty and amazing blessings of my life. I can't. 

Terry [00:07:25] Mm-hmm. That's what she says. She says your brain literally will not allow you to think of a future with promise or hope. 

Bridget [00:07:31] Ugh, it's so true. 

Dr. Margaret Rutherford [00:07:34] People with depression are not whiners. They're not just feeling sorry for themselves. It is a state of mind. It's as if you can't focus on whatever you had in your life that you enjoyed, you no longer enjoy it. And that's not a choice, that's the reality of how you feel. Frequently, there is a genetic predisposition for depression. So, your mother, father, grandparents, somebody before you was depressed and, just like you may have a predisposition for diabetes or predisposition for cancer, you can have a pre-disposition for depression. 

Bridget [00:08:13] It gives me a bad disposition. 

Terry [00:08:16] It gives you what? 

Bridget [00:08:17] A bad disposition. 

Terry [00:08:17] It gives a bad disposition and we both have a predisposition. (Yes.) So then the third expert we called in to talk about this with us is Dr. Maduka Trivedi and he is the head of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center and said that he thinks it's really important that these conversations are being had and he weighed in, too.

Dr. Maduka Trivedi [00:08:45] So I think in general the way I explain to lay people is the following: all of us can have ups and downs in life and when you have a down period you do feel down but there are two easy signals that we tell you. One is even when you are feeling down if there is some positive thing happening in your life or some positive event occurring or somebody — a loved one — calls you, you temporarily or even sometimes immediately get out of that funk and start sort of communicating like you were before. If you have a small-d (depression) ... a sort of bad day. If you have Depression it is very hard to do that because your ruminative negative thoughts just overtake no matter what the environment is. And the second thing is that when somebody has a depressive illness —depression syndrome — then that negative thoughts, negative feelings is basically like a cloud hanging over your head, taking over everything you think and feel and do. 

Bridget [00:09:46] Is Depression real? 

Dr. Maduka Trivedi [00:09:48] Nobody should question that whether this is real or not. This is a brain disease and the signs and symptoms are clear and the difference between somebody who is in the middle of depression and when they are better, thankfully with the right treatment, that difference is night and day. I don't think that people should question this. This is a very common illness and should not be misunderstood as anything but a real illness and it's not a weakness. 

Bridget [00:10:23] A resource that we'd like to share is on WebMD, and they list nine symptoms, and we just want to share that with you. Guess what? The first is a depressed mood, sadness, or an empty feeling. 

Terry [00:10:35] A loss of interest or pleasure in activities you once enjoyed. 

Bridget [00:10:38] Significant weight loss when not dieting or significant weight gain. 

Terry [00:10:43] Inability to sleep or excessive sleeping. 

Bridget [00:10:46] Restlessness or irritability, particularly in children and adolescents, or a feeling of dragging. 

Terry [00:10:52] Fatigue or loss of energy? 

Bridget [00:10:54] Feeling of worthlessness or excessive and inappropriate guilt. 

Terry [00:10:58] Difficulty thinking, concentrating, or indecisiveness. 

Bridget [00:11:01] Reocurrent thoughts of death or suicide without a specific plan or a suicide attempt or a specific plan for committing suicide.

Terry [00:11:10] And the article says if you have five or more of these symptoms for most of the day nearly every day for at least two weeks and the symptoms are severe enough to interfere with your daily activities, you may have major Depression. 

Bridget [00:11:22] and to get yourself into the doctor and see if they can help you manage it. And I think a pill is a huge piece of it, but certainly not the only piece. And it might help you sleep, which is a game changer. 

Terry [00:11:33] Absolutely. Sleep helps everything. So does laughter, which is why it's so nice working with you, Bridget. Love you. Bye. 

Bridget [00:11:39] Bye. 

Terry [00:11:45] We truly hope this discussion helps you better understand your own depression or how to support someone else in your life who lives with it. We invite you to check out the hundreds of other episodes in our archive and to explore both the resource hub and treatment options on Recovery.com. Depression is too dark a road to walk alone. We'll be back next week.