Depression is like a salad. Just like dishes as varied as tuna nicoise, egg salad, and molded Jell-O studded with canned fruit cocktail are all legit salads, the hundreds of possible symptom profiles of depression are all legit depression. This week, Savvy Psychologist Dr. Ellen Hendriksen covers five of the most common faces of depression.
Type #3: Lingering trauma
A meta-analysis of 57 different studies totalling nearly 7000 participants with PTSD found that more than half also had depression.
Interestingly, there was a hierarchy among traumas—survivors of military trauma and other person-to-person assaults like rape or sexual abuse were more likely to have depression than those who had survived non-interpersonal traumas like natural disasters.
This makes sense. Person-to-person traumas, in particular, change your beliefs about the world: I can’t trust anyone; people can turn on you at any moment; if I show any vulnerability, people will exploit my weakness. And those feelings can be profoundly depressing.
It’s possible that trauma feeds this type of depression and vice versa. Let’s take the trauma of bullying. Of course, getting bullied can link directly to depression, but it’s also probable that kids who already grapple with depression—kids who already feel helpless and self-critical—are easier targets for the bullies of the world.
Type #4: Loss
The death of a loved one. A romantic breakup. Although those circumstances are very different, they both represent a loss. There’s no right way and no deadline to heal from a loss, but sometimes the natural healing process gets stuck and the result can be depression. And while “depression” is technically one of the five stages of grief, clinical depression that stretches on and on isn’t a stage, it’s a problem.
With loss and grief, both sleep and appetite evaporate. It’s as if the body goes on strike.
A fascinating study in The American Journal of Psychiatry looked at almost 5,000 people with depression to see if whatever prompted their depression was associated with particular symptoms.
An interesting profile emerged for depression caused by a breakup or death: sadness for sure, not being able to find pleasure in anything—those make sense. But interestingly, eating and sleeping also fell by the wayside. In some kinds of depression, people will stuff their feelings with food or sleep as a way to escape. With loss and grief, both sleep and appetite evaporate. It’s as if the body goes on strike.
Type #5: Failures and setbacks
Failing in spectacular or public fashion—things like job loss or failing out of college—sometimes sparks depression. This particular kind of depression goes along with bone-crushing fatigue, sleeping too much, and a pervasive pessimism, none of which is particularly conducive to job hunting or making up those incomplete classes. It’s as if “I just can’t” were a syndrome.
A couple additional symptoms of failure-related depression are guilt and rumination. Following a failure, it makes sense that individuals ruminate on what went wrong and what they could have done differently. When you ruminate, you spin upsetting thoughts around and around like a car’s wheels spinning on ice. You go nowhere, and all that passive thinking leads to guilt.
Now, there are exceptions to all of these types. Just as panzanella, egg salad, and tuna nicoise are all legit salads, exceptions to all five of these types are all legit depression.
Depression isn’t exactly known for being neat and easily categorized. But it is treatable. There’s no need for you or anyone you love to suffer. And while treatment can sometimes feel like more of an art than a science, the earlier you begin the more effective it is. But even if you’ve been depressed for decades, there is hope. And then? You can start enjoying the ambrosia of life again.
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