What is sadness, and what is depression? As depression rates rise and people wake up to more and more people coming out about their struggles with depression, it seems to some as though people are trying to medicalize sadness. But that’s not the case – depression as a condition separate from normal sadness has been acknowledged for centuries, albeit under different names and under a different understanding.
Instead of being a treatable condition, it was considered a personality trait, or possibly a side-effect of some other factor such as war or trauma. Historical figures like Winston Churchill and Abraham Lincoln famously struggled with “melancholy” and “the black dog”, and fictional characters from eras long bygone experience what sounds like eternal sorrow.
The argument I’m making is simple: depression has always existed, it’s just never been acknowledged as much as it is being acknowledged today, and even if people in the West are arguably struggling with depression more today than twenty years ago, it’s easy to believe major depression and depressive symptoms were at an all-time high during periods of economic distress and war, from the aptly-named Great Depression early in the 20th century, to the civil war in the Ukraine, and the bloodshed in the Balkan peninsula. The progress we have made in attempting to understand and treat mental illness is quite astounding – it’s important to remember that well into the 1950s and 60s, “imbecile” and “cretin” were clinically-sound terms in mental health, and lobotomies were being performed by the tens of thousands per year.
We have the privilege of living at a time when depression is taken more seriously than ever before, with treatments that actually work. Yet our general understanding of depression is still flawed and incomplete. We’re not completely sure how the brain works, and there are many mysteries still to be answered in the realm of mental health. Treating depression is very much a game of trial and error, finding what works for each individual patient, and eliminating treatment methods based on inefficacy or factors that rule out certain treatments.
One myth is that there is only one degree of depression – and that someone who managed to lead a successful career can’t possibly struggle with depression in the same vein as someone who can’t get out of bed in the morning. But the truth is that very few people know what any given person is actually like, and many people with depressive symptoms stay quiet about their struggles, to the point that most people wouldn’t suspect they had any. Suffering invisibly is common for people with “high-functioning” depression, but this does not make their diagnosis any less important to the issue of depression in society today.
What “High-Functioning” Looks Like
High-functioning depression is not an actual diagnosis, but a mild depression in individuals who still go to work, remain social, and in every sense of the term are “high-functioning”. Depression can be debilitating, but many struggle with it in private, their fight unseen by friends or even family except in rare cases.
Someone with a high-functioning depression may go about their day normally, and then fall apart in private. This type of depression is usually caused by stress and other environmental factors, and by reducing stress and taking better care of oneself, the symptoms do gradually go away. This isn’t always the case, of course.
It’s Still a Form of Depression
A person with high-functioning depression still experiences depressive symptoms. Instead of unwinding after the end of a day, leaning back into the couch or chair and going about their hobbies, people with high-functioning depression hide feelings of shame and sadness, struggling to sleep, and finally waking up the next morning, fighting to get out of bed – as per usual. The symptoms may be mild enough to let them work and power through their lives without others noticing, but ultimately, they still fall apart alone or in the arms of their partner, tired and unable to celebrate their efforts.
If you come home every day feeling worn out and blue, even on days when you should – by all other accounts – feel happy or elated, then you may be struggling under way too much stress. Over time, all that stress can develop into a serious problem. In other cases, stress is only a trigger for a depression waiting to happen.
Different People, Different Treatments
Rather than looking at depression as a single disease, it is far more accurate to look at it as a large group of possible disorders, with each case facing unique struggles. You can’t flat out recommend one treatment to everyone because of the textbook definition of their diagnosis – in that same vain, expecting a treatment to help simply because it helped others can set you up for serious disappointment.
Depression is a complex disorder, insofar that it has far too many factors influencing it to effectively categorize people and assign treatment based entirely on their symptoms. Ultimately, treating a person with depressive symptoms means working with them to identify what would work best. In other words: you need to get help, and work with a professional who will help you delve deeper into why you might be depressed, and what would effectively treat your depression.
Talk therapy can be very useful but not for everyone. If the depression takes a severe turn, medication can be life-saving – but it can come with a slew of side-effects, including suicidal tendencies, making it very important to spend time finding the right one. Alternative treatment like transcranial magnetic stimulation can be effective, but in most cases only insurable after other options have been tried. Acupuncture and yoga have also been anecdotally helpful, and studies show a correlation between reduced pain, stress, and depression, after acupuncture treatment.
Lifestyle changes can potentially be huge, too. High-functioning individuals are often under a lot of stress and taking measures to effectively reduce that stress can go a long way. Not only will that give you some time to relax, but it should improve quality of sleep, as well as physical health.
Accepting Help Against Depression
High-functioning depression is always a temporary thing. As time goes on, pushing through against the depression becomes more and more exhausting, and eventually it feels like a fight not worth fighting. Getting help early on is important – life shouldn’t be about constantly fighting your own thoughts and feelings, and with some help, things will be much easier.