The opposite of depression is not happiness, but vitality
People with depression often report still being able to work, socialise, and function, while still feeling flat, heavy, exhausted, or shut down inside. Depression can be missed not because you wake up one day and become depressed, but because you simply start disappearing from your own life, bit by bit.
Signs of depression
Depression is more likely when low mood or emotional numbness crosses multiple areas of your life and functioning. Look out for:
- Persistent low mood, emptiness, hopelessness, worthlessness, or self-blame
- Loss of interest or pleasure in hobbies
- Fatigue or exhaustion
- Poor concentration
- Difficulty making decisions
- Sleep, appetite, or weight changes
- Feeling unusually restless or slowed down
- Withdrawing from people or work
- Thoughts of death, self-harm, or suicide
Why am I depressed?
Often, depression develops through a mix of:
- Chronic stress or burnout
- Grief or loss
- Loneliness
- Family or relationship conflict
- Bullying or discrimination
- Difficult or adverse childhood experiences
- Major life changes or transitions (relocation, childbirth)
- Multiple stressors building up over time
Do note that grief is related to, but separate from, depression. In grief, the pain is often tied to the loss and tends to come in waves. In major depression, the mood is more persistently low, and there is often a broader inability to feel pleasure or hope.
Types of depression
Major depressive disorder
This is the more classic form of depression, which may occur as a one-off event, or recur multiple times. The frequency, duration, and intensity can vary from person to person. This can be the result of significant, acute stressors arising from specific life transitions or events.
Persistent depressive disorder
Chronic depression manifesting as depressed mood for most of the day, most days, for at least 2 years. Symptoms include low energy, hopelessness, poor concentration, appetite change, sleep change, or low self-esteem. These symptoms may become so normalised that the person may not report them clearly unless asked directly. This can be the result of adverse childhood environments or situations that create cycles of stressors continuously impacting mood and mental health.
Perinatal or postpartum depression
Depression can also develop during pregnancy or after childbirth. This arises because a sharp drop in reproductive hormones after childbirth can interfere with normal sleep patterns alongside a loss of identity, stress, and caregiver burnout.
Treatment
Therapy
Therapy can help with:
- Enhancing insight and psychological formulation
- Restructuring maladaptive cognitive, emotional, and behavioural patterns
- Reducing experiential and behavioural avoidance
- Strengthening adaptive coping and emotional regulation
- Restoring functional capacity and psychosocial functioning
Medication
Medication may help when symptoms are more severe, more impairing, or heavy enough that the person struggles to properly engage in life or therapy. For example, Selective Serotonin Reuptake Inhibitors (SSRIs) increase serotonin by blocking its reuptake, which can be supplemented with lithium-based medication in more serious instances of depression.
Research seems to indicate people generally respond better to treatment that combines medication and therapy.
Recovery
Recovery is non-linear and manifests differently for each person. It can look like:
- Better insight regarding triggers and relapse signs
- Slightly better energy
- Less emotional heaviness
- Improved concentration
- Less hopelessness, worthlessness, or guilt
- Slightly more interest in hobbies