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The fine line between sadness and depression

Updated: Oct 19, 2023

"I don't feel good, I don't feel bad either, I just feel empty." That was the comment of one of my first patients. Not finding a concrete meaning to life, not finding pleasure in what used to be enjoyable, that no one can understand how it is to see everything in such darkness means that you feel trapped in a hole, a hole from which you often don't even want to get out, for fear of what you might find. This is how depression can look or feel, a mental disorder often ignored and confused with the emotion of sadness. A large percentage of people who come to therapy is due to a poor handling of sadness, since throughout their lives they have not been instructed how to adequately manage this emotion, which, like any other, is part of the human being and should not be labeled as bad.


Sadness is a normal and common emotion, as can be joy, fear, or shame. These emotions are present throughout our lives, and all people anywhere in the world will share, the problem lies in how we deal with it, taking fear as an example, an emotion that in specific circumstances can help us to survive in dangerous situations.


By the same means, sadness can help us overcome adverse situations, which can affect us, but can also make us grow personally, crying and taking time for ourselves while feeling sad, is beneficial for our mental health.


What happens when sadness overtakes us? The answer to this question is, needless to say complex, sadness is part of depression; however, depression is not part of sadness. Both coexist at a certain point, both are on a thin line, and that is what causes confusion about both concepts, sadness is momentary, we can feel sadness for losing an exam, for a scolding, for a commentary a scolding, for a comment, for more complex things such as the loss of a job or the loss of a loved one.


In these cases, sadness is necessary and justified; losing a loved one takes some time of mourning, but this mourning can be seen as "normal" in such a situation. Now, if this sadness increases in intensity and lasts longer than necessary, this is where this fine line is crossed, and we may be talking about a depressive disorder.


What is depression? Depressive disorders, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are a set of signs and symptoms where a depressed, sad, or discouraged state will be predominant, for some time. The characteristic symptoms of this set of disorders are a depressed mood, decreased interest, or pleasure in activities (Abulia), and the inability to experience pleasure (Anhedonia).


The time spent on this type of disorder is important because it can help to a better diagnosis, just as it can be two weeks, it can be two years. When this symptomatology is present, we can begin to consider the possibility of a depressive disorder, this of course must be supported and diagnosed by a mental health professional.


Along with these symptoms, we can find others that may or may not be present, such as significant weight loss or, on the contrary, significant weight loss or, on the contrary, excessive weight gain, insomnia or hypersomnia, fatigue or loss of energy, a significant decrease in concentration, motor agitation, and the most dangerous symptom, and the most dangerous symptom, constant thoughts of death.


Another important difference between sadness and depression is their intensity, as well as the thoughts and behaviors that come with the latter. When we are sad, feeling down, or discouraged by a particular situation, our attention is focused on the situation, but depression goes beyond that.


Depression can lower our self-esteem considerably, we feel bad about ourselves, we feel bad about ourselves, feelings of guilt, the desire to escape at any moment, and uncontrollable despair, although it is not described in books as such, those who have suffered from depression know what this feeling is like. There are also compensatory behaviors, which by some means try to protect the person from feeling bad. These behaviors can be, for example, performing many activities to keep us distracted, making compulsive purchases, denying the problem, and thus repressing it.


The situation with these compensatory behaviors is that the more you avoid facing the situation, the bigger the problem will become, and the more it will accumulate so that one day all these emotions, feelings, thoughts, and ideas will suffocate the person to the point of collapse.


The uncertainty of not being able to get out of this situation, losing even the notion of time, can make you feel suspended in the space in which you are, without understanding what is happening around you, and slowly consuming you. The most effective way to cope with depression is to face it, which is easier said than done, however, the route to facing ourselves is arduous and must be constant. The effectiveness of therapy in the treatment of depressive disorders has been proven, but the first step to getting better is to accept that we have a problem and that we want to face it, we need to understand where those feelings come from, that symptomatology, embrace our pain and not push it aside, not avoid it.


Once we understand and accept this, change and improvement can begin. It is not always about overcoming, many times we must first understand, to heal our wounds.


Psychological therapy is effective, we should not hesitate to seek it, because when something hurts us or something is wrong with our body, we go to the doctor almost immediately. But when we are feeling the burden of our thoughts, feelings, the emotions, we do not go immediately to the psychologist, we prefer to avoid it, this way also avoiding being labeled "crazy".


Therapies such as cognitive behavioral therapy, which essentially seeks to modify negative thinking and behaviors, have proven to be one of the most effective in cases of depression and anxiety.


Humanistic therapy, which seeks to understand human beings, their feelings, and self-concepts, can also be a solution. In the end, mental health is going to be equally or more important than physical health, let's not be afraid of psychological therapy, the first step to improvement will always be to accept that we have a problem.

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