Depression is not sadness.

I'm getting a little discouraged on the sleep front. It seems as if it's two steps forward, one step back. I'm having trouble falling asleep and I'm waking up later and later. Again.

Probably if I did some exercise it would help. Instead of trying to add stressful things like going to work. Now that I've got a project going on, I need to go in next weekend and work on it.

Not quite depressed but definitely discouraged today. Trending downward.

What is depression, anyway? How do you know when you are depressed, and not just, say, sad or grieving?

There is a lot of information online about the specific symptoms of depression, as opposed to feeling down. Heck there are even quizzes if you want to self-diagnose. I'd recommend discussing the results with a professional.

It's funny, I haven't looked at the clinical definitions in a while until I started researching for this post. When I was working on depression in my twenties, I wanted to try to learn all I could about my illness.

But the first thing I want to make clear is that depression isn't sadness. Everyone feels sad once in a while: maybe because a friend couldn't make it to a date, or you lost a game, or you saw a sad movie. Those are legitimate reasons for feeling sad.

But the thing about sadness is, eventually, it goes away. A different mood takes over, or something else catches your attention. And, poof, no longer sad.

Depression isn't like that. It may start with sad feelings, or be triggered by something sad. But it doesn't go away. It festers. And the sad feeling starts ferreting out all the little memories that made you sad before, and all the little failures, all the times you disappointed someone. It rolls them up into a ball, throws it at you, and knocks you down like a bowling pin. And it's better not to get up, because the ball is ready to go again.

And sad isn't the only emotion present. When I was hospitalized, we did CBT group therapy. I've saved some of the sheets that I got. The first thing you do on a CBT worksheet is to write down the precipitating thought. Then you write down the emotions that it triggers.

There's never one emotion. Here's one of mine: sad, anxious, angry and embarrassed. Here's someone else's: terrified, anxious, remorse, confused, vulnerable.

Remember, this is a response to just one thought. Think of all the little thoughts that you have in the course of one day, and the feelings that they generate. Now imagine that those feelings don't pass. They accumulate into an ocean of feeling, a tsunami heading straight toward you.

How do you fight against that tidal wave of emotion? If you are depression-prone, you shut down.

You. Don't. Feel. Anything. Because feelings, in your mind, are dangerous, toxic. So it's better to shut them out.

There may be periods of sadness, of tears, but a big part of being depressed is just shutting down. Nothing feels good any more. Nothing feels bad, either. It's safer just to stay curled up in a ball.

This is what started happening to me in high school, and has continued for most of my life. The good thing is that I don't feel like this all the time. There are sometimes periods of normal.

The other good thing is that there are treatments. I'm on medication, and I'm in therapy. There are other things that I can do for myself. I've listed some of them here. If you can get support from friends and family, that's another great thing.

I don't get a lot of support from family and friends. I guess I'll talk about that another time.

Here are some articles that talk about the clinical definition of depression, so I don't have to:

National Alliance for the Mentally Ill definition

WebMD article on clinical depression.

The diagnosis of depression is based on the criteria in this fun and entertaining book, the Diagnostic and Statistical Manual of Mental Disorders. It's published by the American Psychological Association and revised every decade or so. The latest edition, the DSM V came out recently, but the info below is based on the DSM IV.

What is the DSM?
DSM IV criterion for depressive disorder diagnosis
DSM bipolar

The diagnosis of mental disorders is controversial. I personally feel that depression is overdiagnosed, and I am alarmed at the increasing number of children who are being diagnosed as bipolar among other things. There are a lot of unknowns in the diagnosing of mental illness. It's not like you can run a culture, or do an ultrasound and say, yup, you're depressed all right. It all comes down to the right doctor asking the right questions, while the patient gives honest answers.