The Depths of Depression

I watched an interesting interview on a morning television program with a well-known actress sharing her lifetime battle with depression. She described quite a dramatic account of the effects of depression throughout her life. She described feelings of despair and entertaining thoughts of suicide. She talked about how she physically shook with feelings of panic and terror. She also admitted that beneath this layer of misery and hopelessness was a child/woman who had very little self-esteem.

It's hard to imagine such a successful actress feeling such self-loathing and despair. And yet, every day I see highly successful entrepreneurs, physicians, teachers, attorneys, mothers, children, etc. who battle this destructive illness.

There are a variety of specific diagnoses all under the broad heading of mood disorders. The particular type of depression described by this actress is referred to as Dysthymic Disorder in the Diagnostic and Statistics Manual of Mental Disorders. (This manual has been developed to help aid psychologists, psychiatrists, and other mental health professionals to more accurately diagnose and treat a variety of mental disorders.)

Dysthymic Disorder is characterized by a person who has been chronically depressed..."for most of the day for more days than not for at least 2 years." (For children this mood may manifest as more irritable than depressed, and the required minimum duration is one year.). Symptoms include poor appetite, or overeating, insomnia, or constant sleeping, fatigue and complaints of very little energy, poor concentration, or difficulty making decisions, and in general, feelings of hopelessness. Individuals may feel uninteresting, or see themselves as incapable. In general they are self-critical and have a very poor self-esteem. Because this pervasive feeling is with these individuals day after day, week after week, for months or even years, these depressed individuals come to believe that this is" just how life is, or just how I am".

As I mentioned earlier, there are many specific types of depression, but all of them involve the individual feeling a sense of helplessness and hopelessness, and subsequent diminished self-esteem. Depression is treatable. A combination of medication and psychotherapy has been demonstrated to be the most effective treatment option. Medication will help to alleviate the somatic complaints. Psychotherapy will train the individual to understand him or herself and create options for feeling more in control of his or her life. Individuals can teach themselves to make choices that are self-enhancing and enjoyable for them. They can begin to take charge of their lives; thus they experience greater self-control. This sense of empowerment mitigates the subjective feelings of helplessness and hopelessness. So often, after seeing a client for a while who presented initially as depressed, I will hear them say, "I had no idea that I was so miserable. I can't believe I spent so much time being unhappy. "The road to feeling better may be bumpy and can be long, but is it travelable. There are options available for creating a life worth living.

Laura R. Meers, Ph.D.
Consulting Psychologists