Is It Depression or a Bad Case of the Blues?

Keri came into my office because she had noticed some changes in her mood. When I asked her what was going on she told me she’d been crying a lot lately, couldn’t sleep well, wasn’t eating much, and she couldn’t concentrate.  I asked her if she could identify any recent triggers to what she had been experiencing. She said that she noticed feeling anxious right before Easter. Her mood had gotten progressively worse after the holiday was over.

I asked Keri about her family history. She explained that she had a difficult relationship with her mother, who had always been critical and cold. I asked if she spent the Easter holiday with her family, she said yes.

Lots of people get the blues during or after a holiday. The holidays are supposed to be a time of connecting, sharing with family and friends, and having fun. But for people like Keri, they can trigger anxiety, loneliness, and depression, especially if family relationships aren’t what we had hoped for or expected.

For most of the year, we can chose to avoid thinking about the disappointments family and the holidays engender, but what happens if those feelings don’t go away? What if we find ourselves down in the dumps long after the holiday is over? How can we tell if we’re just experiencing a bad case of the blues, or if we’re clinically depressed?

While most of us have experienced “down” days for no apparent reason, clinical depression is something altogether different. Making our way through it can feel very much like wandering through a desert wilderness—alone. That’s why it’s important to pay attention to what’s going on inside, and get help if necessary.

 

Noticing the Signs

 

Keri was wise to come in for help. There were lots of things rumbling underneath the conscious surface in her life. Most of them were connected to her beliefs about herself, and her mom. Keri had never made the connection, but as we talked that day in my office, a crystalizing moment occurred for her. She realized she always had a low-grade case of the blues, but she would discount it due to all the other stressors in her life. Keri never stopped to take inventory of her heart, and how all the years of burying her emotional pain over her distant relationship with her mom had affected her. When she would go home, old familiar patterns of relatedness would be triggered and she would experience being even more depressed in the days and weeks to come.

But why had these symptoms gotten so much worse for Keri at her Easter visit? Because she discovered her mother had cancer. Keri admitted that anytime she went home for a visit, she felt anxious and stressed, but this time, after learning of her mother’s illness, it brought all her “stuff” to the surface.

 

Noticing the Signs

The first thing I did with Keri was to help her to notice what had been going on for her physically, and emotionally and spiritually. Her presenting symptoms indicated she had moved from experiencing “the blues” to clinical depression.

How does clinical depression differ from the weekly blues, and what can we do about it? First, we need to understand the symptoms. The American Psychiatric Association outlines the criteria for major depressive disorder in the DSM-IV (Diagnostic and Statistical Manual for Mental Disorders) by the following:

• Persistent blue sad mood for most of the day
• Diminished interest or pleasure in almost all activities most of the day
• Significant weight loss or weight gain, or decrease in appetite
• Insomnia or hypersomnia
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Diminished ability to think, concentrate, or be decisive
• Recurrent thoughts of death, recurrent suicidal ideation with or without a specific plan. A suicide attempt or plan for committing suicide

 

Keri and I began to work on identifying the losses in her life; especially those connected with her mother. As for her occasional bout with the blues, here are some of the tips I gave her to help:

• Manage what life stressors you can and learn to let go of the rest. Stress compounds anxiety and feelings of depression
• Don’t overcommit ---learn to say no
• Practice good self-care skills by identifying what you need and doing it
• Practice deep breathing and muscle relaxation when tense
• Plan things to look forward to
• Don’t allow past hurts and offenses to weight you down
• Allow yourself to grieve if you’re sad. When you bury your feelings, you only bury them alive
• Surrender your rights to have things be the way you want them to, and be willing to face challenges

Clinical depression is treatable. If you or someone you love is experiencing 5 or more of the depressive symptoms listed, consistently, for a two-week period or longer, professional help may be necessary. You don’t just get over it.

So take the time today to notice what’s going on for you in body, soul and spirit. Don’t wait till the blues becomes something more than you can handle. Remember it’s your heart--- keep it alive by checking the emotional pulse.