Monday, May 12, 2008

Health

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Sad? Or Depressed? It's Important to Know the Difference

By Deborah Kotz
Posted 7/17/07

Traumatic happenings, like losing a house in a hurricane or suffering through a divorce, can sometimes trigger the same array of symptoms associated with clinical depression. Insomnia. Weight loss. Exhaustion and feelings of worthlessness. Thoughts of suicide. As a result, doctors may not always successfully distinguish between normal sadness and actual depression—especially during a quickie 10-minute physical. "It takes a while to explore the origins of sadness, whereas writing a prescription takes two minutes," says Ellen McGrath, a psychologist at the Bridge Coaching Institute in New York and author of When Feeling Sad Is Good.

The trouble is antidepressants don't address the source of the sadness, according to William Pollack, an assistant clinical professor of psychiatry at Harvard Medical School who studies depression in men. "When antidepressants are given to those in mourning, their symptoms may go away, but they don't feel good," he says. Sadness lifts, but that often requires time for processing and absorbing it. Denying your feelings or numbing them with medication may only delay the healing.

Losing a loved one can certainly bring on a deep despondency that lasts for weeks or months. In fact, the Diagnostic and Statistical Manual of Mental Disorders, used by doctors to diagnose psychiatric illness, recognizes bereavement as a normal condition that can produce the same set of symptoms as clinical depression. And there's a growing consensus among experts that other losses can do so, too. What's more, Pollack says any change—even a good one—can trigger the blues. "People get sad sometimes when they get a promotion or get married," he says. "Research shows that a massive shift in lifestyle can make someone stressed, anxious, or a little down because of a loss of the familiar."

Recognizing why you're feeling down and talking it through with someone might serve you better than medication. McGrath recommends these three steps to managing and recovering from sadness:

Feel. Acknowledge the depth of your despair and what triggered the feelings.

Deal. Share what you're going through with a close friend, family member, or therapist. "Download to others who can help you manage it," she advises.

Heal. As the sadness starts to lift, integrate the episode into your life experience. Recognize that it's now part of you and allow it to give you a sense of perspective so you can feel joy in happier times.

How to distinguish sadness from depression? Here's a list of common symptoms that might suggest either:

* depressed mood

* lack of pleasure in all, or most, activities

* significant weight loss or weight gain

* insomnia

* severe agitation or slowing down of normal activities

* fatigue or loss of energy

* feelings of worthlessness

* diminished ability to think or concentrate

* recurrent thoughts of death or suicide

Our self-test can help you differentiate between the two. If you experience five or more of these for longer than a few weeks with no signs that they're abating, that's a clue. If you can't work, take care of yourself, or connect in your relationships, says McGrath, that's a clear sign you should see a doctor.

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