The Difference Between Depression and Clinical Depression

My brother once told me that everyone gets depressed sometimes and I need to just get over my depression instead of wallowing in it. Yes, everyone gets depressed but I suffer from clinical depression as a part of my bipolar disorder and trust me, there is a huge difference between the “regular” depression that everybody feels and “clinical depression.” Clinical depression is more extreme in every respect.

Sleep and appetite are such significant bellwethers of depression that my psychiatrist begins each and every session asking about them and has done so for years. (They are known as neurovegetative symptoms although my psychiatrist refers to them as my neuro-vegetables.) Typically, people who are depressed either have problems with sleeping or sleep all the time. I become so enervated that I find it difficult to get out of bed let alone shower and get on with my day. More than once I was sent home from work for lack of showering. That is if I even showed up at work. For a long time, I had trouble being med compliant not because I was rebelling against taking my medicine but rather because I could not muster the strength to get out of bed and pick up prescriptions from the pharmacy. The same extreme also applies to appetite/eating. I overeat typically by going on a fast food or junk food frenzy. There are others who have zero interest in food and stop eating.

And then there are the feelings of worthlessness, hopelessness and of being an abject failure at everything. That frequently goes along with feelings of overwhelming sadness. I used to believe with all my heart that I just wasn’t made for this world. I was too damaged to survive. I used to call my psychiatrist literally from under the blanket because anything else was too much.  At my worst I would create “cocktails” of my various meds because I just could not stand to be awake anymore. I didn’t necessarily actively want to kill myself, it was just too painful to remain awake and if by chance I killed myself then — oh well. And even now when my mood is stable, I still can’t go to sleep without talk radio or tv on as my thoughts just consume me. I need to have someone else’s words to focus on as I’m falling asleep.

 And, of course, there is suicide which includes suicidal ideation, suicide attempts and actual suicide. I’ve been stable for a couple of years thanks to therapy, meds and ECT. That, however, does not mean that I’m immune from depression either the garden variety or clinical depression. You are bipolar forever. Even with my newfound stability when I head into a bout of depression within a day or so I’m right back at suicidal ideation. I’ve been there so many times that by now it’s almost a default position. My guess is the normies don’t think about suicide when they are depressed.

To me one of the biggest differences between regular depression is that clinical depression absolutely has a physical aspect to it. It’s discernable enough that when I feel down I try to determine what kind of depression I’m feeling (The necessity of doing that is a whole ‘nother story.) I feel depression as a weight on my back; a burden that I have to carry. When I’m seated or lying down I feel the many hands of depression pulling my body down making it exceptionally difficult to move. It feels as though the hands are reaching up from the earth and not allowing me to be released from its grasp. It’s not just lack of energy that keeps me abed, it’s an additional weight that pulls me down. I now know that this feeling is not unique to me. A lot of people who suffer from depression feel the literal physical aspect of it. On my twitter feed I see comments about this phenomenon on a daily basis.

I looked at a list of various symptoms of clinical depression and only commented on the ones that I feel most deeply. Below is the list set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. The DSM is essentially the bible of mental illness.

Signs and symptoms of clinical depression may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

So, dear brother, as you can see clinical depression is not something you just get over. It’s something completely different than everyday depression. Diminishing what people are feeling is never a good thing to do but when someone is clinically depressed, it can be especially harmful. When people say they are clinically depressed believe them, support them and assist them in getting any help they may need.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s