Clinical Depression: What about it-where to start?

Around 20 million people experience significant depression annually. This means having more than “the Blues.” This overview on depression is intended to highlight key concerns. Depression interferes with the way we live our lives. Untreated, symptoms can last for weeks, months, or years, and is harder to stop the longer it lasts. It affects feelings, thought, actions, and it can become life-threatening if left unaddressed.

Physical illnesses such as headaches, stomach disorders, and fatigue may be key signs depression has set in. Some other signs include:

  • Difficulty concentrating, remembering things, or making decisions
  • Too much or too little sleep
  • Loss of interest in activities once enjoyed
  • Feelings of worthlessness or guilt
  • Constant feelings and thoughts of sadness, hopelessness, death or even suicide.

Severe/clinical depression is not something you can just “get over” without adequate treatment to recover. Waiting for it to ‘just go away’ can only result in it just getting worse.

While some people appear to inherit a tendency to have a chemical imbalance in their mood-controlling brain chemistry, others of us may experience prolonged disappointments that can make us more fragile and lead to depression. A special note on how depression interplays with physical health: Depression tends to interfere with the accuracy of our memory when recalling our aches and pains. Research continues to explore the psychological overlay between the psychological and physical illnesses we develop. People who are depressed tend to report more physical symptoms than they actually experience. As noted earlier, common physical symptoms include aches and pains,gastrointestinal problems and upper-respiratory issues. Those who had a higher level of depression can be more likely to overstate the frequency of their symptoms. Thus, what happens is that those who have felt depressed can make more errors when asked to remember their physical symptoms. When we are depressed, we tend to exaggerate our experience.

Depression can cause us to be more neurotic, versus neuroticism being behind what causes us to offer more inflated reports of symptoms. This is often a “vicious circle.” This is especially important because symptoms reported by patients play a major role in a physician’s diagnosis and treatment decisions. If you go to a physician, it is important you take a list of your symptoms in with you. This will help physicians better diagnose common symptoms as pointing to a cause. Having a list can indicate serious problems caused by the protracted effects of depression. Remember, individuals who are depressed tend to ‘over-remember’ the frequency of their symptoms. So, if you are a therapist or medical provider reading this, it is a good treatment strategy is to encourage clients/patients to write down their symptoms as they’re happening day to day. That way both the individual and caregiver have an accurate record of what has been steadily going on, rather than relying on their instant memory alone, during the moment of treatment dialogue.

While seeing a therapist/mental health counselor can be as or more effective than medications alone, both may be needed. As the client, let your mental health professional or physician help you determine a good treatment course. Also, getting adequate sleep (8-10 hours for adults, 9-11 for adolescents, and 10-12 for children) and daily exercise, with a healthy diet, are essential foundational needs for optimal recovery and balance. Often, after even a few weeks, to a few months, a significant shift can take place. So avoid the “Someday I will(s)…” and don’t guilt yourself for not already having taken action. Rather, reach out on some level, through prayer, attending church, or through talking to a family member or friend, ask them or your pastor for a referral to a physician or professional counselor. Take action today!


Author: Gregory Sowles PhD, HSPP, LMHC, Clinical / Neuropsychologist Vision Counseling and Psychological Services