What Is Depression?

What exactly is depression? Unlike many physical ailments, mental ailments have no physical test that can be done to determine if someone “has” it. Like two cases of the common cold, no two cases of depression are exactly the same, but they often share a number of common characteristics.

When it comes down to it, if a person is exhibiting enough of a certain list of symptoms to an extent that’s disruptive, they are considered to “have” depression. So, this list of symptoms is itself one way of defining what depression is. The way depression is typically diagnosed is through a questionnaire like the PHQ-9, which helps look at the prevalence and intensity of this list of depression symptoms.

(for the PHQ9 a score of 5-9 indicates mild depression; 10-14 indicates moderate depression; 15-19 indicates moderately severe depression; 20-27 indicates severe depression)

More difficult to pin down than a definition of depression is what causes depression. It is probably the case that there is no single cause, but that there are several different combinations of ingredients that can together create the condition we call depression.

The particularly insidious thing about depression as compared to other ailments such as the common cold is that we tend to identify with its symptoms. When we have a cold, we don’t tend to expand its symptoms into defining features of our identity. We don’t tend to think, “I’m such a sneezy person”, but instead, “I’m sneezing a lot, I must have a cold”.

Depression on the other hand is partly characterized by thoughts that seem to be about us.

In some cases it might be self-criticism: “What’s wrong with me?”, “Why am I so…?”, “I’m such a…”, etc. In some cases it might be a kind of hopelessness: “There’s no point”, “Nothing means anything”, “This is never going to change”, etc. And in other cases it might be isolation: “No one else seems to feel this way”, “No one can understand what I’m going through”, etc.

Like the sniffles of a cold, depression drips with these kinds of thoughts. Unlike the sniffles, we tend to take the symptoms of depression as from us or about us. We come to believe that we are faulty, hopeless, and isolated, beliefs that reinforce the depression and allow it to extend its stay in us.

The dark, heavy cloud of depression acts like the information wing of a totalitarian government, spreading its own propaganda in order to stay in power and blocking information from outside itself. In short, depression is a liar. It drips constant propaganda criticizing us, and then uses how bad we feel as a result as further fuel for its criticizing.

Recovery from depression begins when we are ready to launch a kind of inner revolution, being willing to doubt the endless propaganda, entertain alternative perspectives, and try things that the depression tells us not to do or tries to scare us away from, things that loosen its power over us.

Many of my clients have found it helpful to find out just how inaccurate the isolation messages of their depression are. No one with depression is alone.

In 2020 about 21 million U.S. adults, or 8.4% of the population, had at least one episode of depression. If we consider the number of people who at some point in their life experience diagnosable depression, the numbers go up to around 16% of the American population, or around 52 million people.

If there is good news coming from the prevalence of depression, it’s that there is an incredible amount of help available, and that there is treatment that works. If you are suffering from depression, consider finding a therapist to help support you in your inner revolution. A good therapist can help you better understand your depression, recognize it, dis-identify with it, and build means to keep it from taking hold again.

For more information about depression check out the website for the National Alliance on Mental Illness: https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression.

If you are having thoughts that you would be better off dead or thoughts of killing yourself, please do not hesitate to reach out for support. In the U.S., call the National Suicide Prevention Lifeline for free and confidential help at 1-800-273-8255 or find out more information at https://suicidepreventionlifeline.org/.

You can find additional crisis resources on my Contact page.

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