Library Worklife

Volume 2, No. 1 • January 2005

Work/Life

When Sadness Stops the Music

A Look at Identification and Treatment of Clinical Depression and SAD

By Casey Schacher

Snow wraps Chicago in a loose blanket while new flakes swirl in gusts of wind like children playing chase. Shovels scrape concrete as small-business owners wisely clear the sidewalks in front of their stores, their breath fogging the air as they quickly labor. Sometimes they will smile at me as I walk by. But now they focus single-mindedly on finishing their work and getting back inside. From inside their shops, the smells of roasted duck and fresh-baked bread drift faintly outside. Usually, my mouth waters at the rich, salty aromas. Today, however, the scents are far-off, trapped behind closed glass doors.

It is morning and I am completing my short walk to the station to catch a train to work. My steps are confident and energetic as I spring up the steps onto the platform. I look around to see if anyone in the station noticed my lively entrance. The people have buried themselves deep inside of parkas and trench coats, bound to unwrap again only when the delightfully heated train arrives. Everyone is engrossed in thoughts and solitary activities.

I have seen many of the passengers previously. A man waiting next to me always leans his head back, closes his eyes, and taps his foot to music coming from unseen headphones. A woman I recognize a bit father away has her customary cup of steaming coffee, which she sips carefully while reading the paper. Once she settles onto the train, she will not look up from that paper.

Looking around at the community of morning train-goers, I realize something unusual is happening: I'm happy. I feel like I did when I first arrived in this huge city, absorbing every site and smell with relish. The sounds on this insignificant walk to the train are like a familiar, endearing melody—like a theme song to a favorite show. Today, there is a bounce in my step and I feel like dancing.

This is unusual because, for weeks, it seemed that I had trouble truly enjoying anything. Completing my daily routine required will power since I was without energy or enjoyment to aid me. Things I usually found pleasure in, like fresh-baked bread and the commute to work, did not appeal to me. I told myself, "Snap out of it." But I could not shake a seemingly perpetual sense apathy and sadness.

Until today. Although everything is buried and made inaccessible by a frigid snowstorm, I feel suddenly free. I am reminded that I really do enjoy those little, everyday occurrences. How could I have forgotten to appreciate them?

"For millions, depression stains every thought, every act, every moment. In fact, it will affect one person in four, in his or her life," reported Dr. Sanjay Gupta.¹ Depression is common. To think—possibly one out of every four people in any given place suffer from it. Looking at the expressionless faces around me, I can believe it. Like me, however, I bet they do not even realize it. They have probably gotten used to the "blah" feeling, even as they wonder why they have no energy and why their experiences at home, school, and work seem less fulfilling.

There are ways to identify depression. Depression has clear symptoms, which include:

A persistent sad, anxious, or “empty” mood
A persistent loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
Decreased energy, fatigue
Feelings of hopelessness, helplessness, worthlessness, guilt, and pessimism
Appetite loss and weight loss or increased appetite and weight gain
Difficulty concentrating, remembering, and making decisions
Sleep disturbance (e.g., insomnia, early-morning awakening, or sleeping too much)
Restlessness
Irritability
Thoughts of death or suicide
Persistent physical symptoms that do not respond to treatment, (e.g., headaches, gastrointestinal complaints, and chronic pain).²

Depression can attack at any time and to any person. There is even a special category of depression that affects people at certain times of the year. Many people experience a season-specific form called Seasonal Affective Disorder, or SAD. "Winter depression," a common form of SAD, is "characterized by recurrent episodes of depression, hypersomnia, augmented appetite with carbohydrate craving, and weight gain that begin in the autumn and continue through the winter months."³

Symptoms of Seasonal Affective Disorder (SAD) include:

regularly occurring symptoms of depression (excessive eating and sleeping, weight gain) during the fall or winter months.
full remission from depression occurs in the spring and summer months.
symptoms occurring in the past two years, with no non-seasonal depression episodes.
seasonal episodes substantially outnumber non-seasonal depression episodes.
a craving for sugary and/or starchy foods.⁴

Treatment for both clinical depression and SAD varies and usually requires the assistance of a medical professional. Often, treatment includes the use of prescription drugs. Natural substances, such as St. John's Wort, have also proven effective.

Light therapy, or the use of artificial light to recreate the effects of the sun, has been used to treat SAD. With this form of treatment, patients are exposed to light levels similar to natural dawn sunlight. While this form of treatment has been effective and is covered by most insurance, researchers suggest that one hour of walking in winter sunlight proves as effective at treating SAD as two and a half hours using artificial light therapy (plus you get the added benefit of cardiovascular exercise).⁵

Regardless of the preferred method of treatment, people often find performing everyday tasks while suffering from depression to be nearly impossible. There are some simple steps, however, that you can take to make functioning everyday easier during these times:

Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
Break large tasks into small ones, set some priorities, and do what you can as you can.
Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
Participate in activities that may make you feel better.
Mild exercise, [like] going to a movie [or] a ballgame, or participating in religious, social, or other activities may help.
Expect your mood to improve gradually, not immediately. Feeling better takes time. People rarely "snap out of" a depression. But they can feel a little better day-by-day.
It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition-change jobs, get married or divorced-discuss it with others who know you well and have a more objective view of your situation.
Remember , positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
Let your family and friends help you. ⁶

Remember, these are just coping mechanisms. They can help make daily activities more manageable but will not treat the actual depression. It is important to get help when you suffer from consistent and overwhelming depression. If you think that you might have depression, first contact your doctor. Then, feel good about yourself for bravely taking a healthy step towards getting better.

As for me, I'm going to board the warm train, unwrap myself from layers of wool and cotton, and think about things that I have momentarily forgotten to love. Hopefully the man next to me will continue to tap his foot to the music and the woman will enjoy every drop of her coffee—today and tomorrow.

References

Dr. Sanjay Gupta,"Conquering Depression Today: 'I Didn't Think Anything Was Wrong With Me," CNN.com/Health, March 8, 2002. Accessed Jan. 5, 2005, http://archives.cnn.com/2002/HEALTH/conditions/03/08/conquering.depression/index.html.
The Depression Center, "About Depression." Accessed Jan. 5, 2005, www.depressioncenter.net/professional/about.
M. D. Saeed, S. Ateza,z and T.J Bruce, 1998. "Seasonal Affective Disorders," American Family Physician ( Mar. 15, 1998). Accessed Jan. 5, 2005, www.aafp.org/afp/980315ap/saeed.html.
National Mental Health Association,"Seasonal Affective Disorder." Accessed Jan. 5, 2005, www.nmha.org/infoctr/factsheets/27.cfm.
"Winter Depression," Harvard Mental Health Letter 21, no. 5 (2004): 4.
National Institute of Mental Health, "Depression," 2000. Accessed Jan. 5, 2005, www.nimh.nih.gov/publicat/depression.cfm#ptdep7.