What does depression look like?


If you think that depression is merely an individual that sleeps in a darkly shaded room for 13 hours a day then think again. I think describing depression like the color grey is a well-chosen description, since just like the color there are many shades to depression as well.

In my psychotherapy practice in Sarasota, I have encountered many different shades of depression.  I have seen fully functional clients who are married, maintain a job, and raise a family, yet their mood has been blunted for many years, unable to extract the simple joy out of life.  Clients suffering from depression who view life from a fatalistic viewpoint where the ability to view the glass as half empty comes easily and naturally. Clients who have masked their depression with drugs and alcohol, clients who cannot handle the volatility of their emotional state and release the energy through anger and rage, and even clients unable to attract and maintain a relationship. These can all be indicators of depression. Depression can also be masked by denial as well.  Let’s face it denial protects us from emotional pain.

How do you treat someone who does not see what you see?

In order to get a better understand if there is a possibility of clinical depression I would also consider the following when evaluating a client:

  1. Is their a constant reel of negative commentary in your head? No matter how good, or how amazing ones actions are, they will not be able to give themselves credit for those actions, rather they will quickly proceed to point out the flaws their actions in the situation.
  2. Feelings of being unlovable or unwanted. This directly speaks to self-esteem and feelings of self-worth, depressed individuals rarely see themselves as deserving of anything.
  3. “Joie de vivre” – French for Joy of Life. I use this term to explain the inability to receive and process even the simplest of joys out of life. Again, almost as if the individual believes they are not deserving to have any joy, the emotions are blunted.  One does not always have to be crying to be depressed.
  4. Suspended in Jell-O. I use this analogy to describe no forward or backward movement, just being stuck in the now. In not allowing ourselves to deal with past issues we won’t have emotional pain. In turn, not allowing ourselves to move forward the fear that something bad things would happen to us can be avoided.
  5. Anger. Anger can be a mask for depression. Emotional volatility is not uncommon and feeling overwhelmed or frustrated can easily manifest into anger.
  6. Drugs and alcohol. What comes first, the chicken or the egg? What appears to be addictive behavior could simply be a means of self-medicating to deal with emotional pain which could lead to addiction. Careful evaluation should be made in circumstances of co-morbidity to determine if  addiction is the catalyst for depression, or if the client is clinically depressed and is using drugs and alcohol as a form of self-medicating.

This outline is merely a glimpse of what depression could possibly look like outside the most common stereotypes as the subtlety and variation can be wide . In the end, clinical evaluation will help determine what is in the best need of the client so that they are able to live a full and emotionally balanced life.