Ordinary Human Misery: Am I Depressed Or Does Life Just Suck?

There’s plenty in life to bring us down — economic uncertainty, the struggle to keep up with a constantly changing world, troubled relationships, concerns about protecting our loved ones, worries about health and aging. And even if everything is great in our own lives, we only have to turn on the news for heartbreaking reminders that not everyone can say the same — victims of war, poverty, natural disasters, terrorism.

No wonder then that so many of the people who come to me for help because they are feeling low ask a version of this question: “Am I depressed, or does life just suck?”

In other words, am I having a normal response to the sometimes harsh realities of life, or am I experiencing an illness that needs to be treated?

It can be a tricky question to answer because feeling blue and depression are different things, but they so often get tangled up in each other.

Depression, known medically as major depressive disorder or clinical depression, is thought to be a problem with the chemical neurotransmitters in the brain and with the activity levels in certain brain areas. It can leave you feeling empty or hopeless and unable to enjoy life as you once did.

Sometimes depression seems to start out of the blue. But sometimes it is triggered by a stressful life event or as a result of chronic stress. In other words, if your mood is low because you feel life sucks, you are at greater risk of developing depression.

How distressed you are is far from the only risk factor, however. Others include:

• Your genes. If depression runs in your family you are more likely to experience it too — and to have it reoccur.
• Your personality. Some seem able to look on the bright side no matter the circumstances while others are more prone to take things personally, expect the worst, and accentuate the negative.
• A history of childhood physical or sexual abuse.
• Mental health problems such as anxiety, eating disorders, ADHD and post-traumatic stress disorder.
• Misuse of drugs and alcohol.
• Illness and chronic pain.
• And for some women, pregnancy, childbirth and menopause.

Effective treatments for depression usually involve psychotherapy, especially cognitive behavioral therapy, which can teach ways to change negative thinking patterns, and medication, including antidepressants and anti-anxiety drugs. Techniques such as transcranial magnetic stimulation, meditation, and simple exercise can also be effective for some. And if you do have an underlying condition, such as past trauma or substance abuse problems, that has to be dealt with as well.

It can take a while to figure out the best therapeutic combination in a constantly expanding list of options, but for most people, significant relief is possible when depression is treated.

Signs Of Depression

By contrast, the blues usually lift on their own through the action of that greatest of all healers — time. But it can be miserable waiting to see if what you are feeling will indeed go away. And trying to tough out depression without treatment means missing out on a chance to feel better and return to a more productive life as soon as possible. It can also make a further downward spiral more likely.

So how do you know if what you are feeling is depression and something you should seek treatment for? Ask yourself these questions:

1. Do you feel sad, hopeless or empty most of the time, and have others noticed that you seem down? (In kids, this can appear as irritability.)
2. Do you feel less pleasure or interest in most or all activities?
3. Has your appetite changed, and are you experiencing significant weight loss or gain (more than 5% of body weight in a month)?
4. Are you sleeping too much or too little?
5. Are you restless or slowed down to the point that others notice?
6. Has your energy evaporated?
7. Do you find yourself having extreme feelings of worthlessness or guilt?
8. Do you or others around you notice that you seem indecisive or unable to concentrate?
9. Do you find yourself having recurrent thoughts about death or perhaps thinking about, planning or even attempting suicide?

Now ask yourself:

• Did you say yes to five or more of these?
• Was one of your “yes” answers to question No. 1 or No. 2?
• Are these issues causing significant impairment or distress in important areas of your life such as work or your relationships?
• Are these feelings independent of other issues, such as the effects of drug or alcohol use or some other medical condition?

If so, then you may be dealing with major depressive disorder, according to the criteria laid out in the latest version of the Diagnostic and Statistical Manual of Mental Disorders, called the DSM-5. And the sooner you reach out for help, the sooner you’ll break free from your pain.

Counterbalancing The Negative

So what if you aren’t technically suffering from depression but are still feeling down? Are you supposed to just pretend everything is fine? Suck it up?

Not at all.

All of us should feel comfortable reaching out for help when we are feeling down, whether that means getting professional counseling or therapy or simply making more time for those social connections and activities that lift our spirits.

For example, you might consider volunteering for a cause you consider worthy. Not only is such altruism proven to improve mood and mental health, it also helps us keep our own troubles in perspective. Research even finds it may help you live longer.

And all of us can benefit from working on our mindset. It may seem too simple, but studies confirm that making an effort to think positive and cultivate a sense of gratitude has a powerful effect on mood as well as keeping us physically healthier.

It’s true that even for the luckiest among us, life can sometimes seem to lurch from one disappointment or problem to another, but don’t allow this reality to cause you to miss the forest for the tress. Take a moment to look into the night sky. Watch your child sleep. Tell someone you appreciate them. Yes, there’s plenty of misery in the world, but there are also moments of connection, peace, humor, love and awe. Depression will have a much tougher time taking hold if you remind yourself to notice.

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. As CMO of Elements Behavioral Health, he oversees a network of depression treatment centers that includes Lucida Treatment Center in Florida and The Ranch rehab center in Tennessee.