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Do you need to be depressed to have clinical depression?

"This is an illness that lays waste to the body as well as the mind."

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Depression

Depression Introduction

Depression Symptoms

Less/More Than Sad

Mental Water Torture

Seasonal Affective Disorder

Atypical Depression

Bipolar

Bipolar Disorder - Part I

Bipolar Disorder - Part II

Bipolar Depression

Bipolar or Bichronic

Coping with Bipolar Disorder

The Dark Side of Mania - I

The Dark Side of Mania - II

Cyclothymia

Rapid-Cycling

The Mood Spectrum

Multipolar Depression

The Mood Spectrum

Hard Depression, Soft Bipolar

The True Meaning of Manic-Depression

Co-Occurring

Dual Diagnosis-I

Dual Diagnosis - II

Anxiety

 Less Than Sad, More Than Sad

True or false: You have to be depressed to suffer from clinical depression.

If you answered true, maybe it's time to revisit the DSM-IV, which in its criteria for major depression lists either feeling depressed most of the time for two weeks OR abnormal loss of interest or pleasure most of the time for two weeks.

In another article, I describe my adolescent depression as: "No longer could the world and all its trials hurt me. I had entered a dark but comfortable realm beyond sense and feeling. President Kennedy would get assassinated and I wouldn't shed a tear. Winter would descend with bitter terror and I wouldn't feel the cold. The Beatles would prove to be the biggest thing since the Coming of Elvis, and I would barely notice."

My depression was less of exaggerated sadness and more of lack of emotion, a classic DSM non-depression. Of course, the DSM wasn't around back in the sixties, so my non-depression depression went unnoticed.

More Depression Symptoms

It is also worth examining the next seven items on the DSM menu:

• Appetite or weight disturbance, either weight loss or weight gain.
• Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.
• Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).
• Abnormal fatigue or loss of energy.
• Abnormal self-reproach or inappropriate guilt.
• Abnormal poor concentration or indecisiveness.
• Abnormal morbid thoughts of death (not just fear of dying) or suicide.

The DSM-IV requires five of the nine in total to be checked off, including one of the first two. Oddly enough, most of above don't actually refer to mood. Andrew Solomon in "Noonday Demon: An Atlas of Depression" has this to say:

"With the depression, your vision narrows and begins to close down; it is like trying to watch TV through terrible static, where you can sort of see the picture but not really; where you cannot ever see people's faces, except almost if there is a close-up; where nothing has edges. The air seems thick and resistant, as though it were full of mushed-up bread. Becoming depressed is like going blind, the darkness at first gradual, then encompassing; it is like going deaf, hearing less and less until a terrible silence is all around you, until you cannot make any sound of your own to penetrate the quiet. It is like feeling your clothing slowly turning into wood on your body, a stiffness in the elbows and the knees progressing to a terrible weight and an isolating immobility that will atrophy you and in time destroy you."

And here's a passage from Sylvia Plath's Journals:

"God, if ever I have come close to wanting to commit suicide, it is now, with the groggy sleepless blood dragging through my veins, and the air thick and gray with rain and the damn little men across the street pounding on the roof with picks and axes and chisels, and the acrid hellish stench of tar ..."

If only it were just sadness we had to deal with. Our ancestors had every right to confuse mental illness with demonic possession. This is an illness that lays waste to the body as well as the mind. You can't think, you can't move, you can't function. Small wonder people can't take it. "Well, my own work," Vincent Van Gogh wrote in his last letter to his brother Theo, "I am risking my life for it, and my reason has half foundered." Six days later, he would be dead, a bullet to his chest, an act of suicide.

Sylvia Plath put her kids to sleep upstairs, then went down into the kitchen and turned on the gas. Andrew Solomon tried to contract AIDS.

Those who never had depression cannot possibly comprehend. When they tell us to snap out of it, we must forgive them for their ignorance. This is an illness one must have lived through to truly understand. Far too many of us, unfortunately, wind up taking that understanding to the grave.

For three free online issues of McMan's Depression and Bipolar Weekly, email me and put "Sample" in the heading and your email address in the body.

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Sylvia Plath: "Groggy sleepless blood dragging through my veins."