Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

Almost every morning for the past year I have felt really sad and hopeless. It's a struggle to get out of bed. Once I get going, I feel a little better, but I'm feeling more tired lately, just burdened by this. I have read about depression, but never experienced it. I don't know what to do next.

Answer

In describing your feelings as sad and hopeless, you have touched upon two common symptoms of depression. Research is very positive in telling us that depression is a very treatable condition. Please keep that in mind as you read through this response to your question. Unfortunately, the term "depression" is confusing and vague, though.

Depression is too general a term to be very useful. It describes everything from the mood swings we all encounter, to the disabling and life threatening pain of a major depressive episode. It's sort of like using the word "canyon" to describe both the small gulch behind my house and the Grand Canyon--it may fit both, but describes neither.

To add to the confusion, symptoms of depression are very common in reaction to stressful life events such as death of a loved one, accidents, loss of job, loss of relationship, and other blows to our sense of control. Even positive changes, such as a move for a job promotion, can result in symptoms of depression. One of the most devastating of these mood reactions is called "post-partum depression" that sometimes affects a mother following the birth of her baby.

There may not be any obvious cause for symptoms of depression. The lack of a direct cause is often frustrating for a person struggling to cope with the bleakness of depression. Family or friends may seem to rub in the pain when they try to help by telling you how lucky you are, or to snap out of it and smell the roses. They have no idea of the ashen, barren landscape that surrounds a severely depressed individual.

Have you considered hurting yourself in any way as you have struggled with the hopelessness you describe? Such thoughts are common in any depressive episode, and deserve to be voiced to a concerned friend, family member, mental health or medical professional, minister, or other trusted person in your life. Even if a sense of aloneness seems to block you from others, you will find crisis phone numbers in your telephone book. Think of this tiredness about life as part of the pain you are carrying. Let that pain lead you toward the path for help.

One of the hardest things in depression is asking for help. You may feel as if you don't deserve assistance. You may feel that help would be ineffective. Also, it common in our society to feel ashamed about feeling depressed. You might feel as though you have failed in some way. Please try and dispute these ideas as you prepare to ask for assistance. Become familiar with the symptoms usually found in depressive episodes by searching through the frequently asked questions (FAQ's) found in our links. Being informed about depression will enable you to make more choices for treatment.

As for seeking help, start in the most comfortable way possible. You have already taken an important step by writing this note to me. If you have a positive connection with your family physician, talk with her or him. Some physical problems can result in a depressed mood. If you would prefer to talk with a counselor, you can find out about psychologists or other mental health professionals through the Yellow Pages, through professional associations, or through agencies in your area. A psychologist can assist you in diagnosing the type of depressive ailment you have, and work with other health care professionals as necessary to help you feel better.

The bottom line is that depression does respond to treatment. Specialized forms of counseling such as cognitive therapy are effective for many types of depression. Of course, major advances in medication are very important in treatment too. Please be aware that a hopeful attitude about treatment is very realistic.

02/20/98

Dr. Kenneth Dutro is a licensed psychologist in California. He is a member of the faculty at Humboldt State University, Arcata, California. He has been faculty member of a medical school, and worked for years as a psychologist in university-affiliated teaching hospitals.