Am I depressed or just sad? How to know when to seek treatment

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By Nicole Spector

When I was diagnosed with major depression at 22, I was too deep within the fog of the illness to much care that finally, after years of struggling, I had an answer as to why I felt so impenetrably bad, and that with treatment, I could improve.

Later, once I began therapy and started taking antidepressants, I began to feel better, which resulted both in relief and a strange sort of guilt. I was grateful to be improving, surely, but remorseful that for years I didn’t seek medical help and that I had discounted even severe symptoms as the natural effects of just being in a rut, or of being stressed out.

That I waited so long to take action is not unusual, and my delay was likely a result of both misinformation and lack of information altogether.

“According to recent studies, about 1 in 5 Americans meet criteria for a diagnosis of major depressive disorder,” says Erlanger A. Turner, Ph.D., clinical psychologist and assistant professor of psychology at the University of Houston-Downtown. “However, many people don’t seek help either due to stigma or lack of information about treatment.”

To help, mental experts explain the symptoms of depression to help you determine if you or a loved one may need to be assessed for a depressive disorder.

A sadness that doesn’t have a specific cause and hinders function

“Everyone has sad moods, and most of us know what we do when those moods hit: call a friend, watch a sad movie and cry, eat some comfort food. However, what many people do not know is how to tell if you are moving from being sad to being in a clinical depression,” says Dr. Dara Gasior, PsyD, director of assessment and training at High Focus Centers, an outpatient addiction rehab and mental health services provider.

“The biggest sign that I look for is how much your mood is impacting on your level of functioning,” Gasior adds. “When you are feeling sad, you usually are able to complete the daily tasks of your life, you just feel badly while doing so. When you enter into a state of depression, the sadness starts to interfere with your level of functioning.”

It lasts longer than two weeks

Dr. David Hu, a psychiatrist and the medical director at Behavioral Health of the Palm Beaches, notes that not only does depression differ from sadness in terms of severity, it also differs in duration.

“People who suffer from depression typically have a low mood that lasts most of the day on most days, for more than a couple weeks,” Hu notes.

Your thoughts are black-and-white and pervasive

During these weeks your mind is likely occupied by what Kita S. Curry, Ph.D, CEO of Didi Hirsch Mental Health Services (and someone who suffers from depression) describes as “persistent thoughts of failure, hopelessness or shame, and [you’re] thinking in black-and-white.”

Types of thoughts you may experience, according to Curry: “‘No one has ever loved me; it’s always been this way; it will never get better!’ That’s when you know you’re probably depressed.”

This sense of hopelessness can be so pervasive you may find yourself unable to feel joy, even when great things happen.

“At one point, I knew I was feeling blue, but when I wasn’t excited that I was a finalist in a book contest, I realized I was depressed,” says Curry.

Improving your perspective feels impossible

“Depression does not allow for conversation around change,” says Laura Federico, a licensed clinical psychologist. “It can feel nearly impossible to shift thought patterns, improve motivation, or create a new perspective when coping with depression.”

Federico adds that these feelings are unlike sadness, which though “painful, disruptive, and difficult, [are] ultimately consistent with our sense of self, and manageable.”