People often confuse clinical depression with sadness. That’s a mistake. You can be sad without being clinically depressed, and vice versa. Let’s say, for example, that you have been rejected by a person you love, have been made redundant or have suffered some major setback in some project in which you have invested a lot of time and energy. It would be strange not to experience some feelings of sadness in the days or even weeks following such a reversal of fortune. But if such normal sadness is short-lived and not accompanied by some of the tell-tale signs of depression listed below, no doctor would diagnose you as being clinically depressed. You would expect to see the feelings of sadness diminish over days or weeks and be replaced by other feelings – elements of relief, hopefulness or even happiness and, together with those feelings, optimistic thoughts. Maybe it wasn’t such a great relationship and you’re better off out of it. And the job wasn’t necessarily that terrific, now that you think of it; some other job may suit you better. And as for the reversal of fortune, it hurt, no question about it, but it wasn’t critical. You take your knocks, learn your lessons and move on.
As you will see in the pages of this book, a capacity to get on with things is not a hallmark of depression. When you are depressed, you feel trapped and stuck. Solutions do not present themselves to you. It can seem as though there is no way out. So sadness by itself does not mean you are depressed, even though sadness is certainly one of the cardinal symptoms of depression. Often this is not an ordinary sadness, focused on a single situation or event. Rather it is a pervasive sadness that seems to settle on everything. The sadness can take over all other feelings, leaving little room for happiness, contentment, good humour or even anger. But even though sadness is one of the most common symptoms of depression, it is also one of the easiest to connect with the condition. In our everyday language, a person might say T feel sad’ or T feel depressed’ interchangeably. In contrast, there are other symptoms that may be less obviously associated with depression, but are nevertheless cardinal symptoms and signs of the condition. I have called them the seven tell-tale signs of depression. It is easy to attribute these signs, incorrectly, to conditions other than depression. But when they are present, depression is one condition that should always be considered.
The Seven Tell-Tale Signs of Depression
Running on empty
Nothing seems like fun anymore; life seems dreary
Failure – at work and in relationships
Biological disturbances: sleeping, eating, weight and sex drive
The future looks bleak
Life seems not worth living
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