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What is the difference between sadness and depression?

Many people confuse sadness and depression, in part because of highly effective advertising aimed at making medical problems out of everyday experiences and emotions. It is normal to experience sadness and unhappiness after the loss of a loved one, out of dissatisfaction with your job (such as difficulties with a colleague), related to the natural cycles in life (such as the menstrual cycle, menopause), when adjusting to normal changes in your life (such as starting university, moving away, giving birth) or coping with new or ongoing challenges (such as chronic pain or illness). While many of the symptoms are the similar, sadness can usually be traced to a life event or cause such as a feeling of loss or adapting to a major life change. Sometimes sadness or unhappiness can grow into depression, but other times there is no obvious trigger.

What are the symptoms of depression?

Depression is highly individual, and women experience it in different ways. The symptoms are both emotional and physical. In clinical or major depression, the symptoms include intense emotions and anxiety that affect your ability to cope with daily life, leaving you emotionally and physically drained and feeling hopeless. Often women go to their doctor because of the physical symptoms. The following are some examples of symptoms.

  • Feelings of worthlessness, despair, self-blame, hopelessness, excessive guilt, irritability and/or emptiness that do not go away
  • Feelings of anxiety all the time
  • Difficulty concentrating, remembering and/or making decisions
  • Loss of interest in usual activities, withdrawing or detachment from family and friends
  • Decreased sex drive
  • Crying easily or feeling like crying but not being able to
  • Thoughts of suicide and/or self-harm
  • Changes in sleeping patterns (such as too little, too much or not restful) and fatigue (including feelings of exhaustion)
  • Changes in appetite, eating patterns and weight
  • Frequent headaches or stomach upset

What are the risk factors for depression?

Women are at least two times more likely than men to be diagnosed with clinical depression, possibly because they are also more likely to seek treatment and consequently to be diagnosed. Many of the risk factors for depression are simply situations of chronic stress with inadequate support. As women we continue to take on more of the unpaid and largely unrecognized caregiving responsibilities for young and old alike. We are also represent a growing part of the workforce, but are more likely to be unemployed or underemployed and working in unpaid positions. Gratifying as some of these roles are, work-life balance can be hard to achieve and can cause stress which increases the risk of developing depression. Extra strains on the body—such as medical illness, homelessness or housing insecurity, past or ongoing trauma, alcoholism, marginalization, weight and body image issues, and isolation—further stress the body and make it harder to cope and prevent depression. Sometimes, the triggers of sadness can turn into depression over time, and sometimes there are no apparent triggers for depression.

Is depression a disease of chemical imbalance in the brain?

There is a theory that people with depression have a chemical imbalance in their brains—insufficient serotonin (a neurotransmitter) in their brains. This theory has never been verified by research although it is often cited in drug marketing and in popular media.  Depression is not a disease, it is a health condition, and there is no evidence that medications “cure” depression although they may be helpful as part of the treatment for major depression along with non-pharmaceutical therapies.  Although it is not a disease, depression can cause immense suffering and it is important to seek help to get through it.

How can I help someone who I think is depressed?

Some consider depression a normal reaction to life with inadequate social support. It can be hard for someone with depression to seek help. It can also be very difficult to cope with for those living with someone who is depressed, make sure you take care of yourself too. It’s important not to blame someone for their depression or tell them to “pull it together” when they are not feeling up to the things they could do before. This only makes someone who is depressed feel more isolated. To be helpful, you can simply listen. You should not feel like you need to fix anything, but instead help them to express themselves. You might find it helpful to ask the depressed person if it is okay to involve other friends or family. If the depressed person wishes to go to a health professional, you can offer to take them to the appointment. If you are a parent, it is extremely important to teach children that they are lovable and worthwhile, developing their inner strength and resiliency to help them get through the challenges of adolescence and early adulthood.

How can I help myself if I am depressed?

Note: Anyone having suicidal thoughts or thoughts of self-harm needs to ask for help immediately. Call a friend, family member, health professional or helpline and reach out.

Often, seeking help and knowing that you are not alone is the first step to recovery. Anti-depressants may be helpful to help treat major depression along with other non-pharmaceutical therapies. Medications are not recommended for mild depression due to the serious side-effects that may outweigh any benefit. For mild depression, try some of the suggestions below before considering medication. Don’t be afraid to talk to your doctor about your symptoms, this will also help them to rule out any other physical explanation for how you are feeling. If your doctor prescribes an antidepressant, it might be helpful to bring a list of questions to ask him about it before accepting the prescription. Check out: Don’t swallow everything you hear about women’s health: “tips about what to ask your health provider before starting a drug treatment.”

Lifestyle changes. Many of the lifestyle changes for depression are simply ways to strengthen mental health and well-being overall. Changing your lifestyle requires effort but can be worthwhile in the long run, helping you to develop long-term skills to cope with depression and potentially to address the root causes of the depression. The following is a list of a few examples of things that can help, whether you are taking medication or not:

  • Social support from family, friends, or self-help, community support or spiritual groups. Some find great satisfaction in volunteering and helping others.
  • Exercise regularly. Sometimes joining a fitness group or sport’s team can be helpful.
  • Eat a balanced diet with lots of fruits and veggies, whole grains, seeds and nuts. Some women have hidden allergies that can contribute to some of the symptoms of depression, and it is helpful to try to weed these out by trying some time away from certain foods and seeing how you feel. Try to take in less of the following: processed food, caffeine, sugar, cigarettes, drugs and alcohol, and consider consulting a nutritionist for tips on a healthy and affordable diet.
  • Fun and relaxation. Find time to do the things that you find fun or relaxing.
  • Work. Try to finding meaningful work, paid or unpaid.

Are there therapeutic alternatives to medication?

Everyone is unique, so it is important to figure out what works best for you. Some alternatives to medication treatment include:

For more ideas and a strategy to cope with depression, see the Network article by Miriam Hawkins and Angela Bischoff “Are there alternatives to drugs?”

Where can I find more information?

This FAQ may provide medical information, but is not meant to be a substitute for medical advice. When you have questions about your health, it is always advisable to ask a health care practitioner.

February 2015.