“Am I sad or depressed?” is a conversation I have with my psychiatrist on a regular basis. He’ll ask me how I’m doing and I tell him that I’m not sure. This week is easy. With Robin Williams’ death, I am sad, but it’s not always that easy to tell the difference. I guess it’s a good problem to have because it means I’m balanced more than I use to be. I still get manic and I still get depressed, but most of the time I’m in the middle.
About once a week I have a day that sucks. The door stays locked, the blinds stay closed, no shower, no shaving and I eat a lot. My daily trip to Starbucks across the street doesn’t happen because I can’t even drag my ass out to the mailbox.
When I tell my pdoc that I’m having a hard time determining whether I’m sad or depressed, he drives me crazy with his typical response, “That’s always the big question isn’t it?” That’s the only response I get. WTF??? Not very helpful. We then go on to something else and end our short discussion with my prescriptions being handed to me. I’ve accepted that if I want the answers it was up to me to figure it out.
The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V), published by the American Psychiatric Association is a tool doctors use to assist them in making a diagnosis. If you are suffering from insomnia, I highly recommend it. It’s more effective than Ambien. Using the DSM-V for my quest to help determine whether I’m sad or depressed I learned there’s not much difference. What makes them different is simply a matter of degree.
If you’re sad or have the blues, you may experience some of the following feelings:
◦ depressed mood, nearly every day during most of the day.
◦ Marked diminished interest or pleasure in almost all activities.
◦ Significant weight loss (when not dieting), weight gain, or a change in appetite.
◦ Insomnia or hypersomnia (excess sleep).
◦ Psychomotor agitation or psychomotor retardation. psychomotor is related to movement or muscle activity associated with mental processes (ex. Rapidly bouncing leg up and down – twitch)
◦ Fatigue or loss of energy.
◦ Feelings of worthlessness or inappropriate guilt.
◦ Impaired ability to concentrate or indecisiveness
◦ Recurrent thoughts of death, recurrent suicidal
Any of this sound familiar? Sure, we all face some of these, or even most of these at some time in our life. So how do you know if you are sad or depressed? A diagnosis of a major depression would be:
1. At least 5 of the items listed.
2. These symptoms must be present during the same 2 week period.
3. These symptoms must represent a change from a previous level of functioning
I guess what I experience each week would be described as sadness – at least that’s what it is when I go by the book. But, since I’m heavily medicated, is it sadness or is it a little of that good ‘ol depression popping in for a day? It’s hard for me to classify these weekly episodes as sadness because they are so heavy and difficult to get through. They last a shorter piece of time, but, they feel exactly like the deep, dark depressive hole I use to live with nearly every day. Am I sad or depressed? Now I’m even more confused and am not sure. I’ve just decided to call it whatever the hell I want to, which is….oh hell, I don’t know.