You often hear people use the words sadness and depression interchangeably. As if being depressed is akin to losing your jacket at a restaurant, and feeling distraught for several days. For those who have never experienced this disorder, or never treated someone suffering from depression, let me share the words of a writer who captures the phenomenology unlike any scientist....

Real depression, the narrator insists, is different. To me it's like being completely, totally, utterly sick. I will try to explain what I mean. Imagine feeling really sick to your stomach. Now imagine your whole body being sick like that. Imagine that every cell in your body, every single cell in your body, is as sick as that nauseated stomach. Not just your own cells even but the E. coli and lactobacilli too. The mitochondria basal bodies, all sick and boiling, hot like maggots in your neck, your brain, all over, everywhere, in everything. All just sick as hell. Now imagine that every single atom in every single cell in your body is sick like that. Sick. Intolerably sick. And every proton and neutron and every atom swollen and throbbing off-color. Sick with just no chance of throwing up to relieve the feeling. Every electron is sick. Here, twirling off balance and all erratic in these funhouse orbitals that are just thick and swirling with modeled yellow and purple poisoned gases. Everything off-balance and woozy. But even this doesn't capture the overwhelming experience of depression for the narrator. The bad thing is you...Nothing else. You are the sickness yourself. You realize all this, here. And that I guess is when you look at the black hole, and it's wearing your face. That's when the bad thing just absolutely eats you up. Or rather when you just eat yourself up. When you kill yourself. All this business about people committing suicide when they're severely depressed, we say, holy cow, we must stop them from killing themselves! That's wrong. Because all these people have you see, at this time, have already killed themselves where it really counts. When they commit suicide, they are just being orderly.

- David Foster Wallace (genius and author of my desert island read)

rolling stone
Source: rolling stone

Send this to your romantic partner who is tired of your pessimism, fatigue, and loss of libido.

Send it to your family, so that they might understand why you prefer to be alone but wish it could be otherwise....

Send this to friends, the next time they tell you that life is beautiful, and there are people that love you, and others in the world who are really suffering - starving or physically disabled - and thus, you have no reason to be depressed.

Depression affects approximately 20% of the population. In the past, scientists characterized depression by a loss of interest in previously enjoyable activities (underactive reward system) and intense melancholy and hopelessness (overactive punishment system), among other symptoms. But new insights have led to a more fine-grained understanding of depression.

Researchers have discovered that the presence of frequent, intense negative emotions and thoughts, and infrequent positive emotions and thoughts might not be central to depression. Perhaps what is central is the inability to engage with the outside world. 

Whether watching happy films or sad films, people who are clinically depressed report less change in their emotional experience and similarly, they experience less physiological reactivity (including less sadness and crying in response to sad stimuli).  Whether discussing their happiest or worst memories, once again, depressed adults report fewer emotional reactions and less physiological activity than healthy adults. Those depressed adults who are particularly unreactive to circumstances, remaining apathetic/indifferent to sexual escapades and high-end sushi as well as rejection and failure, fare worse in treatment. My colleague, Dr. Jonathan Rottenberg, has conducted the bulk of this work and coined the phrase "emotional context insensitivity" to capture this revised profile of depression.

These discoveries suggest that instead of becoming more stressed by stressful events those who are clinically depressed suffer from psychological rigidity.  A term that hints at David Foster Wallace's suffering that extends to the molecular level.

Through literature and science, what becomes clear, is that the cost of depression is greater than previously imagined. As we become better at adopting the perspective of someone suffering from depression, we will gain the traction to commit greater resources at the optimal targets....

******NOTE: for the underappreciated benefits of normal sadness and other darker emotions, check out this Q&A in the Washington Post******

Dr. Todd B. Kashdan is a public speaker, psychologist, and professor of psychology and senior scientist at the Center for the Advancement of Well-Being at George Mason University. His new book, The upside of your dark side: Why being your whole self - not just your “good” self - drives success and fulfillment is available from Amazon, Barnes & Noble, Booksamillion, Powell's or Indie Bound. If you're interested in speaking engagements or workshops, go to: toddkashdan.com

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