Are You Stressed or Depressed?

Source: Sarah Pauker, used with permission

“How are you doing, Sharon?” asked her cousin Tina.

“I’m holding on,” Sharon said.

“Holding on? Holding on? That’s not great. I think you’ve got to speak to a therapist, Sharon. You can’t just stay in a mode where you are barely surviving.’

Sharon relayed this conversation to me when she explained what brought her to therapy. The reason for her dire answer to her cousin, she explained, was that she had just returned from two weeks in Arizona, where she had been caring for her aging mother, who has dementia. She told me that she was exhausted, physically and emotionally. Her mom’s memory loss and combativeness, along with fighting with her siblings about decisions regarding her mom’s care, had left her drained.

While previously, Sharon and her husband Steve enjoyed a pretty idyllic suburban life, now, at age 56, they were struggling to care for needy, vulnerable, widowed parents. Both Sharon and Steve had been laid off from their jobs and were fearing for their financial future. Meanwhile, their 20-something children were struggling to find footing in their careers.

“I feel guilty if I’m not there for my mom and responsible for trying to help my kids get settled into adulthood,” Sharon told me. “I think I need medication to survive.”

As Sharon experienced, the demands of caregiving can be grueling, guilt-inducing, and suffocating. Relentless job requirements, divorce, financial fears, chronic illness, moving to a new city, state, or neighborhood, and balancing work, family, home, and finances are some of the many other situations that can lead to feeling overwhelmed.

Stressed or Depressed?

It’s easy for a crescendo of pressures to lead you to think you are depressed. Antidepressants can look like an appealing cure-all to many who are experiencing the physical, emotional, and mental fatigue of balancing relentless responsibilities.

But how do you know when the avalanche of such challenging feelings constitutes a depression that needs to be treated? In truth, it’s a fine line. Stress can and often does lead to depression if steps aren’t taken to practice self-care. Whether that means incorporating meditation, music, exercise, good nutrition, mini-getaways, napping, or lunches or dinners with friends, it is such soothing measures that can and will make a difference in keeping your mood calm, modulating your anxiety, allowing you to breathe mindfully, and think more clearly.

Many people ignore signs of stress... at their own risk. Yes, of course, there are reasons why you’ve become more short-tempered or are having trouble thinking clearly or are distracted when speaking with family and friends. You are balancing a lot of balls in the air, so feeling stressed is a normal reaction. Experiencing loss and grief can also lead to feeling overwhelmingly stressed. Not having your loved one with whom to share life's joys and sorrows, feeling lonely and abandoned after a death or divorce, or experiencing the sadness of a spouse or life partner suffering in pain or losing their faculties are major causes of stress. Neglecting to acknowledge and address signs of stress poses the risk of creating an escalating situation that is defined by a dark cloud of negativity. It’s essential to remember that just as you are trying to care for others, you need to care for yourself!

When It’s Time to Treat

The diagnosis of depression is based on having emotional (sadness, irritability), cognitive (lack of focus and concentration), and physical (difficulties relating to sleeping and eating) symptoms. If these symptoms last longer than two weeks and are interfering with your life and functioning, you are experiencing depression that must be treated. You are having a biological reaction to situational stressors. Psychiatric medication can decrease the intensity, which will help you make better decisions, have calmer relationships with others, eat and sleep well, and be able to incorporate some of those healthy mind-body practices that I mentioned above.

As for Sharon, as we delved further into her everyday life, it was clear that her sleep had begun to be disrupted, she was ruminating—going from one negative, pessimistic thought to another—and losing patience with her husband and children. We discussed having her start on a small dose of an antidepressant to decrease the darkness she was enveloped in and to increase her ability to use her resilience and skills to deal productively with the problems she was facing.

Remember that seeking emotional help is a sign of strength, not weakness. Whether it is stress or depression you are experiencing, there is every reason to expect that you will overcome your negative attitude and begin to see the light. Scheduling a consultation with a psychiatrist or other mental health practitioner will provide you with a clear picture of how to address your condition. Most of all, it should instill you with hope that, yes, there is a better future ahead.

To find a therapist near you, visit the Psychology Today Therapy Directory.