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How Depression Potentially Shows Up

20.04.21

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Alkeme Health

You got your full eight hours and yet you still wake up tired. So you roll back over and fall asleep for another two hours. You just “don’t feel like it today,” and the bed is so much more comfortable than the outside world.

We’re all familiar with this feeling. Tiredness is one thing (we all can overwork ourselves!) but a lack of desire to get out of bed may stem from something a lot more sinister. After all, when you’re asleep, you don’t have to deal with your feelings. Vulnerability is something that Black people and families are still trying to navigate. But it is important to know the difference between exhaustion from a long week, and an unrelenting exhaustion of life.

Depression is an emotional experience that can be clinically identified. Alkeme Health spoke with Registered Psychotherapist Meghan Watson, MA, RP on the signs that we or someone we know may be depressed.

“When I see depression in Black folk, I see it show up commonly as shame, avoidance, exhaustion and defeatism,” says Watson. “It can also present as anger and rage. All of these emotional experiences signal that there are feelings underneath that need to be addressed. All of these that I see in my Black clients are in addition to the clinical signs of depression (based on the DSM-5).”

DSM-5 stands for “Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.” It is the most commonly used manual for the assessment and diagnosis of mental disorders.

Clinical depression can show up in many different ways including:

  • Depressed mood all day, nearly every day.
  • Loss of interest or pleasure in activities.
  • Decrease in appetite or significant weight loss (outside of dieting) or increase in appetite and weight gain.
  • Marked slowing in thoughts and physical movement (also observable by others).
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or inappropriate guilt nearly every day.
  • Trouble concentrating or difficulty making decisions.
  • Recurrent thoughts of death or suicide, suicide attempts or specific plan for committing suicide.

An interesting aspect of depression is that those who are depressed can easily identify the symptoms in friends and family, but have a lot more difficulty identifying those issues in themselves. Depression typically starts off with a few symptoms and gradually over time, can look and feel more like “episodes” that stay around for weeks, months or even years.

“When depression becomes more intense and harder to hide, it begins to permeate every aspect of your life - from work to your relationships,” says Watson. “Depression exists on a spectrum and is often categorized clinically as mild, moderate or severe - short term or long term.”

Watson also notes that depression can become “treatment resistant” where symptoms may persist, worsen or evolve over time despite therapy or medicine. If you’re worried or unsure about what you are feeling, talking to a professional is the best course of action.

So where does depression even come from? Do we just wake up with it? According to Watson, it can have multiple causes. “Depending on your school of thought, depression can be biological, environmental, social, internal – you name it. Personally, I think it’s a combination of biology, learned emotional and belief systems, as well as triggered by social and familial patterns.”

If you feel that you suffer from depression or have questions about depression, there are some important courses of action you can take. It’s important to know that treating your depression doesn’t automatically mean you will have to take a pill such as Zoloft or Prozac.

“I’ve seen individuals treat and manage their depressive episodes through lifestyle changes such as changing their home environment, changing jobs, as well as just doing therapy or medication management,” says Watson. “Figuring out what works will be an individual process, so remember to take it slow, and seek support as you heal.”

Unsure about how to take the first step on your mental health journey? Reach out to a friend or family member, research. The important thing is to start. Taking our own mental health into our own hands is the best way for us to identify and heal our issues. And although depression is something our culture struggles to accept, it is important to know that you are not alone and there is help available.