What is depression and how is it different from sadness?

If you’re like most people then odds are you probably don’t know the difference between depression and sadness – and who can blame you when they are very similar? 

For starters, sadness is a normal reaction that every person goes through at some point during their lives and is typically short-lived. 

These individuals are aware of the reasons why they are sad, which is often in response to negative or stressful life events, such as the death of a loved one, job loss, or failure. 

However, people who feel sad are still able to function in their day-to-day lives, and self-esteem is preserved.

Depression, on the other hand, is a mental health condition and is the umbrella term used to describe depressive disorders. It is also referred to as clinical depression, major depression, or major depressive disorder.

Unlike sadness, however, individuals with depression experience a generally depressed mood that is not caused by any particular reason. And unfortunately, as a result, it is not uncommon for depressed individuals to be accused of faking or exaggerating their symptoms. 

Depression is also extremely debilitating and significantly interferes with normal functioning in private, social, and occupational settings. 

For example, many individuals struggling with depression often neglect personal hygiene, such as regular showering, grooming, or teeth brushing because the emotions they feel are usually overwhelming and exhausting.

There is also a loss of interest and pleasure in previously enjoyed activities. A good example would be if an individual suddenly quits a sport they love – and have played for many years – without a good reason.

Finally, depression is persistent and episodic so symptoms typically come and go in waves with a brief period of no symptoms in between.

It is important to note that much of the confusion between depression and sadness comes from the misuse of these terms, such as saying “I feel depressed” when they are actually feeling down or sad. 

TL;DR

• Sadness is a normal human response while depression is a mental health condition.
• Depression is not due to any specific reason while sadness is.
• Self-esteem is still preserved in those with sadness but not for those with depression as feelings of worthlessness and self-loathing are common.
• Sadness does not interfere with normal functioning while depression does.
• Sadness is short-lived and will go away on its own. Depression, however, is persistent and episodic.

Symptoms of Depression

To be diagnosed with depression, one must meet DSM-5 criteria for a depressive disorder. Below are symptoms that may be indicative of clinical depression. 

Note: Please keep in mind that this is not medical advice so do not diagnose yourself or others. If you have any concerns, you should consult with your doctor or a licensed professional.

1. Depressed mood

A generally depressed mood is one of the hallmarks of depression and is its most recognizable feature. Individuals with depression will feel depressed most of the day and more days than not. They also report feelings of intense sadness, emptiness, and hopelessness.

2. Loss of pleasure in hobbies or activities

Anhedonia, or the inability to experience pleasure, is another extremely common symptom of depression. 

Individuals often lose interest in doing activities they had previously enjoyed like arts and crafts, swimming, golfing, meeting with friends, and sexual activities. This change is usually sudden and without any good reason.

Many also find it difficult to experience a brightened mood even during normally positive events, such as graduations, job promotions, or the birth of a child.  

3. Changes in sleep pattern

Due to the constant negative emotions, individuals with depression generally feel mentally overwhelmed and exhausted. 

As a result, many have difficulty maintaining sleep (insomnia) or sleep significantly longer than usual (hypersomnia).

What’s important to note is that many will still feel fatigued and exhausted despite having enough sleep.

4. Changes in appetite and weight

Depression can also lead to changes in eating habits and body weight. Similar to disturbances in sleep, changes can be in either direction: too much or too little of something. 

In this case, a person with depression may increase or decrease food intake which, in turn, results in significant weight gain/loss. 

This is because eating may become a source of comfort for some while for others it may feel like a chore; every person responds differently.

5. Diminished self-esteem and sense of worth

Feelings of guilt, shame, and worthlessness often accompany depression and can happen for a variety of reasons. 

A person struggling with depression may believe s/he is:

• Not a good friend for not wanting to leave the house or canceling plans at the last minute.
• Not a good family member for not helping enough around the house.
• Not a good partner for not contributing as much to the relationship. 

Many also experience guilt for having depression, not recovering fast enough, or being a perceived burden to others. 

These beliefs are often excessive and not true. Even in the face of contradicting information, there is the lingering sense that one is not worthy of the love and support they receive from friends and family. 

Shame is also common due to the stigma associated with mental illness, which makes it even more difficult to open up to other people.

6. Difficulty completing small tasks

The constant exhaustion and fatigue associated with depression make completing even the smallest of tasks difficult and overwhelming.

As a result, basic tasks like dressing and waking up in the morning can take twice as long and require significantly more effort. 

These daily challenges also negatively impact life in the classroom and workplace, which further worsens the situation.

7. Poor hygiene

Depression is extremely debilitating and affects many areas of functioning, including that of personal living. Keep in mind that depressed individuals are typically consumed with negative thoughts and emotions, which make it difficult to keep up with regular self-care. 

These changes can come in the form of irregular showering, teeth brushing, or grooming. Therefore, a constant lack of a clean and kempt appearance can be an indicator of emotional turmoil.   

8. Restlessness and flattened affect

Depressed individuals can also exhibit psychomotor changes, such as agitation, fidgeting, and pacing. Other examples include the lack of an emotional response or facial expressions and slowed speech and movement. These behaviors are often severe enough to be observed by others.

9. Hopelessness and negative outlook

Pessimism about the future is a very common sign of depression and is the belief that negative situations will not improve over time. 

This mindset traps the person in a vicious cycle of catastrophic thinking that turns small setbacks into insurmountable obstacles, which undermines any progress towards improvement.

10. Impaired attention and memory

Many individuals struggling with depression experience impaired memory recall and concentration. As a result, they become easily distracted and have difficulties remembering past events. 

This impairment also makes it difficult to complete goals since these tasks require self-directed attention and effective decision-making. 

All in all, given that depressed individuals are usually preoccupied with negative thoughts, it isn’t surprising that their concentration, and subsequently memory, suffer in the process.

11. Thoughts of death or suicide

Suicidal ideation, or the preoccupation with thoughts of death or suicide, is very common in depression. And in some cases, individuals may have a detailed suicide plan or attempt suicide. 

Many who struggle with it often believe they are unlovable or have no other option left but to end their lives. 

Regardless of how it presents itself, it is a major warning sign and should always be taken very seriously. If you or anyone you know may be considering suicide, please use the resources provided at the end of this article. 

Please know that there are effective treatments out there and things do get better over time. Above all else, please know that you are worthy and you are loved.

Some examples of suicidal thinking:

• “I wish I was never born.”
• “I don’t want to be alive anymore.”
• “Everyone would be better off without me.”
• “It would be easier if I just killed myself.”
• “I want to kill myself.”

12. Physical symptoms

Also known as psychosomatic symptoms, they are physical manifestations of psychological symptoms. Many who suffer from depression report chronic physical symptoms like body aches, headaches, and joint pain. 

These symptoms are typically observed in cultures where mental illness is stigmatized, such as Asian and African American communities. 

A red flag to look out for is if your physical symptoms have no medical cause and are reported as “normal” by healthcare professionals. 

What not many people fully appreciate is that the way we think affects the way we feel. So when we experience overwhelming stress and negative feelings, it elicits an intense physiological response and our body goes into overdrive, which can ultimately shut down on us.

What causes depression?

Like all mental illnesses, depression is very complex and there is not a single cause. Rather, there are many factors that are known to increase a person’s risk for developing depression and they often interact with one another in unique combinations. 

Here is a list of known risk factors:

• Abuse
• Advanced age
• Adverse childhood experiences
• Changes in brain structure
• Chemical imbalance in the brain
• Female
• Genetics
• Impaired mood regulation
• Major life changes
• Medical conditions
• Medication and drug use
• Stressful life events
• Temperament
• Trauma

I might be depressed. What should I do?

Below is a list of effective coping strategies to help those who have – or believe to have – depression. However, it is important to note that these strategies are intended to supplement your current treatment plan, not to substitute it. 

Overview:

• Reach out to loved ones
• Seek professional help
• Journal your thoughts
• Engage in physical activities
• Practice mindfulness and meditation
• Eat wholesome meals
• Change the way you view negative events
• Change the way you think about yourself
• Set time every day for self-care
• Listen to your mind and body
• Listen to your doctor
• Watch funny movies and videos
• Stop to smell the roses
• Get more sunlight

Coping strategy #1: Reach out to loved ones

Your friends and family are your first line of defense because they care about you the most and have your best interests in mind – so why not give them a chance? Whether it’s to lend you an ear or offer you a shoulder to cry on, you will feel much better. 

Being with people we love can also lift our mood since we will feel heard, validated, and valued. This is important since it creates a supportive environment that encourages us to seek help from a professional and overcome barriers as a team.

Coping strategy #2: Seek professional help

There is no shame in admitting that you need help once in a while because we’re all human – we all have our ups and downs. 

A mental health professional, whether s/he is a psychiatrist, psychologist, or counselor, will support you every step of the way and without any judgment. Just remember that you are never alone and help is always available.

There are many treatment options that are effective and can help improve your symptoms. Your clinician will work with you to determine the best course of action and a treatment plan that works for you.

Coping strategy #3: Journal your thoughts

Taking the first step towards self-improvement is always the most difficult part, but if you want to go at a slower pace, you can start by journaling your thoughts. Write about how certain people or situations make you feel and your reflections through it all. 

Here are some ideas you can write about:

• What are the stressors and problems in your life?
• What triggers and worsens your symptoms?
• How has it affected you? How does it make you feel?
• What makes you feel better (e.g., people, activities, situations, coping strategies)?
• How have you tried to resolve your problems? Are there obstacles in your way?

There is no right or wrong way of doing this; just include any information that comes to mind. Then when you are ready, you can use it as a reference when speaking to loved ones or give it to your clinician.

Coping strategy #4: Engage in physical activities

Exercise is a great way to improve symptoms because physical activity encourages our brain to release feel-good chemicals, such as endogenous cannabinoids, and lower stress hormones. 

Note: In case you’re wondering, yes, endogenous cannabinoids are similar to marijuana, but it’s produced by our body. It explains why some people experience “runner’s high” after a good run. 

Staying active also forces us to focus on the present and away from negative thoughts, which helps to clear our mind and energize us for the day.

To maximize results, it is recommended that you exercise for at least 30 minutes a day and 3-5 days a week. 

Pick an activity you already enjoy or are interested in, such as gardening, yoga, pilates, jogging, biking, swimming, taking your dog out for a walk, or even sex – the options are endless!

Coping strategy #5: Practice mindfulness and meditation

Mindfulness is effective because it clears negative thoughts and improves mood. Many who go through this training report feeling more refreshed and less stressed after each session. 

It has also been incorporated into existing treatments, such as cognitive behavioral therapy (CBT), and was found to be just as effective as medication in reducing depressive symptoms minus the side effects.   

Coping strategy #6: Eat wholesome meals

It’s not an exaggeration to say that we are what we eat. Eating unhealthy food makes us feel bloated, groggy, and go on a sugar high-crash, which can worsen depressive symptoms. 

Certain foods and beverages can make us feel sick and include processed foods, sugar, simple carbs, alcohol, and caffeine. 

Replacing junk food with healthier options like fruits, vegetables, white meat, tree nuts, and seeds, not only enriches our brain and gut health but also nourishes our body. 

Eating healthy has also been shown to improve mood, self-reported happiness, alertness, focus, and energy level. With time, you will eventually look and feel better.

Coping strategy #7: Change the way you view negative events

Having a positive outlook not only makes it easier to overcome obstacles but you also become more resilient. 

This mindset will make the difference between seeing something as the end of the world or as a temporary setback. 

When we are able to see the silver lining in negative experiences, it then becomes easier to learn from the situation and move on. 

Research has found that positive thinking predicts better coping skills, improvement in depressive symptoms, and less stress. 

It is important to note that this doesn’t mean ignoring reality or minimizing the severity of problems. Instead, it is the decision to not allow failure to hold us back.

Coping strategy #8: Change the way you think about yourself

Self-talk has an enormous effect on how we see ourselves. When we are self-critical and unkind, it sets us up for failure because it undermines our ability to respond to negative events.

If you believe that you’re worthless and incompetent then it leads to a self-fulfilling prophecy. You will begin to act in ways you expect yourself to and only remember the times when you failed. 

Examples of negative self-talk include “I’m not loved,” “I can’t do anything right,” “it’s all my fault,” and “I’m not good enough.”

Instead, here are some examples of positive self-talk:

• “It’s okay if I fail because no one is perfect and it is a new learning experience.”
• “I believe in myself but if things don’t go according to plan at least I tried my best.”
• “This is just a small setback. What I’m feeling now is valid but it will pass.”
• “I am worthy, I am loved, and I am capable.”
• “I don’t care about how I may be perceived or how others think of me. I always put my best foot forward and that’s all that matters.”

Coping strategy #9: Set time every day for self-care

Self-care isn’t something you do once in a while or when you feel depressed – it’s a way of healthy living. We all need to check-in with ourselves each day to see how we’re doing and make the necessary changes. 

Set time each day to focus on yourself and do the things that spark joy in your life. This can mean meditating and enjoying a cup of tea in the morning, hiking with friends in the afternoon, and movie night (with snacks of course) in the evening.

Other great habits include: 

• Daily affirmations
• Getting enough sleep
• Taking breaks even when you don’t need it
• Indulging in comfort food once in a while
• Bubble baths and saunas
• Going out for walks
• Watching the sunset
• Exercising with a friend
• Maintaining regular contact with loved ones

Keep in mind that some days will be more difficult than others and we may not feel at our best – and that’s okay! 

We all start at different points in our lives and are a work in progress, so the best thing you can do is to start where you are comfortable and go at your own pace.

Note: It is very common for people to experience stumbling blocks along the way but don’t be discouraged. What’s important is continuing to believe in yourself and getting the help and support you need.

Coping strategy #10: Listen to your mind and body

No one knows you better than your mind and body so listen to them! If you’re overwhelmed and need a break, take as much time as you need and return when you are ready. 

If you have aches and pain, don’t ignore them. Go see your doctor and find out what your body is trying to tell you. Remember, unexplained physical symptoms can indicate underlying depression.

Coping strategy #11: Listen to your doctor 

Always follow your treatment plan exactly as your clinician instructed. This means taking all medications on time and attending all weekly therapy sessions otherwise you risk having a relapse. 

Even when you’re feeling a lot better, don’t skip sessions with your doctor and continue your usual medication regimen because depression is episodic and comes and goes in waves. 

If you have any concerns about your treatment plan, always bring it up with your clinician and s/he will adjust it based on your feedback. 

Also, refrain from drinking alcohol or using drugs because they can interfere with your medication and increase risky behavior. 

Coping strategy #12: Watch funny movies and videos

Some days it can be difficult to find a reason to smile or laugh, but there is no better medicine than laughter.

Whether you’re in a bad mood or feeling down, laughing will naturally lift your mood and remind you that everything will be okay. Laughter has also been shown to reduce stress and alleviate pain. 

Coping strategy #13: Stop to smell the roses

Live in the present. Many people struggling with depression constantly think about past mistakes or making future ones. 

Instead, take the time to enjoy the smaller things in life like watching the sunset, stopping to admire the flowers, listening to your favorite music, de-stressing with a coloring book, building a puzzle, reading a book, dancing while you cook, meditating in nature, and making arts and crafts.

Coping strategy #14: Get more sunlight

Our physical environment affects the way we feel and how we approach the day. Many people who struggle with depression prefer dark, quiet settings because they are constantly exhausted by negative thoughts and want to shut themselves off from the world. 

However, these settings only worsen depression because they interfere with areas of the brain that regulate emotions. 

Alternatively, increasing your exposure to sunlight for 15 minutes each day can significantly improve your mood since it releases feel-good hormones like serotonin (just remember to bring sunscreen). 

Light exposure therapy is also a treatment option for depression and has been found to be just as effective as other treatments. 

How is depression treated?

Depression is very treatable and there are many options that are effective and can significantly improve symptoms. The list below is an overview of some of the interventions used to treat depression.

• Medication
• Mindfulness training
• Psychoeducation
• Cognitive behavioral therapy (CBT)
• Electroconvulsive therapy (ECT)
• Interpersonal therapy (IPT)
• Psychodynamic therapy
• Transcranial Magnetic Stimulation (TMS)

What resources are there for people with depression?

There are many free and low-cost resources available for individuals struggling with depression and are offered in a variety of modalities. 

Whether you prefer online over in-person, support groups over individual sessions or Zoom over phone calls, there’s at least something for you. Check out the different categories below to learn more.

• Chat groups and forums
• Mobile apps
• Support groups
• Telehealth
• Veterans and service members

When can I stop treatment?

This is a decision between you and your clinician because every case is different. But keep in mind that most successful treatments are those that are long-term. 

However, as you start to feel better, your doctor may recommend a lower dosage and less frequent therapy sessions. 

It is also important to note that you don’t have to stop meeting with your clinician if you don’t want to, even when you start to feel better. 

You can continue to update them on the progress you’ve made since your last contact and report any difficulties you may have.

I am having thoughts of suicide. What should I do?

First, determine your level of risk. If you believe you are in imminent danger of self-harm, please call 911 immediately and have a friend or family member wait with you while help arrives. If you have a safety plan, please use it now (click here to learn more).

Next, remove all access to any lethal means in your residence. This means locking any firearms, large knives, and pill bottles in a safe and giving the key to someone you trust. However, if this isn’t possible then remove yourself from the situation to a safe one.

If you are not in immediate danger of self-harm, please seek professional help or talk to someone using any of these free, 24/7 resources below.

• Crisis Text Line. Speak with a crisis counselor through SMS or Facebook messenger. All conversations are completely anonymous.
• National Suicide Prevention Lifeline. Call 800-273-8255 to speak with a trained professional over the phone.
• The Trevor Project. This is a resource for people who identify as LGBTQ+ and want to speak with a trained counselor over the phone or online.
• Veterans Crisis Line. If you’re a veteran or service member and need help, you can speak with a trained VA responder anonymously over the phone, text, or chat.

Although it may not feel like it now, please know that there are people who love you and care about your safety and wellbeing.

If you are thinking about suicide, please seek professional help and use the provided resources.