The Face of Depressive Suffering

Clinical depression can be debilitating. It’s different from sadness (though sadness is one symptom of depression). And while there is overlap, it’s different from grief. Too many people struggle with depression and do not get the help they need.

Understanding what depression looks like can help you better understand what you might be up against emotionally if you suffer from depression.

Just as all individuals are not alike, not all depression is alike.

There are milder forms of depression and more extreme, severe kinds of depression. For some, symptoms of depression might also include mild-to-intense anxiety, an experience of worry and physical nervousness/jitteriness. There might be a specific fear (e.g., the fear that someone you love might get injured or die) or a more generalized, “free-floating” fear that colors most of your experiences. For some, depression and anxiety go hand-in-hand.

Depression can be triggered by stressful life circumstances (losing a job; a divorce/relationship ending; being ostracized by peers or publicly shamed on social media); while other episodes of depression seem to come out of the blue, unrelated to what’s going on in your life. 

Below are hypothetical (but authentic) descriptions of how the experience of depression might present itself, grouped according to symptoms commonly seen in depression, or facets of life that are affected by depression. Think of these as first-person, subjective descriptions of depression.

Having one or a few of these experiences doesn’t necessarily mean you would meet the criteria for clinical depression, but your life might still be negatively impacted by any of these symptoms. And you’ll notice that even within the same theme (for instance, sleep) individuals can have very different experiences (some sleeping a great deal, some finding sleep elusive).

The face of suffering: the experience of depression

Low mood

For as long as I can remember, I’ve felt blue. Sometimes the sadness is like background noise, at other times it’s more pronounced. It’s been with me for so long that I wouldn’t even know what it’s like to not feel like this.

I feel down most of the time. A deep pit-in-the-stomach emptiness. There are times when something might distract me for a moment, but once the distraction is gone, I fall right back into what feels like a black hole. It’s like it’s waiting there for me, letting me know I can’t escape it.

I’ve been sad before in my life, but being depressed is different. It’s an overwhelming sadness. It blankets everything. I cry for no reason I can put my finger on. It’s like the sadness is a thousand-pound suit of armor that I can’t get out of.

Nothing seems to make me happy. I watch people around me having fun, but I feel disconnected from it all.

I feel numb to most things. It used to give me such joy to watch my kids play, to paint or go for a walk with our dogs. Now when I do those things, it’s like I’m just going through the motions. I feel empty inside.

Concentration & energy

It takes so much effort to focus on something. I just can’t concentrate. I don’t have the mental energy to even have complete thoughts. Midway through a thought I just run out of steam and think, ‘Why bother?’

I used to love to read. Now when I try I don’t retain anything. I find myself rereading the same paragraph and not comprehending any of it. It’s so frustrating.

It’s hard to get up and get through the day. And when I try, it feels like I’m walking through quicksand, like there’s a counter-force that makes moving and getting around difficult.

I fall asleep exhausted and I wake up exhausted. (And often, with dull headaches or neck aches.) There’s no escape from the fatigue. From the malaise.

Self-criticalness, perceived failure, hopelessness

Why bother trying…nothing works out for me anyway.

I keep thinking about my life and everything I didn’t accomplish. All the dreams I had, all the goals I was going to reach. What a joke. I feel like such a failure, a real loser. God, why would anyone want to be around me? I can’t even stomach my own company.

If anyone really knew me, got to see the real me, they would run the other way. I know this for a fact. That’s why I have to keep a certain amount of distance with everyone. The downside is loneliness, but that beats rejection.

The people in my life think I’m a success, that I’ve got my life together. My friend even said she envies me. That’s crazy. They should know I feel like an imposter most of the time. I could put on a good show, but it’s just a charade. I’m just waiting for it all to come crumbling down.

I’m starting to feel convinced that I would be better off dead and that others would be better off without me. The thought of being alive has started to feel like a prison with no reprieve except suicide. It’s gotten so bad that thoughts of ending my life have become comforting. Part of me knows this sounds crazy, but it feels like the only place that I have control over what happens.

Sleep

The only escape for what I feel is sleep. I can easily sleep sixteen hours a day.

Ever since the sadness took over, I spend nights wide awake, my mind racing about the people I’ve hurt, the mistakes I made, the things I’ll never be able to take back.

I wake up in the middle of the night, and there’s no falling back asleep. I’ve tried so many things and nothing seems to help. It’s like I’m wide awake and exhausted at the same time.

Interpersonal relationships

I dread being alone. Panic surges through me when I feel like I’m completely alone in the world. Alone and lost. The panic makes me feel like no one will ever find me. The only comfort is when I’m around my husband or my sister. But I can’t be with someone twenty-four hours a day. And I know this is taking a toll on them, too.

Whenever possible, I try to avoid people. I can’t pretend and put on a happy face for them, but that’s what is expected. And I’m always comparing myself to others and coming out as the loser. It’s just easier to isolate from the world.

I’m overwhelmed by emails and texts I have to return. I know my friends want to see me. I know they care for me. Last month I met a friend for coffee and it was OK. I was glad I did it and we made plans for the following week and I didn’t show up. I don’t know why I did that. She texted and called and I just turned my phone off. It was like I was hiding from something I couldn’t name.

The other day my husband encouraged me to get out of the house. He said being around people would help me “snap” out of the funk I’m in. So I got in my car and drove to a coffee shop. The anxiety was overwhelming. I couldn’t push myself to go inside. So I sat in my car and just cried. I know he’s going to be really disappointed in me and that makes me feel even worse about myself. So maybe I’ll just lie and tell him it felt good to be at the coffee shop.

Work

I slept through my alarm and I’ve been late for work a half a dozen times now. My boss told me that if it happens again he’s going to have to let me go.

I just stopped showing up for work. I’ve never done anything like that in my life.

I tried to work but I couldn’t. I’d sit at my computer frozen. It was like an out-of-body experience. I kept telling myself to get going. Unfinished projects kept piling up but I couldn’t move. This is the second job I’ve lost. And now I feel even more lousy because I can’t even keep a job and support my family. I know my wife blames me, thinks it’s a “choice” I’m making. But I’ve never felt more helpless and more powerless in my life.

~~~

The above descriptions are a few examples of how signs of depression might manifest. This list isn’t exhaustive. Think of the above as a starting place to self-assess and raise questions about your emotional wellbeing.

According to the National Institute of Mental Health, an estimated 16.2 million adults in the United States have had at least one major depressive episode. Depression is the number one mental health issue faced by people. Yet it still remains misunderstood. And many who are depressed do not get the care they need.

Remember, to be depressed is to suffer. Depression isn’t a sign of failure or weakness. It’s a disease that impacts many of us. If the experience of depression starts to snowball and rob you of your life, impairing your ability to function, convincing you that life isn’t worth living, there is help available. Reaching out to someone can be an important first step in reclaiming your life.

If you believe you are depressed and would like to set up a consultation appointment to discuss what might be helpful, please feel free to contact me.  I offer online counseling services to Texas residents as well as residents in other states (please contact me to find out if I am able to offer online counseling where you live).

And if you are struggling with suicidal thoughts, you can visit the Suicide Prevention Resource Center (which has information about suicide prevention and a hotline if you need to speak with someone): www.sprc.org

Richard Nicastro, Ph.D.

Licensed psychologist