Understanding Depression: A Journey Toward Awareness and Support

✎ Dr. William Koo, PharmD, RPh

willkoorph@gmail.com

ORCiD 0009-0003-3612-9391

Depression is one of the most pervasive mental health disorders worldwide, affecting millions of individuals regardless of their background, age, or personal circumstances. While the causes and experiences of depression vary, the weight it imposes on a person’s mental, physical, and emotional well-being is universal. Despite its widespread nature, depression is still often misunderstood, underdiagnosed, and stigmatized, making it difficult for those suffering from the disorder to seek the help they need. This article explores the various types of depression, their effects, the common misconceptions about the condition, and the importance of seeking help—whether through personal support systems or professional treatment.

The Many Faces of Depression

Depression manifests in many forms, and the medical community has identified over ten different types of depression. Some of the most common include Major Depressive Disorder (MDD), Dysthymia, and Persistent Depressive Disorder (PDD). While these types of depression differ in severity and duration, they share a common theme: they profoundly impact an individual’s daily life and ability to function.

Major Depressive Disorder (MDD) is the most widely recognized form of depression and is characterized by prolonged periods of intense sadness, a loss of interest in daily activities, significant changes in appetite or sleep patterns, and feelings of worthlessness or guilt. According to the National Institute of Mental Health, approximately 8.3% of U.S. adults experienced MDD in 2021, which equates to around 21 million people. The disorder can recur throughout a person’s life, often becoming a chronic condition if left untreated.

One of the distinguishing factors of MDD is that it doesn’t simply pass with time or willpower. Those suffering from MDD may find that activities they once enjoyed no longer bring them pleasure, and they may struggle to perform basic tasks, such as getting out of bed or maintaining relationships. Importantly, the DSM-5 criteria for diagnosing MDD require that an individual experience five or more symptoms nearly every day for at least two weeks. These symptoms include feelings of worthlessness, fatigue, insomnia, psychomotor agitation, significant weight changes, difficulty concentrating, indecisiveness, and recurrent thoughts of death or suicide. If these symptoms persist and interfere with daily life, it’s critical that individuals seek professional help for proper diagnosis and treatment.

In contrast to MDD, Dysthymia—now classified under Persistent Depressive Disorder (PDD)—is a chronic, milder form of depression that can last for years. While the symptoms may not be as severe as those associated with MDD, individuals with PDD experience persistent feelings of sadness, low energy, and a general lack of motivation. They may not experience the intense emotional lows of MDD, but the constant, low-grade depressive symptoms are equally damaging over time.

According to the DSM-5, PDD (which includes dysthymia) is diagnosed when a person experiences a depressed mood for most of the day, for more days than not, for at least two years in adults (or one year in children and adolescents). During this period, at least two or more of the following symptoms must also be present:

• Poor appetite or overeating

• Insomnia or hypersomnia

• Low energy or fatigue

• Low self-esteem

• Poor concentration or difficulty making decisions

• Feelings of hopelessness

  
  

The key difference between PDD and MDD lies in the duration and intensity of symptoms. PDD is more persistent and less intense than MDD, but it can be equally disruptive to an individual’s ability to live a fulfilling life. People with PDD may feel like these symptoms are just part of their personality or daily experience, making it harder for them to seek help or even recognize that they are suffering from a mental health disorder.

It’s not uncommon for people with PDD to feel like these emotions are just a part of who they are, which can make it more difficult for them to recognize their condition and seek help. According to research, about 1.5% of adults in the U.S. have experienced dysthymia in the past year, and 2.5% have experienced it at some point in their lives. Unlike MDD, where episodes may come and go, PDD often becomes an enduring aspect of the individual’s daily life, making it even more challenging to treat. In both cases, finding effective treatment—whether through medication, therapy, or a combination of the two—is essential to managing the symptoms and improving quality of life.

The Hidden Burden of Depression

One of the most challenging aspects of depression is that it often goes undiagnosed or untreated. In the U.S., an estimated two-thirds of depression cases go unreported. This can be attributed to several factors: the stigma surrounding mental health, a lack of awareness about the condition, and the normalization of symptoms by those who suffer from depression. Often, people who are depressed believe that their symptoms are simply part of life or that they are a personal failure rather than the result of a diagnosable mental health condition.

This underreporting has severe implications for both individuals and society as a whole. Depression is one of the leading causes of disability worldwide and is a significant source of lost productivity in the workplace. Employers lose billions of dollars annually due to absenteeism, reduced work performance, and healthcare costs related to untreated depression. The economic toll is staggering, but the personal toll is even greater.

Depression doesn’t just affect the mind—it affects the body, too. Many people with depression also experience physical symptoms such as chronic pain, digestive issues, and headaches. These symptoms can make it difficult to separate mental health issues from physical health problems, further complicating diagnosis and treatment. In addition, depression often coexists with other mental health disorders, particularly anxiety. About 60% of people with anxiety disorders also experience symptoms of depression, and vice versa. This comorbidity exacerbates the burden on individuals and healthcare systems alike, as treating one condition without addressing the other can lead to incomplete or ineffective treatment outcomes.

The impact of depression extends beyond emotional and physical health; it also influences societal issues such as suicide rates. People with MDD are about 20 times more likely to commit suicide than the general population. Despite this alarming statistic, fewer than half of those suffering from depression receive any form of treatment. Even for those who do seek help, the care is often insufficient, leading to a cycle of untreated or inadequately treated depression that continues to affect them throughout their lives. These untreated cases contribute to rising suicide rates and the worsening of symptoms over time.

Recognizing the Symptoms of Depression

Recognizing the signs of depression is the first step toward getting help. Depression can manifest differently in different people, and its symptoms don’t always look the same. However, several common signs may indicate that someone is suffering from depression:

• Persistent feelings of sadness, hopelessness, or emptiness

• Loss of interest in activities once enjoyed

• Changes in appetite or weight (either increasing or decreasing)

• Trouble sleeping (insomnia or sleeping too much)

• Fatigue or low energy

• Difficulty concentrating or making decisions

• Feelings of worthlessness or excessive guilt

• Thoughts of death, suicide, or self-harm

  
  

These symptoms can last for weeks, months, or even years and can significantly impair a person’s ability to function in daily life. Often, individuals don’t realize they are experiencing depression until it begins to interfere with their ability to work, maintain relationships, or engage in self-care. Friends, family members, and co-workers may notice changes in behavior or mood before the individual does, and it is important for those around a person suffering from depression to approach the situation with care, empathy, and support.

Real Stories of Struggle and Empathy

Depression doesn’t exist in isolation—it intersects with the everyday events of life. In my own experiences, I have encountered individuals who, despite external appearances, were silently battling their own struggles. One such story involved a close colleague who, after enduring public humiliation in the workplace, opened up about her struggles with Major Depressive Disorder (MDD). She had been working hard to improve her self-image, but the incident caused her to spiral into a deeper depressive episode. Although she tried to keep it hidden, the emotional toll was profound, and eventually, she left the company.

Another poignant moment occurred on the subway. I sat beside a woman whose arms were covered with self-harm scars. She was quietly sobbing, and though hesitant at first, I eventually asked if she was alright. She opened up about her depression and the racial discrimination she faced daily. Listening to her, I realized the depth of the pain people carry—often unseen by those around them. All she needed was someone to acknowledge her struggle and offer a kind word.

Another unforgettable experience involved a woman I encountered at a subway station. She was trying to carry her baby and stroller up the stairs while crying uncontrollably. She confided that her partner had recently left her, and she was struggling with postpartum depression while caring for her newborn alone. She felt overwhelmed, hopeless, and abandoned. I offered to help her carry the stroller, and while walking with her, I listened as she talked about her struggles. Though I couldn’t solve her problems, I saw firsthand how simply being present for someone can make a difference.

During my college years, I became close friends with a classmate who had come from Singapore to study pharmacy. Over time, I noticed that he started to withdraw from our group, stopped attending classes, and began isolating himself. When I reached out to him, he revealed that he was feeling deeply homesick and had fallen into a depression. Despite my efforts to support him, he eventually left school and returned to Singapore. His departure left me with a sense of helplessness and regret, as I wished I could have done more for him.

These personal stories highlight an essential truth: you never truly know what someone is going through unless you take the time to listen. Depression can be invisible to the outside world, but it leaves a deep and lasting impact on those it affects. Each individual experience serves as a reminder that mental health awareness and compassion are critical components in helping others.

Seeking Treatment and Support

Treatment for depression typically involves a combination of medication and psychotherapy. While antidepressants, such as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), are often prescribed to regulate brain chemistry, they don’t work for everyone. The process of finding the right medication can take time and often requires multiple adjustments before a patient finds the right balance. This trial-and-error approach can be frustrating for those already struggling with the weight of depression, but persistence is key.

Psychotherapy, or talk therapy, is another essential aspect of treatment. Cognitive-behavioral therapy (CBT) has been shown to be particularly effective for many individuals, helping them to identify and challenge negative thought patterns. Therapy provides a safe space for individuals to explore their emotions, confront past traumas, and develop healthier coping mechanisms. However, therapy, like medication, takes time. Finding the right therapist is akin to finding a good friend or confidant—someone whose approach aligns with your needs and personality.

In addition to professional treatment, one of the most powerful tools in combating depression is a strong support system. Friends, family, and even co-workers can provide much-needed emotional support, though it’s crucial that they understand how to approach someone suffering from depression. Listening, offering reassurance, and avoiding judgment can make a world of difference.

The Road Ahead

Living with depression is not an easy journey for those affected by it, but it is one that many people travel. For those currently struggling, it’s important to remember that help is available. Seeking assistance from a psychiatrist, therapist, or support group can be the first step toward recovery. Even though depression may feel overwhelming at times, with the right support and treatment, it is possible to manage the symptoms and regain a sense of control over one’s life.

Furthermore, awareness and education about depression are vital. The more we understand this disorder, the better we can combat the stigma that surrounds it. We need to create a culture where people feel comfortable seeking help, where depression is recognized not as a weakness but as a treatable condition. By working together—whether through professional treatment, personal support, or simply offering a listening ear—we can create a world where those with depression feel understood, valued, and supported.

For anyone battling depression, remember: you are not alone. There is always hope, and the journey toward healing, while difficult, is worth taking.

Cite this article:

Koo W. Understanding depression: a journey toward awareness and support. Drug Information Blog. WritePharma. September 26, 2024. https://www.writepharma.com/news/understanding-depression-a-journey-toward-awareness-and-support