I. What is Depression?

Depression is a symptom, a syndrome, and a mood disorder. According to the DSM-5, it's an umbrella label for eight different types, namely, Disruptive mood dysregulation disorder, Major depressive disorder, Persistent depressive disorder (dysthymia), Premenstrual dysphoric disorder, Substance/medication-induced depressive disorder, Depressive disorder due to another medical condition, Other specified depressive disorder, and Unspecified depressive disorder like Seasonal Affective Depression (APA, 2013a).

Seasonal affective disorder, often referred to as SAD, is not as uncommon as it may seem. This specifier is applied when at least two major episodes consistently occur during a specific season of the year. For example, a person who has an increasingly difficult time getting out of bed and going to work every fall and winter may have a seasonal pattern of depression or ‘winter depression’. (Source: mentalhelp.net)

II. Impacts of Depression

Depression can have various impacts on a person’s brain, emotions, and behavior. When left unmanaged, its influence becomes evident affecting one’s self-concept, relationships, and daily activities. 

a. On the Brain

Depression is intricately tied to the brain, with a  multitude of contributing factors ranging from genetics to environmental influences. One crucial insight is that depression isn't just about emotional symptoms; it involves the brain's structural and functional changes.

According to a 2018 journal published by the National Library of Medicine,

depression may affect our brain’s frontal lobe causing a combination of lesions, shrinking gray matter, poor communication to the rest of the brain which affects our mood regulation, loss of motivation, cognitive abilities, emotional bias, and apathy.  

Other parts of the brain like the parietal lobe, hippocampus, thalamus, and striatum can also be affected. Here is a true fact that affects all people who are depressed, diagnosed or not, depression changes your brain!

b. On Emotions                   

While sadness, apathy, emptiness, excessive worrying, stress, and numbness are common, it's essential to recognize that depression also encompasses disgust, irritability, frustration, and even anger.  Although the DSM-5 does not have a diagnosis for anger problems, several disorders reflect enduring and dysfunctional anger.  Anger, aggression, or irritability as a symptom is listed in more than 32 disorders. 

Research has shown that the presence of anger alongside a primary emotional disorder like depression results in more severe emotional problems and can be more resistant to treatment.

For instance, Disruptive Mood Dysregulation Disorder (DMDD) is a mental health condition that causes chronic intense irritability and frequent anger outbursts in children.  DMDD has an onset as early as 10, it will not be diagnosed for children under 6 or adolescents above 18. This diagnosis often transitions into major depressive disorder or generalized anxiety disorder.  

Research found that 30% to 40% of people with major depressive disorder experience severe rage or anger. These outbursts, commonly known as ‘anger bursts’, are often characterized by flushed skin, erratic heartbeat, profuse sweating, and tightness in the chest. For some people, it may include behaviors like shouting, slamming doors, or breaking objects.  

Some studies also state that anger bursts are more common in men with depression than women. The frequency of anger bursts has more to do with social factors as men are often socialized to express anger, while women may be taught to suppress it.

c. On Behavior

Depression impacts what you do and how you do it.  These behavioral changes may include crying uncontrollably, alcohol or drug use, shifts in mood, social withdrawal,  changes in sleep and eating habits, and, in severe cases, self-harm or suicidal thoughts. 

Depression can also be the culprit behind a lot of inappropriate behaviors. Some uncommon symptoms include being a workaholic, anger bursts, numbness, anxiety, and high-risk behaviors such as hypersexuality and overcompensation through outward displays of happiness. Depression also leaves a person cognitively impaired and with emotional dysregulation. From there, the behaviors follow.  Can you spot depression in those around you or in yourself?

For instance, consider some of the posts you see on social media.  Those who are constantly posting selfies and fun photos of excursions, activities and/or a highly entertaining social life just may be overcompensating, depressed, or experiencing sadness in multiple areas of their life.  Remember, acknowledging your pain is better than overcompensating for it. 

Similarly, consider the workaholic who goes in early, comes home late, and even works on vacations. For some, anger accompanies behaviors like shouting, slamming doors, or breaking objects, and in extreme cases, it may lead to domestic violence.  Highly successful and driven individuals can often find themselves overwhelmed and pressured, which can result in them commonly having conflicts at home and anger outbursts. In The Journal of Nervous and Mental Disease researchers found that high levels of anger and hostility were associated with more severe treatment-resistant depression.

III. How to Heal from Depression

Here's a crucial fact to remember: You can heal from depression. It does not have to be a lifelong diagnosis. However, it’s essential to be honest about the severity of your symptoms. 

Utilizing tools like the Patient Health Questionnaire-9 (PHQ-9) can help you gauge the extent of your condition and determine an appropriate plan of care. Moreover, there are also evidence-based practices that really work for combatting depression like psychotherapy and medication.

Here are some tips to aid you in your healing journey:

• Acknowledge Your Emotions: Recognize and accept that you have those feelings.  Become more self-aware as it is a necessary life skill. 

• Set Your Intentions: Understand that thoughts precede reality. Everything happens twice, once in the mind and then in reality. Knowing how is not required! 

• Focus On Solutions: Shift your thoughts towards solutions and create action steps to establish a sense of flow. 

• Guard Your Mind: Think of things that are positive and joyous. Set your mind for victory. 

• Guard Your Ears: Limit negative conversations, both with others and within yourself. Listen to music or comedy to lighten your mood. 

• Seek The Good: Look for the happiness in life; within you, your relationships, and your environment.

• Gratitude Journal: Keep a journal to count your victories and log the good things going on in your life.  

• Get Sunlight: Spend time outdoors, under the sun, to get Vitamin D3 which is known to help regulate mood. 

• Move Your Body: Engage in 3 to 5 minutes of intense aerobic activity which is equivalent to a shot of an antidepressant naturally made by your body.

• Eat to Live: Your food definitely impacts your mood. The mind-gut relationship is real, so eat healthy for your mind to stay healthy.

• Connect With Others: We are built for connection, and having healthy relationships allows us to see the beauty in life. 

In conclusion, depression is a complex and multifaceted challenge that goes beyond just feeling sad; it impacts the brain, emotions, and behavior, often leading to a profound sense of hopelessness and despair. However, there is hope! Depression can be a formidable adversary, but with determination and the right support, you can overcome it and rediscover the joy and vitality that life has to offer. Remember, your journey toward healing, begins with awareness, commitment, and the belief that brighter days lie ahead.