There are lots of depressions, ranging from light to heavy. Passing to staying. So each of us likely has our own experiences with it and our own working definition of depression. Some of us may equate that term with a slight interruption in our usual bounciness. Others may associate depression with the downness that comes with PMS.

We all, sooner or later, get to know about situational depression around a big loss or a close death. At first there is shock, then all that pain and heaviness, but as the weeks go by it gradually it falls away…

Others have slogged along for years in a state of weariness that is all they have ever known. They don’t think they are depressed. They just see life as hard. They might say they feel tired a lot. Not having any other state to compare it to, they are surprised to hear someone call them depressed. They might think they would have to feel worse to qualify as depressed.

A person is said to be clinically depressed—that is, he is depressed enough

that it is considered a treatable disorder—if he meets 5 of these diagnostic criteria during a 2-week period. However most depressed persons will have some but not all of these symptoms, and they may vary in intensity, even hour by hour:

-Depressed mood, loss of usual interests, absence of joy

-Extreme lack of energy or extreme agitation

-Can’t sleep or can’t stop sleeping (extreme sleeping behavior)

-Loss of appetite or overeating (extreme eating behavior)

-Very strong feelings of worthlessness/guilt

-Inability to concentrate

-Suicidal ideation

Depression may be mild and temporary or severe and unremitting. And guess what? Persons who are the least depressed have the best hope for getting through it and coming out feeling better.

Persons who are overwhelmed with temporary circumstances in life may have some passing depression. Maybe you are caring for a dying parent, or you have young children who need you constantly. Maybe you are stuck in a job that you find boring or exhausting. Under these circumstances you may feel bent-but-not-broken from your ordeal. You may be able to lift your mood by focusing on the joys you do have. Getting more sleep may make a big difference to you. Noticing your patterns of thought and changing them to be more positive may make a difference to you. Getting out for some regular exercise, or a vacation will probably help a lot.

If suggestions like this refresh you, wonderful! Be sure to continue to do what you can to pull yourself up out of the blahs. At the same time, please understand that milder depression is very different from severe depression. What works for you here you may want to offer to others, but be prepared to accept that your depression may not be their depression.

Sometimes the above suggestions may help the moderately depressed person, but they won’t always work. Depression is not a single mood that stays constant. A moderately depressed person may have days when he seems to function well, but it would be a mistake for us looking on to assume that the person has a constant, static feeling state.

We may become exasperated because at times he seems to do better, or get over it or work through it, but then he sinks again. It is easy for us to get impatient then. We may start to wonder if the person is doing all he can. We may want to give up, concluding that there is a measure of willfulness or even a lack of intelligence on the part of the sufferer. If you and I become frustrated, just looking on and trying to help, image how difficult it is to be the person trapped inside depression all day, every day.

Then there are those who are severely depressed. On their worst days they can’t even get out of bed and take a shower. Housework piles up around them. Or they can’t bring themselves to show up for work. Nothing holds their interest. They can’t get moving, or stay moving. They feel like they weigh a million pounds. There is a heavy air of defeat and hopelessness around them. Nothing you try helps.

Many of the most depressed folks feel horrible about themselves. They think they are big losers who are getting what they deserve. They may call themselves the names they grew up hearing and continue to put themselves down with harsh, abusive language.

These folks may think and talk about ending their life. Some are more direct than others about letting others know they wish to die. What they really want, naturally, is to end this horrible feeling of depression. When they are in it they may be absolutely smothered in despair. They cannot remember when they didn’t feel that way, and they have little hope that it will ever lift. Their depression is so enveloping that they have a hard time thinking, reasoning or planning. Their depression owns them.

Be sure to notice how different life is for the severely depressed person. The antidotes that bring some relief to a mildly depressed person will not work for this person. She is not being willful. Severe depression is completely involuntary. In fact, if you keep on making suggestions for things she might try, she will probably use these as further indications of what a failure she is, and how bad she is.

Bipolar disorder describes a person who is sometimes very down, but then has times when he soars with artificial energy and enthusiasm. A person who has been depressed and then finds himself in mania likes the change. Feeling manicy—all charged up and enthused—feels much, much better than depression. In fact a person who is in a manic state feels like he can do anything! Which is what makes this a disorder. In a manic state a person is not thinking realistically and makes decisions that make sense to him at the time, but hurt him in the long run. He gives away his money, or starts huge projects he can’t finish.

There are meds that help to even out the high-low states of manic depression (the older name for bipolar disorder), and I suggest that sufferers give them a try. As with depression, mania can vary, too, from mild to severe.

The antidepressant medications on the market today have done a lot of good for millions of folks. Admittedly the meds are far from perfect, but for many seriously depressed people they have made the difference between life and death. So consider trying them if you are the depressed person. And if you are reading this trying to think of a way to help a very depressed person, use your influence to get them to try. They may not be very cooperative, I realize. So you may have to negotiate in smaller steps. You may start with, “Let’s just make an appointment with our family doctor and go ask her if she thinks the meds would help you.” Then at the appointment you might ask the doctor, “Is it possible that we could just try these for 3 months and then decide to stop if they aren’t helping?” You get the idea. Do some horse-trading to get your loved one to make smaller moves in a healthy direction. That’s all there is.

If you have a very depressed person in your life, you might also find these articles helpful:

Helping Others

Malingering—Faking or Not?

Medications

Psychotherapy

What about Self-Harm?

Suicidality