In my last post, I described how I experience depression. I wrote a description that doesn’t exactly fit the DSM IV criteria. In some ways it did, but in others it was different. Let’s look at this:
The DSM, in simple terms (for length I paraphrased), defines a diagnosis of depression as follows:
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
1) depressed mood
2) sharp reduction in interest/pleasure in activities
3) weight loss, decreased appetite
4) excessive insomnia/sleepiness
5) psychomotor issues
7) feeling worthless
8) trouble concentrating
9) thoughts of death (1)
Right off the bat, I admit that I do experience a loss of interest or pleasure in some (and I mean some) things — so that covers the main item.
I don’t, however, get blue or overly sad — more so I get vacant. Not depressed per se, but just blah, blank, void. It’s not a dark void, just a nothingness — not frightening, not scary at all… It’s nothing…
We already said that I lose interesting in some activities that I would normally find pleasure in. So that’s one in the count of symptoms.
I don’t lose my appetite and I wish I lost weight…ha!
Sleepiness, oh yeah. I could sleep all day. I don’t consciously do it to escape anything. I just can’t seem to help it, or keep my eyes open. I just fall asleep, or want to sleep, or feel exhausted (see below). This is probably my main symptom. So that’s number 2.
Psychomotor issues — slower thoughts and movements. According to my wife, I tend to just drag myself around the house. Like I don’t walk with a purpose or with any energy. I personally don’t notice this. I also seem to just drop myself into my chair in front of the TV. I am happy to drive more slowly on my commute home. So I guess we can check this as yes — number three.
Fatigue, see sleepiness.
Feeling worthless — yeah, I guess my self-esteem is much lower when I am depressed, I also experience paranoia and a lot of anxiety, fear about financial stuff, work stuff, how we are perceived in the neighborhood (things I don’t think about when stable)– so number 4.
Oh crap — trouble concentrating — check! I do have a hard time staying focused at work, or paying attention to people when they are talking (particularly if it’s casual talk) — I tune out, kinda fall inward and don’t notice the outside as much.
Thoughts of death — not really, this is one thing I don’t ever really consider. I might consider considering it — like what would it take to drive me that point where it would be an option, but I am never at point where I think about wanting to go that route.
So I said I didn’t fit the classical criteria for depression — I guess, upon writing it out, I do.
Internally, I don’t admit it — I try to stifle it, so that it isn’t obvious I am struggling. Sometimes admitting isn’t possible, because I don’t even know I am struggling. I just see it as being tired and really bored.
I think that is a big difference in how men experience depression, men disconnect or deny feeling ‘feelings’. The programmed psychological response to distress (internal or external), the culturally encoded behavior of being impervious and “powering through’ problems because that is the ‘manly’ response takes over. The inability to admit to themselves there is problem causes men to withdraw or lash out.
In my case, I will explain away the symptoms (not consciously thinking they are symptoms of depression, but just how I am feeling that in that moment). If I explain them away, as if there is no ‘problem,’ is if everything is okay — I am just tired, bored, burnt out — when really I am depressed.
I will stamp them down inside until they are packed so tight and under so much pressure they burst forth in a moment of anger and rage, triggered by some fear, some perceived slight that touches a nerve of some long suppressed wound from childhood.
- DSM IV : Major Depressive Episode. (2016, September 1). Retrieved from http://www.mental-health-today.com/dep/dsm.htm