Thursday, 20 August 2015

What is Major Depressive Disorder? - Part 3

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A short time ago I quoted the definition of Major Depressive Disorder (see here). When you read it, you see that the definition of MDD relies on two factors: (1) the simultaneous presence of multiple symptoms; and, (2) a duration of time over which these simultaneous symptoms are experienced nearly all day every day.

When you read the symptoms, you're probably struck by how vague they are: depressed mood (sadness) most of the day, nearly every day; diminished interest in pleasure most of the day, nearly every day; weight loss or weight gain of more than five percent in a month or a change in appetite nearly every day; insomnia or hypersomnia nearly every day causing psychomotor retardation (slowed down movements and thinking); fatigue nearly every day; feelings of worthlessness nearly every day; diminished ability to think or concentrate nearly every day; and recurrent thoughts of death or suicide.

But within that vagueness is a lurking danger. Notice the repetition of the phrases "most of the day" and "nearly every day". Notice the multiple mentions of slowed thinking and the multiple suggestions of slowed or reduced activity. Weight gain, or loss, is rapid and excessive. You either sleep too much or too little, again to an extreme degree - nearly every day.

In short, your mind and your body are slowing down, day by day by day, as they become deeper enmeshed in a depressed state. You are listless. Every small task or decision seems like a mountain to climb. Everything is a challenge; something as simple as getting out of bed can be overwhelming. You're indecisive, unsure of what to do and, if you do something, you're sure that somehow you'll screw it up and then you beat yourself up for not completing the task perfectly.

You don't understand why you're paralyzed by such simple things. You believe that there's nothing wrong with you and you try to work and think your way through it. And when this doesn't work - and it can't because you're body and mind are slowed - the negative self-talk begins. You talk to yourself in ways that you'd never talk to anyone else, heaping vile abuse on yourself. In time, you come to loathe yourself, deeming yourself to be worthless.

You start to isolate. In the beginning, you do this so you don't "bum out" friends or family. You feel guilty about this. In time, you just don't care; after all, no-one wants to be with someone so worthless anyway.

So you close into yourself. You feel more and more empty, more and more numb. And you tire. And you lose hope.

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Therein lies the danger. Experiencing all of these things, each and every day, practically the entirety of each and every day, is exhausting in ways that only those who have suffered depressive episodes can comprehend. Each day is both a mental and physical struggle. You struggle to think, to decide, You struggle to sleep or stay awake. Some days you don't eat, you can't eat, and others you binge on comfort foods, eating more than you should because you have not eaten for a while. The struggle robs your life of all joy, fatigues you to the point where you cannot get any rest. And the numbness consumes.

Sadness is too inadequate a word to describe this state. Depression, another word, is also inadequate. Tell someone you have cancer, and they will nod and sympathize and express regrets. Tell someone you are depressed, and they'll ask for the reasons why, tell you to "get over it already", tell you about their deprerssion and why it's really no big deal. And inside you both agree and disagree and a new bout of self-abuse begins.

This is your life, 24 X 7. You loathe yourself. You are empty. You have lost all hope. You are in constant pain. You see no way out of the pain. Thoughts of suicide creep in. And with the constant pain, the exhaustion, the numbness, the never-ending despair, it seems to offer a solution.

So re-read the definition.  Read between the lines. Take the words to an extreme. See the depths before you. Dwell on them. And then you might have an inkling of what it means to live with Major Depressive Disorder. Maybe then you'll appreciate just how deadly it is.

Please refer to this page about medical advice.

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