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An Overview of Major Depressive Disorder for Writers
Society as a whole is getting better at understanding mental disorders and sympathizing with those who experience them. I believe that much of this advancement is due to the arts and the fictional portrayal of characters who live these experiences. Fiction is a mirror on society. As we tell our stories, our readers see themselves and those around them reflected back. Which is why I believe having our information about mental illnesses correct when trying to create characters is so important. That is why I have focused so heavily on what mental illnesses really look like in my blog. Today, I’m going to share you a gross overview of clinical depression and what it looks like in a person.
Feeling depressed is something everyone experiences on occasion whether that be through prolonged stress or just having a bad day. It’s not unusual to have a day when you simply don’t want to get out of bed. Generally, pressures of society keep us going and we force ourselves forward to meet our obligations. Often, those around us know we’re having a bad day because we are irritable and just generally unpleasant to be around. This, however, is not clinical depression. Clinical depression is characterized by at least 2 weeks of continuous depressed mood or loss of pleasure in nearly all activities as well as four of the following symptoms: “changes in appetite or weight, sleep; decreased energy; feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decision; or recurrent thoughts of death or suicidal ideation, plans, or attempts” (Videbeck p. 281). These symptoms also impact social, occupational, or other important areas of functioning.
This last part is key, because it separates being sad and having a mental disorder. We all have periods of sadness whether it be from the loss of a loved one, a loss of a job, or broken heart, but depression impacts day-to-day living with a significant impact on the person’s life.
There are many causes of depression: chemical, hormonal, genetic, or depression can come from an extended period of grief. Short term depression if left untreated can lead to chronic depression.
Depression can occur in tandem with anxiety which I’ve written about extensively. Basically, the body has used up all its reserves for the anxiety, so it crashes. It is rare to see chronic anxiety without some form of depression.
Depression does not always look like one would think. It’s not just someone who sits around crying all the time feeling bad for themselves. I’ll paint a quick picture for you:
Anna lays facing the wall, staring at nothing as she has done for the past twelve hours. Outside her door, she hears her youngest squeal with laughter and the thud of footsteps chasing after her. Anna cringes as she draws the covers in closer. Why doesn’t the sound of my own child’s laugh make my smile? I’m a horrible person.
“Mama, would you like some dinner?”?” Joel, her oldest cracks open the bedroom door, but Anna continues to lie on her side in the dark away from the door. She shakes her head, and the door closes back.
Joel shouldn’t have to make his own dinner. I should have made it for him. I just—I feel so tired. Why do I feel so tired? And why can’t I sleep? I’m a worthless burden on my family. I should just end it all so they don’t have to put up with me.
And that is often the case with depression. It’s a lack of motivation, a lack of energy, of joy. It’s not that the person experiencing it is particularly lazy. They literally do not have any energy. This inability to function takes a toll on the person’s self-esteem and the depression feeds into itself making it worse and worse.
There are some treatment options for depression. Unfortunately, these do require some energy expenditure, and there is no guaranteed cure, just management. Sunlight, healthy foods, and better sleep patterns are some of the treatments, but consider a person like Anna who doesn’t want to eat. She lies in bed most of the day, but has trouble sleeping. In order to get sunlight, she has to have the energy to get out of bed. As you can see, the spiral of depression can swallow a person whole.
This does not mean a person should stay in the spiral. Yes, it’s hard living day to day without a functioning incentive-reward center in the brain, but if you don’t get out of the spiral, it will consume you. It will take a bit of faith to get up day after day, sometimes for a very long time without results. But those suffering from depression are not alone. Others have gone before them and succeeded.
Exercising, removing junk food from your life, treating the underlining conditions such as anxiety, and receiving therapeutic help are key to getting out of depression. But you are worth it. Your life is worth it. Get help. Surround yourself with people who will hold you accountable—not by belittling you or abusing you, but by supporting you and your efforts to get better.
I write this last bit to the writer themselves because I have seen many writers speak about their depression and their battles with mental health. Writing is not just for the entertainment of the masses. It can also be a pathway to healing for the writer themselves. As you create these characters living their struggles, reflect on your own life as well. How will Anna get out of the depression cycle? How will you?
Disclaimer: This is a writing blog and not intended to be used as a tool for diagnosing or treating anyone with mental illness.
Psychiatric-Mental Health Nursing, by Sheila L. Videbeck, fifth ed., Wolters Kluwer/Lippincott Williams & Wilkins, 2011.
RW Hague is a registered nurse with over eight years of experience within the medical field. Using her medical expertise, she writes stories that are gritty and compelling.