Just not that into it: Coping with depression.

Depression is a fairly common condition but is widely misunderstood and misdiagnosed (or not diagnosed at all).

For starters, depression doesn’t always look like the way people may imagine it; slumped on the couch in front of the TV for hours, wearing the same pajamas from last week (unwashed), not answering the phone, and saying you just want to die.

While there certainly are people whose depression does look like that, there are many whose depressive symptoms may be less obvious, even to their partners and family members, and go unrecognized for extended periods of time. (When it comes to loved ones, sometimes there can be a proclivity to ignore alarming behavioral changes; not because of negligence or naiveté, but because of the unsettling feelings that can arise when you admit to yourself that someone you love isn’t in a good place.)

One of the core clinical features of depression is anhedonia, which is the is inability or significantly decreased capacity to feel pleasure. Anhedonia can manifest as feeling less vibrant in how you feel and how you are able to enjoy activities that normally would evoke positive feelings. Many of my therapy patients have described their depression along these lines: I feel like I am living my life, showing up, going through the motions, and on the surface it all looks good in the pictures, but I’m not really there. I look at all the blessings in my life and wonder, gee that’s a fortunate existence, but why can’t I feel any joy or happiness? They may not be glued to the couch, but the sense of flatness and disconnect can be lonely, saddening, and feel plain old stuck.

Overcoming depression is a unique path for each individual, which is why it is important that treatment providers don’t have a one-size-fits-all approach in the way they treat the person suffering. There are many treatment options out there for depression — therapy, medication, alternative therapies, holistic approaches, herbs, behavioral exercises, etc. — and it is good to keep an open mind about what is out there that can be helpful.

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