It’s natural for us to feel sad at times. It could be because you lost a family member, your parents got recently divorced, or you lost your job. Sometimes, the winter season and no sun for days can also bring sadness. You may hear yourself or your loved ones saying the following statements

• I feel bad and I dont know what to do?
• Today, I dont feel like doing anything. I feel blue.
• Im feeling down
• Im feeling sad over losing my job
• Dont make me sad. Im already feeling down for not seeing the sun for days and freezing winters.

Thus, it’s normal to have feelings of grief and sadness. Such feelings mellow down over the days. Here are some sad photos in the following illustration that depict possible reasons for your sadness or grief.

However, sadness and grief may become problematic when they stretch over two weeks or more than that.

If you hear yourself saying ‘I am sad or ‘I feel blue longer than two weeks, chances are that you’re depressed. Sadness or grief is different from being depressed. And there’s a higher possibility that yours is a case of clinical depression.

What is Depression?

Depressed feelings would be marked by hopelessness and helplessness. You may find yourself cursing yourself for feeling depressed. Likewise, you may not like activities that you earlier enjoyed doing and may feel fatigued most of the time.

Also, you lose interest in daily activities and may want to stay alone away from family and friends. In severe cases, there are chances people feel like killing themselves or have suicidal thoughts to get rid of their pain.

What adds to this situation is that you have been saying I’m sad for more than two weeks. But, you don’t know why you feel so and what to do when you are sad?

Why You May Not Know Youre Depressed?

It is quite possible to feel depressed and not know why you’re feeling down. If you don’t know why you’re depressed, there could be several reasons for that.

1. Depression Occurs Differently in Different People

Both you and someone very close may be feeling depressed at the same time. But it is very much possible that your symptoms may not match with the symptoms seen in your loved one.

For instance, you may not be enjoying your hobby of reading anymore, prefer staying away from family and friends, and feel irritated. Your loved one on the other hand may experience loss of appetite, a sense of worthlessness, find difficulty concentrating, and lack interest in routine activities.

Now, both of you face different symptoms. However, these are the symptoms of Major Depressive Disorder (MDD).

Much like different symptoms, you both may feel depressive to various degrees. For instance, where you may be able to function and take up your responsibilities along with feeling depressed. Your loved one, on the other hand, would experience severe symptoms of depression. This may interfere with his normal functioning to a great extent and may be unable to work.

2. Some Symptoms Many Not Look Like Depression Symptoms

There may be times when individuals are actually experiencing depression symptoms. However, they may not know it as they tend to make presumptions about symptoms.

For instance, it’s not necessary that a person who is sad is the one who is depressed. A person need not be sad yet can be depressed. Further, he may have difficulty concentrating on tasks and may experience a sense of worthlessness. Or he may lack interest in activities which he previously loved doing.

Apart from this, there can be situations in which one may link certain symptoms with life stressors or the work pressure one may have. Whereas those may sometimes cause depression symptoms. For example, difficulty in sleeping and weight change may be put on life stressors.

Whereas, these are some of the important depression symptoms.

3. Depression Symptoms Develop Overtime

The process of the development of depression symptoms is very slow. That is why one might not see any observable changes in the person experiencing such changes.

Now, we may not understand these small changes in us like fatigue, having a low mood, etc. However, when these become severe, we are not able to relate to ourselves and are unable to identify the person in us.

4. There May Be Sound Reason That May Prevent From Identifying Depression

When something episodic happens in our lives, we often have a bad mood, lose interest in activities, etc. Thus, in the event of losing a loved one, losing a job, going through a breakup or divorce, one is bound to feel bad.

In fact, not being affected by such events is normally considered to be strange. But in reality, these events are critical forecasters of depression which are typically considered normal.

These events forecast depression because a person tends to lose dependable means of earning, support, etc.

5. Not All Depression Symptoms Develop Simultaneously

As mentioned earlier, depression symptoms develop over a period of time. So, one may see different symptoms developing at different times. For instance, one may start losing interest in activities he loved doing before. And then some weeks later one may see that he feels a sense of worthlessness.

Now, one may not be able to relate both these issues and understand that these two are actually linked to depression.

6. The Stigma Attached Prevents Us From Accepting Depression

No matter how much we have developed in respect of other fields, there’s still a stigma attached to mental health. People typically consider themselves to be strong, confident, and persevering. And thus think that they can never face depression given their personality and nature.

That’s why many of us try to ignore depression symptoms and try to associate them with some other condition like a bad day or ‘ normal stress.

Thus, it is very much possible that you may not know why you are feeling down and hence may end up saying ‘I don’t know what to do.

Therefore, it’s important to know depression symptoms so that you can identify them as and when they occur. Also, you need to understand that depression is treatable and that consulting a mental health care professional can help you understand various depression treatments.

Depression Symptoms: Why Feeling Sad For Long is Not Good?

The following are the physical and psychological depression symptoms. These depression symptoms must be present in an individual for the past two weeks or more.

1. Depressed Mood

One of the critical depression symptoms is a depressed mood characterized by hopelessness, sadness, and demotivation.

2. Lack of Interest

This refers to individuals losing interest in activities they previously used to like.

3. Concentration Issues

One may find it challenging to focus on various tasks and activities.

4. Sense of Worthlessness

This refers to one illogical negative analysis about oneself or one’s worth.

5. Sleep Challenges

Sleep issues may include either excessive sleeping or lack of sleep.

6. Anger Issues

This includes experiencing irritability over petty issues.

7. Psychomotor Agitation and Retardation

Where psychomotor agitation refers to a lack of ability to sit still. Psychomotor retardation, on the other hand, refers to facing issues like slowed sleep, movement, and thinking.

8. Suicidal Thoughts

This is marked by repeated suicidal thoughts or feelings of getting rid of one’s pain if one dies.

Depression Treatments: What To Do When You Are Sad?

What adds to this situation is that you have been saying I’m sad for more than two weeks. But, you don’t know why you feel so and what to do when you are sad?

The commonly used depression treatments include psychotherapy, pharmacotherapy, or a combination of both. One of the initial depression treatments includes psychotherapy, medications, or both.

A combination of psychotherapy and medications has been proved to be more effective than either of the standalone treatments.

1. Medications

FDA has approved some of the anti-depressants that are commonly used to treat depression. However, each of these has its own side effects.

a. Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are typically the first line of treatment and are the most recommended antidepressants by mental health professionals. These include citalopram, escitalopram, fluoxetine, sertraline, paroxetine, and fluvoxamine.

b. Selective-norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are usually prescribed to individuals with comorbid pain disorders. These include duloxetine, venlafaxine, desvenlafaxine, milnacipran, and levomilnacipran.

c. Atypical Antidepressants

These are recommended to patients who experience sexual side-effects with the use of SSRIs and SNRIs. These are recommended as monotherapy or supplementing agents and include mirtazapine and bupropion.

d. Serotonin Modulators

These include vortioxetine, trazodone, and vilazodone.

2. Psychotherapy

These include:

(i) Cognitive-Behavioral Therapy (CBT)

CBT is a psychological intervention that consists of a host of strategies for treating mental issues. It follows a problem-solving approach in which a mental health professional and the patient come together. Further, they work together to identify and understand issues faced by the patient.

This study of the problems is undertaken in respect of the patient’s relationships, feelings, and behavior.

(ii) Interpersonal Therapy (IPT)

IPT is also a psychological intervention that is based on the factors of psychotherapy. In this too, both the therapist and the patient come together to understand and give necessary treatment to the patient. Thus, IPT treats depression as a medical issue, not something that is a mistake or defect on the part of the patient.

This approach helps in clearly defining the problem instead of blaming the patient. Secondly, IPT adopts the principle that life circumstances have a direct impact on one’s mood.

Thus, IPT establishes that it is the life events of the patient that lead to a mood disorder.

Accordingly, IPT is also a time-bound treatment that comprises the initial, middle, and end phases. The initial phase involves the therapist identifying depression symptoms using DSM-V criteria, ICD 10 criteria, or rating scales like Hamilton Depression Rating Scale (Ham -D).

Further, the therapist focuses on the patient’s interpersonal aspects. These include his behavior patterns in interpersonal relationships, analysis of the existing relationships, and the patient’s potential for intimacy.

Now, the therapist connects the diagnosis with the interpersonal focus.

What Does Interpersonal Focus Include?

This interpersonal focus includes:

• Complicated bereavement – losing a loved one
• Role dispute – a struggle with the significant other
• Role transition – the patient experiencing critical life changes
• Interpersonal deficits – the absence of a life event

Thus, IPT focuses on defects in the interpersonal aspects of life and not the defects in the patient himself/herself.

Then, the middle phase involves the therapist using strategies to deal with the four interpersonal issues mentioned above. Finally, in the last stage, the therapist cautions the patient that the therapy is coming to an end and makes him feel more competent and independent.

The therapist also tries to remind the patient of the things he has achieved during the 12 – 16 week-long IPT.