Why is Depression so hard to recognize?
According to Gallup, 29% of American adults have been diagnosed with depression in their lifetime (up 8% since 2018). Depression has likely been present in humans since the beginning, however the prevalence of depression has been on the rise in recent history likely due to destigmatization, the emergence of new studies, and increased access to resources such as therapy and other mental health providers. Although the numbers surrounding depression have become more clear, there is still a large population of people that are experiencing depressive symptoms that are unaware that depression is what they are experiencing due to its deceptive nature. This is why depression is so hard to recognize.
But we all get sad sometimes, right?
One of the most deceptive aspects of depression is its talent for manifesting as seemingly ordinary emotions or experiences. It is normal to have feelings of sadness, fatigue, disinterest, and overall lack of enjoyment in things that you previously did. It is easy to dismiss them as fleeting moods or momentary setbacks. However, if you are noticing these emotions persist for an extended period and begin to interfere with your daily life, they may be indicative of a deeper issue. Because of the long term persistance of these symptoms, it is easy to not realize the depth of impact they are holding over you.
Additionally, despite significant strides in mental health awareness, stigma is still a present force that holds people back from opening up discussions about their mental health.. Many individuals hesitate to acknowledge their struggles due to fear of judgment or perceived weakness. This reluctance to confront the issue head-on can perpetuate a cycle of denial, making it even harder to seek help. Realizations in life are often found in conversations with others, and stigma makes it difficult for some to initiate conversations surrounding mental health.
The Mask of Emotional Numbness
Depression has a way of numbing the senses, dulling the ability to experience emotions fully. This emotional numbness can make it challenging to recognize and articulate feelings of despair or hopelessness, as the capacity for self-awareness becomes clouded by a sense of apathy.
Depression Coping Mechanisms
In an attempt to cope with internal turmoil, you could be grappling with depression in order to develop coping mechanisms that serve as protective shields. Whether it’s putting on a brave face in social situations or burying oneself in work to distract from inner turmoil, these coping strategies can create an illusion of normalcy, further obscuring the reality of depression and preventing those around them from noticing changes in appearance or behavior.
Furthermore, societal and cultural norms and expectations have significantly impacted our awareness of how depression is experienced. Men are often taught as young boys not to cry otherwise they are being “babies” or are weak. In East Asian cultures, depression is experienced in more somatic presentation such as body aches or fatigue, while in Latin American cultures depression might be expressed through symptoms of “nervios” (nervousness) or “ataques de nervios” (attacks of nerves), which include a mix of emotional and physical symptoms such as trembling, crying, and chest pain. How we learn and identify depression varies from family to family, and culture to culture.
The Vicious Cycle of Self-Doubt
Depression often breeds self-doubt, whispering mistruths about one’s worth and capabilities. This internal dialogue can distort perceptions of reality, leading individuals to question the validity of their emotions and downplay the severity of their struggles to both themselves and others. In the absence of external validation and opinion, it becomes increasingly difficult to trust one’s own judgment and acknowledge the presence of depression.
Depression Varies Based on Age
Identifying child and adolescent depression is difficult because the symptoms vary from those in adults. Unlike the classically depressed adult, who reports low energy sadness, and hypersomnia or insomnia, a depressed adolescent is more likely to manifest a decreased interest in formerly pleasurable activities and irritability A practitioner looking for the lethargic, weepy, and expressively depressed patient may be misled by the irritable adolescent.
Self-destructiveness is also a classic marker for depression in youth. Many studies have found that psychiatric disorders in adolescents, especially major depression, make high-risk sexual behaviors and substance abuse more likely.
The Importance of Seeking Support
You can break free from the grip of depression beginning with acknowledging its presence and reaching out for support. Whether through therapy, medication, or the support of loved ones, there are various avenues for healing and recovery. However, this journey can only commence once the veil of denial is lifted and the truth of one’s condition is confronted with courage and honesty.
In conclusion, the confusing aspects of depression lie in its ability to hide itself, making it hard for individuals to recognize the signs within themselves. By shedding light on this phenomenon and fostering open dialogue about mental health, we can work towards dismantling the barriers that prevent people from seeking the help they need. Remember, you are not alone, and there is hope and support available to guide you through difficult times towards a brighter tomorrow.
Therapists at Miracles Counseling Centers are very skilled in helping you to recover from depression. Please reach out to us to set up an appointment if you need guidance and support in this process.
Learn More
Our Inner Voice Impacts to Mental Health
The Inner Voice from within….
We all have an inner voice, one that speaks to us throughout the day and helps to guide many of our decisions and behaviors. Sometimes this voice is kind and at times it is critical. This voice offers sound advice one moment and then tells us we are unworthy the next. For many people, the challenge is learning to decipher the negative self-talk that goes on in their head and to correct it with truth. This can be especially difficult to do, however, when one lacks awareness and has become accustomed to a self-critical and limiting narrative. Fortunately, it is possible to correct this chatterbox and to develop an inner voice that maintains a healthy, well-balanced perspective.
When it comes to self-talk or our inner narrative, it is helpful to think of the tone. When we read literature, for example, the narrator of the story has a certain tone, which may come from a variety of vantage points. Whether told in first- or third-person, the narrator’s voice is one of authority and frames the events and perspectives of the story. Your inner voice has the same role in that it is constantly narrating the events, interactions, and decisions of your daily life. This voice is developed in early childhood and may take many tones throughout the lifespan. For those who grew up in loving, nurturing homes, for instance, the tone of this voice may be patient or flexible. For those who have endured abuse or trauma, on the other hand, this voice may be one of self-doubt and perfectionism.
There are some helpful questions to ask yourself when first learning to distinguish the tone and vantage point of your inner voice. These include, but are not limited to, the following:
- Is the voice (or self-talk) recurring?
- Is this my voice talking or the voice of someone I know?
- Is this voice building me up or putting me down?
- Is the voice coming from a place of fear or possibility?
- Would I talk to someone I love or care about in this tone?
- Is my narrative balanced or one-sided?
- Is my self-talk based upon experience or “what-if” scenarios?
Sometimes it is helpful to journal the self-talk you engage in to begin identifying themes and tones. Unfortunately, many people are so accustomed to the negative narrative they tell themselves that they have never questioned it and do not realize it may not be accurate. Journaling these thoughts serves as a type of mirror to help build your awareness and to address thoughts that need changing. Talking to a trusted friend or family member can also be helpful so long as this person is someone who can remain relatively objective and provide loving and honest feedback. Finally, working with a therapist can also be instrumental in teaching you to identify thoughts that need adjustment, learn skills of reframing and rewriting your narrative, and develop healthy coping mechanisms to deal with daily stressors, anxiety, and depression.
Amending your self-talk isn’t just about saying nice things to yourself, although that is certainly part of it. And, it isn’t saying things that are unrealistic, a Pollyana syndrome of sorts. Rather, it is more about choosing the way in which you frame thoughts, behaviors, interactions with others, and life events. It also often includes speaking truths to yourself that you might not yet believe, such as “I am beautiful, capable, a good mom/dad, worthy, loveable, intelligent, empowered,” etc. We can choose to engage in self-talk that fuels the voice of shame in our head or we can recognize that voice, call it out, reframe it, and rewrite the narrative it speaks.
Cognitive Behavioral Therapy (CBT) and Narrative Therapy are two modalities that help to address the process described in this article. If you would like to learn more about these options and connect with a therapist who is trained in one of these approaches, please contact us. We look forward to serving you!
Written by Sarah Groff, LCHMC
Sarah has been part of the Miracles Counseling Centers team for over 5 years and treats adolescents through adults on issues of marriage and divorce, blending families, depression, anxiety, and adjustment to issues specific to teens and young adults. She is presently pursuing her PhD in Developmental Psychology at Liberty University.
Learn More
What does high functioning anxiety or depression look like?
You may have heard people around you using the term “high-functioning” to describe themselves and their mental health. Phrases such as high-functioning anxiety and high-functioning depression are being used more and more, but what do they mean?
High-functioning anxiety and depression are not technically clinical diagnoses because they are not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook used by mental health professionals. However, many practitioners and researchers recognize that people can experience symptoms of anxiety or depression and continue to be highly functioning, productive individuals. Those who have high functioning anxiety or depression may not appear to struggle with it on the surface, despite experiencing symptoms internally. To others, they may seem to have it all together or go about their days as they normally would.
What Does High-Functioning Anxiety Look Like?
People with high-functioning anxiety may experience symptoms of anxiety disorders, such as excessive worrying most days, feelings of restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or trouble sleeping. However, these symptoms do not cause significant problems across areas of their lives and do not inhibit daily functioning. Some common characteristics of individuals with high-functioning anxiety include:
- High-achieving, with a fear of failure
- Extremely organized & detail-oriented
- Engages in nervous habits, such as nail-biting, hair twirling, lip biting, leg shaking, etc.
- Perfectionist with a harsh inner critic
- Active & needs to keep “doing,” finding it hard to relax
- Appears calm on the outside, but may have racing thoughts
- People pleaser who has a hard time saying no
- Procrastinates when stressed
- Talks a lot or has nervous chatter
- Overthinks and overanalyzes everything
- Difficulty expressing emotions
- Need for repetitions and reassurance
- Tendency to dwell on the negative
What Does High-Functioning Depression Look Like?
Similarly to high functioning anxiety, individuals with high-functioning depression may not meet the criteria for a clinical diagnosis of depression, but are able to function normally most of the time. Thus, their depression is often not clear to others or themselves. Typical symptoms of depression would include persistent sad mood, feelings of hopelessness, worthlessness, and/or guilt, loss of interest in hobbies or activities, fatigue, irritability, trouble sleeping, changes in appetite or weight, or thoughts of death or suicide. The following may be characteristic of an individual with high-functioning depression:
- Feeling a little down most of the time
- Poor self-esteem
- Difficulty making decisions
- Low energy and motivation
- Performs well at school or work, but has difficulty focusing on tasks
- Crying a lot without any concrete reason
- Forcing oneself to engage in social activities when they’d rather withdraw
- Feeling overwhelmed
- Feeling lonely
The Role of Stress
Before determining whether or not you have high-functioning anxiety or depression, it is important to first consider current stressors and evaluate their impact on your life. April is National Stress Awareness Month. We all experience stress in response to challenging circumstances and some times are more stressful than others. This is our body’s normal response. However, if these symptoms persist well beyond a stressful event or are consistent and unrelated to specific stressors, you may be experiencing high-functioning anxiety or depression.
This truly highlights the importance of good mental health care and scheduling check in’s with a mental health therapist. The opportunity for building insight and awareness of our emotional loads and the management of that load is done best with the help and insight of a professional who can guide you through this. Everyone should consider seeing a therapist! When you are ready to do so, you can visit our therapist’s page to find a clinician who fits you best.
Sources: nimh.nih.gov, rtor.org, psyccentral.com, waldenu.edu, health.usnews.com, washingtonpost.com
Learn More
How to Manage Grief During the Holidays
Managing grief during the holidays
The holiday season is generally regarded as a time of joy to be shared with family and friends. However, for those who are grieving lost loved ones, this is often not the case. The holidays can actually magnify our sense of loss. Seasonal events and traditions that are supposed to be festive and fun may serve as painful reminders of our loved ones’ absence. Whether this is your first or tenth holiday without a loved one, you may find yourself experiencing heightened feelings of grief that seem overwhelming. We want you to balance your grief with still finding joy in the holidays. So how can you manage these feelings and survive the holiday season? Here are some tips:
- Avoid engaging in grief comparison- Grief is a universal response to loss, but the actual experience of grief is unique to each individual. Everyone processes and copes with grief differently, so your grief may look different from another friend or family member’s grief in response to the same loss. Know that there is no right way to grieve.
- Create new holiday traditions- Don’t be afraid to do something different because this year is different. Get creative and do something out of the ordinary or alter your previous traditions to better fit with this change in your life. For example, if you don’t feel like you have the energy to cook your usual meal at home, then go out to dinner!
- Find ways to honor your loved one- Acknowledge the absence of your loved one and participate in a holiday ritual to remember them. Here are some ideas to consider:
-Light a candle for the dinner table or leave an empty chair
-Eat your loved one’s favorite food
-Share your favorite memories of your loved one
-Say a few words of remembrance for your loved one
4. Give yourself permission to grieve- There are so many different feelings that can come with grief. You may experience sadness, anger, guilt, and joy all at once this season. All of these are valid. Accept these emotions without judgement. Allow yourself to feel them.
5. Set boundaries- Do whatever feels right for you during this time. You don’t have to go to every holiday event. Do things because you want to do them, not because someone else would want you to. If you need to be alone, honor that. If you need to be around others, seek them out. Make time to care for your own needs. Get enough rest and exercise.
6. Plan ahead- Many find that the anticipation of the holidays without a loved one is worse than the holidays themselves. Planning ahead can ease your anxiety about what the holidays will be like. Be sure to plan some comforting activities to look forward to. Come up with an escape plan so that you can easily leave an event or activity if you’re feeling overwhelmed.
7. Volunteer/Give- Spending time helping others this holiday season may bring some comfort in the midst of your grief. Donate to those in need in your loved one’s honor or volunteer with an organization.
8. Reach out for help- Don’t be afraid to ask for help when you’re struggling during the holidays. Talk about your feelings with loved ones and be honest about how you’d like to do things this year. Consider seeing a mental health professional or joining a grief support group. Here are a few resources:
-KinderMourn – Sliding scale services for bereaved parents, children, and teens
-GriefShare – Local grief support groups
https://www.griefshare.org/findagroup
-Novant Health Hospice & Supportive Care – Free counseling and bereavement support groups for anyone grieving the death of a loved one (Huntersville, Charlotte, Matthews)- (704) 384-6478
-Hospice & Palliative Care Charlotte Region – Sliding scale support groups in Huntersville, Lincolnton, Davidson, Charlotte, & Pineville
https://www.hpccr.org/grief-counseling
If you are grieving the loss of a loved one this holiday season, know that you are not alone. We understand that this can be a difficult time and are here to support you. Reach out to us!
Source(s): health.harvard.edu, psychologytoday.com, mayoclinichealthsystem.org, aarp.org
Learn More