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Less Than Sad, More Than Sad

© John McManamy

"This is an illness that lays waste to the body as well as the mind."

True or false: You have to be depressed to suffer from clinical depression.

If you answered true, maybe it's time to revisit the DSM-IV, which in its criteria for major depression lists either feeling depressed most of the time for two weeks OR abnormal loss of interest or pleasure most of the time for two weeks.

In another article, I describe my adolescent depression as: "No longer could the world and all its trials hurt me. I had entered a dark but comfortable realm beyond sense and feeling. President Kennedy would get assassinated and I wouldn't shed a tear. Winter would descend with bitter terror and I wouldn't feel the cold. The Beatles would prove to be the biggest thing since the Coming of Elvis, and I would barely notice."

My depression was less of exaggerated sadness and more of lack of emotion, a classic DSM non-depression. Of course, the DSM wasn't around back in the sixties, so my non-depression depression went unnoticed.

It is also worth examining the next seven items on the DSM menu:

• Appetite or weight disturbance, either weight loss or weight gain.

• Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.

• Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).

• Abnormal fatigue or loss of energy.

• Abnormal self-reproach or inappropriate guilt.

• Abnormal poor concentration or indecisiveness.

• Abnormal morbid thoughts of death (not just fear of dying) or suicide.

The DSM-IV requires five of the nine in total to be checked off, including one of the first two. Oddly enough, most of above don't actually refer to mood. Andrew Solomon in "Noonday Demon: An Atlas of Depression" has this to say:

"With the depression, your vision narrows and begins to close down; it is like trying to watch TV through terrible static, where you can sort of see the picture but not really; where you cannot ever see people's faces, except almost if there is a close-up; where nothing has edges. The air seems thick and resistant, as though it were full of mushed-up bread. Becoming depressed is like going blind, the darkness at first gradual, then encompassing; it is like going deaf, hearing less and less until a terrible silence is all around you, until you cannot make any sound of your own to penetrate the quiet. It is like feeling your clothing slowly turning into wood on your body, a stiffness in the elbows and the knees progressing to a terrible weight and an isolating immobility that will atrophy you and in time destroy you."

The copyright of the article Less Than Sad, More Than Sad in Depression is owned by Kathy Brewis. Permission to republish Less Than Sad, More Than Sad in print or online must be granted by the author in writing.