For some, depression is caused by genetics. For others, it is the result of a traumatic life event, such as bereavement, infidelity, or financial meltdown. This is known as "situational depression" and, though it may be normal and natural, that does not make it any less painful.
If you are experiencing, or have experienced, depression, you are not alone. According to one study, around 5% of Americans experience serious depression every year. Such statistics are notoriously unreliable, however. Depressed people often grit their teeth and struggle through, telling no one and waiting for it to pass. Others have no idea what is wrong and blank it out with alcohol or drugs. It would therefore be safe to assume that the true figure is much higher.
And yet, common as it may be, certain myths stubbornly persist. Depression has nothing to do with cowardice, weakness, or self-pity, for example. On the contrary, the depressed often show immense courage. Those fortunate never to have endured it urge friends to "pull yourself together." Of course, what they often mean is "I'd never get like that – I'm far too tough and strong and brave." But depression is very different to being unhappy or feeling blue. True depression is a crippling illness that, in extreme cases, can lead to psychological breakdown and even suicide.
First, it must be said that depression manifests in different ways. Some experience the classic low, flat mood. But in others, depression combines with anxiety to create a restless, agitated state in which they feel a sense of impending doom. Some literally cannot get out of bed, while others cannot sit still or stop talking. Some just want to be left alone, others desperately need company and support.
Initially, people lose interest in things they love. And this is where depression differs from low mood. When you feel low, you can usually cheer yourself up by watching a favorite movie or listening to a favorite song. When depressed, such things merely irritate. Imagine you wake up one morning and stand in front of something you adore. Let's say, for example, that you have a Harley-Davidson motorbike. You bought it in a dilapidated state and have spent the last six months restoring it. For weeks it has brought you immense pleasure to paint and refit it. But this morning you feel nothing. It brings you no pleasure, no thrill, no buzz – that is depression. Everything you look at or think about makes you want to cry or fills you with terror or disgust. It is as though you are wearing thick, dark glasses and now everything you look at is black.
Other common symptoms include a loss of energy or motivation. Even getting out of your chair and walking across the room demands an immense concentration of will. Depression also influences the content of your thoughts. Depressed people think obsessively about death; even the most trivial things will remind them of it, from closed curtains to the meat in butcher's window. Sleep patterns will usually be interrupted, becoming either shallow and restless or deep and prolonged. Sex drive usually disappears as well, as does appetite, concentration, and self-esteem. And, though people often feel pessimistic about the future, they find it impossible to motivate themselves to take action. In any case, they may consider their own life so worthless there is no point in trying to make things better.
So what are the "situations" that trigger depression? Perhaps the most obvious would be bereavement. For the average person, the death of a beloved parent or grandparent is the most common cause. But depression does not occur simply because they miss them or have been traumatized by their suffering. People who were abused or neglected by a parent can also suffer depression when that parent dies. Now there is no chance of putting things right – no chance that they will ever explain why they did what they did, or tell you they are proud of you, or that they love you, etc. Indeed, it is often the parent we struggled with whose death most disturbs us.
The breakdown of a relationship is another very common trigger. Again, this isn't always so simple as one might expect. It isn't only those whose partner cheats on them or walks out who suffer depression. People who end relationships or are themselves unfaithful can suffer in this way. Even people trapped in a thoroughly miserable and unhappy relationship may suffer depression when it ends. Suddenly, they are alone again, haunted by the fear that this is how it will always be.
Then there is redundancy or job loss. This is especially painful when someone's job was also their identity. For many, their career provides them with purpose and meaning. It is the reason they get up in the morning. And it is also a source of pride. Job loss can send people into a downward spiral. First, their self-esteem takes a hit. Money also becomes tight and their worries increase. They may feel rejected, embarrassed or ashamed and so they avoid family and friends at the very moment they most need them.
For those vulnerable to depression, even quite trivial events can cause it – especially when they undermine one's sense of stability and normality. So if you are prone to depression, be wary of imminent change. A child getting married, for example, though it should be a happy occasion, can also create a sense of loss and emptiness. Parents may suddenly feel purposeless and redundant. Some people even find moving home causes depression. Milestone birthdays, like a 30th or 50th, can also trigger it – as can the milestone birthday of someone we love.
Whatever the situation may be, it usually causes the individual stress. If this is prolonged, the autonomic nervous system is overactivated, producing the stress hormones adrenalin and cortisol. When the body is flooded with these over long periods of time, neurotransmitters are depleted and depressive symptoms appear. Of course, not everyone responds to the same things in the same way. What stresses one person may make a second laugh or merely shrug their shoulders. And not everyone is as sensitive. This is why it is so important not only to be prepared for life's major upheavals (the death of a parent, for example) but also to know your triggers.
If you find yourself in such a situation, or if you know that one is imminent (if your father is very ill and expected to die, for example, or your relationship is breaking down) there are certain things you can do. Most important of all, be conscious of what you eat and drink. Cut caffeine, alcohol, and refined carbs from your diet. It would also be wise to reduce the amount of sugar and junk food. Instead, eat lots of fresh fruits and vegetables and plenty of oily fish. You should also increase your water intake, drink herbal tea (especially camomile), and stock up on walnuts, Brazil nuts and pumpkin seeds. And be sure to eat at regular, set times.
Exercise is also helpful. But this needs to be qualified. Many people, when they feel depression creeping up, try to combat it by hitting the gym, assuming that the harder you exercise the better you will feel. This isn't always true, however. When gripped by depression it is best to make your work-outs gentle and regular. Push your body too fast and too hard and you may actually feel worse, especially if you are not eating properly (a burnt out, exhausted body is the last thing you want). Walking, swimming and yoga are best. If you can do these with other people, preferably outside in natural light, then even better.
More generally, do not shut people out. That does not mean throwing yourself into a hectic social life. On the contrary, some people can make you feel worse. When depressed, especially following something like bereavement, people often grow hyper-sensitive and find that they see through others in ways they never did before. Someone cold, selfish, or spiteful seems demonic when your emotions are raw and your mood is low. Reach out to people, but make sure they have sensitivity and depth. If someone doesn't care what happens to you, you will quickly sense this, and it may be the final straw. Good, kind, cheerful people, on the other hand, bring you back to earth and remind you that normal, happy life is possible and does still exist.
In De Profundis, a letter composed as he sat in prison recovering from depression, Oscar Wilde wrote, "I have a strange longing for the great simple primeval things, such as the sea..." And Wilde was right to long for these. Nature can heal you – if you let it. So try and immerse yourself in the natural world. Go for a swim in a river or lake, for example. Or simply find a hidden sand dune or patch of grass and lay there, motionless, watching the clouds and listening to the wind. Animals can also be therapeutic, so go fishing, or simply fuss a dog or horse. And when you are in nature, breathe, slowly and deeply, in through your nose and out through your mouth.
If possible, add in some mindful meditation. Watch your thoughts arising and falling, coming and going. They are just something crazy that you mind does. You are not your thoughts. Thoughts are illusions that keep you focussed on the past or the future. True reality is here and now. Focus on the sensation of the sea washing round your feet or the grass brushing against your arm. Here and now – this is real. Don't fight your thoughts and emotions, just allow them to be there, neither judging nor resisting them.
If you know or love someone prone to the disorder, be conscious of situational depression. For example, if your golfing buddy has had bouts of depression and you know he is dreading retirement, ask him if he'd like to come and play a few rounds the weekend after he quits. If your sister's son has just got divorced and you know this is upsetting her, suggest a coffee and a walk in the park. Don't make a big deal of these things. Mention casually that you are aware of their troubles and then steer clear of the subject altogether.
When helping someone through such depression, accept that there is often little or nothing you can do about the situation itself. If you can help them see it in a new light, then that's great, but in general they may find your advice irritating. They have probably thought of everything you are going to say anyway. Above all, do not become annoyed when you fail to cheer them up. Depression, even at the earliest stage, is not mere sadness. The best thing you can do is be there. On the whole, they'd probably prefer you to be quiet. And remember, depression can sensitize people. They will probably be more sensitive to your attitude or demeanor, so be conscious of everything you say and how you say it. Just be there as a kind, loving presence. If your sympathy is sincere, they will sense it.
Some people are lucky. They are by nature so resilient and cheerful that they seem to recover from life's traumas within days. Others, though they will experience sadness and pain, seem impervious to depression. For most, however, situational depression is as natural part of life as bad weather.