When psychiatrists and psychologists test people for depression, they ask, Do you feel sad, blue, unhappy, or down in the dumps? Do you feel tired, low on energy, unable to concentrate? Too many yeses gets you a diagnosis.
People with depression have a much richer vocabulary for describing their anguish, one that rarely matches the clinical observations.
When hell feels normal
Many describe a heaviness and difficulty getting out of bed. When Jennisse Peatick, 36, of Hillsborough, N.J., gets down, "I am in the bottom of a well and it is a very gray cloudy day and I am looking up at this insurmountable cloudy day and I can't climb out," she says. "It is silent and very isolating." Watch one patient describe his experience.
For patients like Terrie Williams, 53, of New York City, depression sneaks up so gradually it starts to feel normal. She had launched a high-profile public relations company that counted Eddie Murphy and Anita Baker among its clients. She organized exciting red carpet events and attended glamorous parties, but she'd fall into bed utterly exhausted. "Mornings were hell," she says.
But after a while hell started to feel almost normal, she explains: "I would wake up with an overwhelming sense of dread and anxiety. I would lay there for hours, sometimes in a fetal position, crying. I would pull a sheet over my head."
Williams didn't realize it, but her feelings and behavior were classic signs of depression. "I would get a burst of energy and check my voice mail and respond. Then I would go back to bed."
Too many people suffer in silence
As many as half of all people with depression suffer for years without treatment, and Williams was one of them until friends forcefully intervened. "A couple of friends saved me. They got worried when I hadn't answered the phone for a couple of days. They knocked on the door and I still wouldn't answer. So they got the key from the concierge downstairs and came in." They got her out of bed and made her take a shower. Then one of them gave Williams the name of a good therapist who got her on the road to recovery with medication and weekly psychotherapy sessions.
Stories like Williams's are familiar to Sharon Charles Haznedar, an administrative director for behavioral health services at New York's Saint Vincent Catholic Medical Centers and a psychiatric nurse practitioner, who says depression is insidious because it often renders victims unable to ask for help: "I've had depressed patients tell me that they need a plan just to walk across the room," she says.
"Depression drains a person's energy. The idea of visiting the doctor, figuring out whether your insurance plan will cover the visit, and filling prescriptions can be daunting when you're depressed. If you're already seeing one or more doctors for other health conditions, the difficulties associated with another illness can be overwhelming."
Worse than physical pain
Jim Hawkins, 78, of Rockville, Md., says the feeling of being depressed is almost indescribable. "I tell ya, I've had some miserable physical experiences burst appendix, a slammed door on a finger, abscessed teeth, horrible. But I would cheerfully have all three of those, the pain of all that, than to go through the pain of depression again."
Williams urges others who worry about the stigma of the word depression to seek help. She says she was amazed at the relief, and eventual transformation, an actual diagnosis sparked. "Once I heard the words, 'You're clinically depressed,' I breathed a huge sigh of relief and thought, 'So that's what's wrong with me.' "