What Is Sadness, and What Is Depression?

We don’t have a good way of talking about the difference between them.

Comments: 192

  1. Sometimes when we are sad, connecting to something or someone helps. But if we have no interest in connecting, no matter how beautiful the sunset is or how loving the friend is, our sadness turns into depression.
    Finding a way to connect is critical when we are deeply sad.

  2. The hardest thing about depresison is that its really hard to explain how you feel to people. It also affects people differently, some suffer from extreme imposter syndrome, others suffer from the difficulty in finding joy or the energy to do the things that they love. I used to love doing things, learning things, exploring. I used to love people and life, but now I don't care anymore, I don't care that I'm late on several payments, I don't care that my house is a titanic mess. I don't care that I'm typing this message, whilst still in my bed a good hour late for work.

  3. James, I've been where you are now. Find a good therapist that you love even if it takes a few tries to get started. I know you don't feel like doing anything but do it. Your brain chemistry is derailed and it doesn't have to be that way. I once only wanted to die and now I live a good life filled with gratitude. There are people to help. You can get back to your old self only it will be much better. Please do it.

  4. I'm sorry you're struggling, James. My heart goes out to you. As a person who has struggled with depression (and as psychotherapist), I know what it's like to lose touch with life's pleasures. And, at least for me, this loss of joy has been temporary; I've always found my way back (with the help of therapy and medication). I can't offer you a fix, but I do send you compassion and caring. Courage. You're not alone.

  5. I really appreciate your honesty and courage writing what you wrote James. This will no doubt sound corny, but this person in Oakland CA, me----is really hoping that there is something bright in your day today. I also hope that you can imagine that there are many who are reading your post--that feel the way I do. Hopeful for you.

    IF you can, please let someone who you care about know what you are experiencing. One person or loving animal can make a difference in the days that will follow today.

  6. Thank you Jennifer. I have a playlist too. Mine ends with Michael Frantii's "It's good to be alive today."

  7. When I’m depressed, I try a few strategies. I tell someone; I get some exercise l, even just a short walk; I make a small to do list and try to do just one item - if I find I want to keep going I do and if not, I try again the next day.

  8. Excellent.

  9. Sadness = Grief. Loss. It is an emotion that comes with a realignment to a new reality that is not really what we wanted.

    Depression = A pervasive, constant, existential hopelessness usually centered around disdain for one's self and a great deal of anger at the self which is completely internalized. It is characterized by extreme isolation and withdrawal from relationships, either physically or in terms of staying honest with others about what is really going on.

    Sadness is an element of depression, sure, but these are the clear differences.

    The real question is what causes depression? Depression is not really an emotion in and of itself; it is a state of being and living and actions.

    We are social creatures who cannot really handle emotional living life disconnected and isolated from one another. When we feel totally alone in our feelings life is unbearable.

    We rely on others to be there for us so that we do not suffer alone. And when society is experiencing turbulent times that cause disruptions to our connecting institutions, the suicide rate goes up because we do not feel like anyone cares or can relate.

    But the fact of the matter is, deep down every person is pretty much the same, we are just too afraid to show it because everyone else's exterior looks so radically different from our inner experience.

    We all suffer, perhaps not in the exact same ways, but suffering is universal to living and is in fact one of the primary guideposts to finding our meaning.

  10. Thank you. How eloquent and truthful your expression of the differences match my own personal experiences with the clinical depression I have lived with since in my teens and early 20s. I am now 71 and the despair and loneliness are almost unbearable, almost, as I have come to the edge of that cliff and turned back. Some cannot. I am one of the lucky ones to have medical support, but I've seen that blackness come roaring like a train into my life too often.

  11. I really like your last paragraph.

  12. I find Pete's description above to be, well, very descriptive, truthful and helpful.

  13. There is a third factor that people do not want to talk about and that is how much can we take physically. People with chronic illnesses that progressively gets worse and adequate treatments are not available or those with terminal illnesses face physical limits on how much pain and suffering they can take. This is not depression nor is it sadness.

    Everyone is different. The worse thing we can do is to minimize someone else's pain and suffering or dismiss the form that these take. We also need to admit that some times there isn't any Sunshine and that its okay. We need to be willing to communicate show love, compassion, and caring to all the people around us because it is the right thing to do. We also must not feel as if we completely failed if people still commit suicide. It is highly possible that they had gone beyond their physical limits.

  14. Yes, two countries that share a border but two very different countries when their make-up is considered. Depression in many cases is a reaction to a loss, can be like a summer storm - intense, destructive, powerful but then suddenly gone, a reaction to a specific confluence of atmospheric events. Sadness is different, more like a season (i.e., winter) than an intense but finite event, it casts a lasting, gripping hold - and unlike depression - requires a different, much more concerted, way of helping a loved one or one's self. Pharmaceutical intervention is indicated in cases of moderate to severe depression but is not particularly helpful and may be damaging in instances of chronic sadness, a very different country and one requiring an array of lifestyle changes, daily struggles, and psychological therapies - the type dependent on the etiology of the sadness as this state, like the states of any country are often very different.

  15. May I add Shearwater's song "Backchannels" to your playlist? For me it is no less the most powerful song I have ever heard regarding the pain of depression, and the hope of getting through it.

  16. Thank you for recommending this song! I just listened to it and love it. The one thing that can lift my spirits is knowing there are fellow beings out there who understand.

  17. Everyone deserves understanding. The harder work is understanding one’s self. The hardest work is doing the work to not romanticize depression, not to lean on it like a crutch, not to pretend you slit your wrist when really you got cut by glass accidentally.

    There was a reason that Despair was one of the seven deadly sins, in allegory: it was a temptation that we were meant to resist - or to put it more strongly, repudiate. As a child of a parent who took her life over and over for 15 years (usually rescued by family until the final time), and a person who has had to unlearn the depressive mindset (not depressed, depressive: oriented toward the negative), I believe that part of the task is to repudiate the seduction of Despair. The romanticization of suicide is a dangerous thing. It is not the same as understanding.

    Writers do not help when they draw seductive stories, like this one. Despair is bleak. It wrecks lives of those who yield and those left behind.

  18. @ Aubrey
    Your counsel is harsh, but has validity. Why capitalize despair ? That seems romanticizing.
    Aren't the seven deadly sins pride, greed, lust, envy, gluttony, wrath and sloth ?
    I'm guilty of all eight.

  19. Now, I disagree that stories like this don't help. Yes, suicide wrecks the lives of those left behind--but when you're considering it, you can't think of that, or you don't believe it.

  20. A child knows that sadness is the realization that a wonderful moment has passed into history and cannot be retrieved to experience anew and relish, but lacks the language to express.

    Age changes the child into an adult, who has experienced more than one realization that a wonderful moment has passed into history and cannot be retrieved to experience anew and relish ... but, if fortunate, has developed language and action that will memorialize the wonder ... and also developed methods of retrieval, sharing the wonder.

    So ... wherever your life's journey places you in this continuum ... reach out and hug somebody.

    My recommendation comes from personal experience. Sometimes I can succeed at it ... sometimes I fall short. But the key is to reach out and hug somebody. As often as possible.

    Thanks to everyone who added their comments to this section. I enjoy reading each and all.


  21. What is the relationship between sadness and depression? If sadness increases the risk for depression, than what makes an individual sad? There are serious implications for public health and prevention contained within the concept of sadness. Some life events are obviously sad and can be prevented. Are individuals who have lost children to gun violence at increased risk for depression? Sadness, obesity and depression are interrelated health problems that are treated by medicine and psychiatry. Should obesity prevention be considered when treating depression? If antidepressants are intended to treat depression but cause weight gain, are they really therapeutic? If society values depression prevention, should we also consider those things which make people sad? Problems such as low pay, poor job opportunities, insufficient housing and poor nutrition are all preventable health problems that usually cause sadness. These problems are also related to public policy. Americans value rugged individualism, but if rates of depression are related to sadness, and we can can prevent sadness (through policies that reduce gun violence or improved nutrition and housing), shouldn't public policy focus these issues, too?

  22. Excellent questions! Things I hadn't thought of, that make very good sense. Thank you!

  23. Sometimes depression is looking at reality accurately. I am old, very old. I can no longer see well, hear well, walk well. Have multiple health problems including diabetes and cannot eat any of the food I enjoy.
    In many books this is called situational depression. And because it is based on the situations in one's life is not treated with the usual medication.
    Everyone dies. Sometimes sooner is better than later. Nice that some countries and states recognize this.

  24. As a person nears the end of their life it can be hard to cope with the losses that start to pile up, this is true.

    I'm not sure if I'd say depression in that context is looking at reality accurately, however. Sadness and grief in that context can be, certainly.

    The accuracy of reality is that you have been afforded a life, however finite, that arose from an otherwise hollow void as a gift. And while it has nearly passed surely something fond and good has come of it that you can be grateful for.

    Now a time approaches for it to pass like all things must pass.

    If life did not pass it would be truly meaningless. If life were not finite there would be no animating concept to matter to make meaning of our short time here. We would be like the immortal non-living matter that surrounds us and that we are made of, and to which we will all return.

    It is only mortality and the passing away that affords any possibility of finding a personal meaning to life.

  25. This comment merits repeating. Over 40 years ago when he himself was young, singer/songwriter Scott Walker recorded a song called "Joe." The hook line sticks with me to this day:

    "There ain't no one left alive to call me Joe."

    To my way of thinking, when a person reaches the point where there's no one remaining to whom the person means anything, it's time to check out.

  26. The author offers an excellent description of depression. I would disagree that "we don't have a good way of distinguishing between them." Depression involves guilt, shame and self-loathing which are not a part of sadness. Depression blocks out any view of future possibilities and any experience of pleasure in the present. Depressive thoughts cycle in unending ruminations that are negatively distorted. Sad thoughts, when allowed to be fully experienced and especially when shared with another person, move through a progression toward a resolution of grief. Depression is like a stream that is blocked and allows for no movement. Sadness flows a natural course toward acceptance of life's inevitable loss and suffering.

  27. In the 50s of the last century, an anglican priest named Chad Varah was giving an eulogy to a 14 year old girl who committed suicide. When he learned of the reason - the girl had her first period and thought she had contracted STD, so she killed herself - the Samaritans was born in the UK.

    It is a hotline staffed by volunteers who would listen to people in a befriending way. It doesn't pretend to be professional even though it has good relationship with first responders (the term did not exist then) and its "selling" point is that it respects callers' privacy. The service has since spread to other countries, including to the U.S.

    It is heartening to see many write-ups responding to the recent high profile suicides have included the National Suicide Lifeline's number; however, it is important to stress it is not the only service. In fact, it shouldn't be.

    People commit suicides for many reasons (or non-reasons). When they have decided, they may not reach out. Very often, a hotline services those who are in the intermediate state. People suffer a lot of psychic pain and ending it all is seen as a solution. Some even choose suicide by cops. While there are scenarios without real solution, the human spirit can handle a lot if it is not left alone. A severe depressed has probably exhausted one's resources, friends, family, therapists. Their resources need support too.

    Education, not ignorance, is the first and last thing of suicide prevention

  28. The first step out of depression is to give something to another person. Step out of yourself long enough to give a smile, a helping hand, a few dollars, send a message of care, or donate to a cause, etc. When you give to another person or even an animal, it reverberates back onto the giver and lifts up the soul.

  29. Giving to others doesn't restore chemical balance to the brain.
    Victim actions don't cause depression; their actions can't cure it.
    It's always there.

  30. It's important, though, to give only up to the point of someone's comfort level.

    Years ago I had people telling me that I was "selfish" if I didn't do things like volunteer to feed the homeless. Never mind that I could barely pay my rent, buy food for myself, etc. I really resented that advice (and still do). It doesn't mean I don't like to give (I've always been a giving person--sometimes too much); it just means that my personal comfort level has to be respected.

    It's entirely up to me to decide how and when I give and how much of my time, money, energy will be spent on outside giving.

    I had to learn to give to myself first before I could adequately (and safely) give to others, even a smile. It's still a delicate balance.

  31. For people who have a true clinical depression, what you describe is as likely to help as it is to help a person with cancer. Both are diseases. You can't smile or give your way out of them.

  32. Psychiatry provides useful criteria for distinguishing between major depressive disorder and related conditions vs other forms of sadness. It does have a "language" for describing the symptoms of depression. Unfortunately, too few people who eventually suicide seek such help (not that treatments always work-but they often do). This essay is beautifully written, however.

  33. Thank you for the eclectic playlist. I will put it to good use. From a fellow sufferer, I appreciate your writing and wish you well.

  34. When it comes to depression there are several fundamental truths that need be emphasized. The first is, for some reason, it is pervasive in today's society. We are missing something as to the why and how. Yes, it is definitely a chemical imbalance, but what in our daily environment triggers it? Next, the affected individual should not be ashamed. S/he is neither insane nor alone. That dedicated mother, your doctor, that person who excels in her or his profession, your spiritual advisor or counselor, are our sisters and brothers in our constant challenges within our own minds. And know thyself. As this piece explains, sadness is okay. It is appropriate especially during those times of loss. But if that sadness is relentless, crippling, like a mountain on our shoulders surrounded by thick clouds, we need to seek help. We deserve to live life fully engaged, to stop and smell those roses,,,because we still have those beautiful flowers.

  35. And the environment is both mental and physical. Who knows what various chemicals are doing to our emotions?

  36. I don't think depression is more prevalent, if you look at historical records people always suffered from melancholia. On the London Bill's of Mortality there are listed people who died of grief and lethargy. Also there is a grouping for people who did away with themselves. The one main difference in today is anxiety is worse. Work is dull and inspiring, with little reward. We have to deal with strangers everyday. I don't think our species evolved to deal with large groups of people, in the past we lived in small groups, tribes and communities with strong support networks.

  37. Lack appears, then reposes.
    Fullness rushes in.

    Pain aches, then relieves.
    Wellness rebounds.

    Fear arcs, then retreats.
    Safety resides.

    Want acquires, then relinquishes.
    Freedom reigns.

    Grief absorbs, then renders.
    Comfort rests.

    Anger ascends, then relents.
    Peace restores.

    Blame apprehends, then releases.
    Compassion resonates.

    Hostility accrues, then reduces.
    Acceptance resounds.

    Confusion abounds, then recedes.
    Vision regains.

    Overwhelm amasses, then remits.
    Gratitude resurges.

    Despair advances, then reverses.
    Meaning reveals.

    Death arises, then reclines.
    Life revives.

    Neither run, resist nor revel in.
    Wait and watch what waxes and wanes.
    All come and go.
    Love remains.

  38. Sadness doesn't come with a menu of symptoms like clinical depression does. With sadness, one can function to a lesser degree but still function. Depression, while some people may still be able to function, must push through the desire to isolate, self medicate with food, alcohol, or drugs, exhaustion, sadness, crying, suicidal thinking, low self esteem and self worth, thinking the world would be better off without you. If you can get thru a day, it takes a supreme effort. Classically, if these symptoms last two weeks, professional intervention is in order. As a 20 plus year depressive, I wouldn't wait one minute longer; I would get to a clinician as soon as possible to get the medication or tools from talk therapy to begin to feel better. You don't have to feel this way. There is help.

  39. Depression is not difficult to diagnose in my opinion. Depression is not the same thing as sadness. Depression is anger turned inward. Depression causes the rib cage to be pressed down, and that keeps the lungs from being able to expand normally. Several things happen as a consequence: breathing is suppressed resulting in shallow inhalation and exhalation, toxicity therefore remains in the system longer, the body becomes tense. Depression is deadening. We stop moving and in fact there is tremendous resistance to movement.

    Characteristics of depression: An overwhelming feeling of heavy weight compresses all our physical and emotional processes. It becomes hard to do anything. Life is colorless.

    The inactivity that results exacerbates symptoms. Inactivity actually changes our attitudes about life. The more inactive you are the less you want to do.

    What builds depression? Negative thoughts. Anger directed inward. Messages like: "No-one understands me.", “I'm a failure.”, "Life is just downhill." Messages we may have heard from others (especially parents or loved ones) come back to haunt us. We suppress ourself.

    What is the solution to this really difficult intractable personal problem? MOVE. The very best solution to our problem is exercise. But we won't want to. We have to use mind over matter. Research has confirmed that exercise improves depression symptoms. Every additional exercise class you add to your schedule each week reduces the risk of depression by 50%.

  40. Who "moved' more than Bourdain? And Spade was an active, very productive, person.
    Moving may help, keeping busy and on the go. But, it can also put off the inevitable confrontation with the dark self.
    I have witnessed the most amazing, productive, kind, generous, loving, (all forms of movement) stop and then they were gone.
    Beautiful, fit, productive, valuable people.
    It may be the answer for some - MOVE - but it is not the answer for all.

  41. Very well put. I would also add that "moving" outside, in Nature, can often be as therapeutic, if not more, than exercise alone.

  42. This "anger turned inward" nonsense infuriates me.

    Depression is caused by a chemical imbalance in the brain, which is why drugs that rebalance the chemicals can be very effective very quickly.

  43. I think everybody needs a purpose in life, and in spite of having something to do, something to create or having someone to help,(that's critical) we feel occasional sadness and can believe that what we're doing isn't really that good. thank us

    But somehow we carry on and immerse ourselves in what we're doing. And people will praise us, thank us, or show some method of appreciation. That keeps us going.

    At age 75, I'm finally beginning to accept that everybody has issues that make their lives difficult. And everybody has worth even if we doubt ourselves.

  44. The ways I helped my patients make the distinction between clinical depression, which required immediate often life-saving psychotherapeutic/ pharmacological intervention, and normal grief were: use a subjective mood rating scale on every office visit ("0"=worst mood ever, and "10"=best mood ever, so, current mood =?), including assessment of treatments; objective assessment of "biological" mood markers/symptoms (these are well known but include anhedonia, loss of sex drive, insomnia, loss of appetite, weight loss or gain, suicidal ideation with or without plan/means, recent loss(es), social support, history of mood problems, lethargy, mental slowing, melancholic thoughts, etc.), hx. of treatment/response, etc. Bottom line: grief has a clear hx. of loss and is self-limited with social support/supportive psychotherapy, but clinical depression may come on "out of the blue" in a stressful life, includes dangerous suicidal ideation with plan/means/family or personal history, and should be treated as a medical emergency with potential for hospitalization to prevent self-harm and to begin intensive psycho-/pharmaco-therapies. The key is finding an experienced clinician to make the call and guide appropriate therapy. Good Luck! Stress R Us

  45. Perhaps we should first learn to respect people's choices instead of treating them as if they were somewhere between mistaken and deranged.
    Suicide is an ancient phenomenon; I remember reading of a suicide in the Epic of Gilgamesh. And it's likely that even further back in the dim reaches of time people were doing away with themselves. It's one of the clearest expressions of human agency.
    Of course, statistics suggest that in certain times of wide spread distress the rate of suicide increases. Maybe we should work on making everyone's life better/more secure/less stressful and leave individual choices to individual people.

  46. Laurence, you characterize suicide as "people's choices," "an ancient phenomenon," and "one of the clearest expressions of human agency."

    On the contrary.

    It is the end stage of a debilitating, disabling, potentially terminal illness.

    It is mentioned in ancient texts because humans suffered illnesses in ancient times, too. Manifestations of depressive illness, such as suicidal ideation and attempts, are not "phenomena," they are clinical signs.

    The disease of depression is a progressive loss of mental, physical, social, emotional and spiritual agency. When the disease is terminal, suicide is the nullification of all agency.

  47. A shorter version of what I wrote below:

    Depression is a state of disconnection from love and compassion for one's self.

    It is a distortion of the mind, in it's isolated thinking, that separates us from the Universal Truth that the gift of our existence alone shows that we are worthy of giving and accepting love from ourselves and others.

    Such love is the nature of reality; it is an unconditional relationship with whatever forces led you to be here; it is we who disqualify ourselves from this love through our negative core beliefs about our own identity and self, about how we have fallen short or messed up or been bad. It is caused by our attempts to quantify ourselves by thinking, when the reality is we are beyond definition.

    To define ourselves is necessarily to separate ourselves from the whole of the system that we are, in reality, inseparable from. And this breeds isolation and despair.

  48. It's a chemical imbalance that its victims cannot control and did not cause.

  49. We are a society of solvers. Depression cannot be solved. The mind, because of some kind of trauma, creates a loop. The loop is powered by the energy of reinforcement. The insidious thing is that it seems solvable, as if it's a problem with a rational solution. What's more, in its own way, it feels good.
    The answer is letting go. That's why music, friends, baking, even drugs, work. They distract the mind, lessening the energy going into the loop. When one is alone, one has to realize that there's "nothing there", nothing to solve, nothing to resolve, the thought loop is simply a physical fact produced by some kind of broken series of events, too complex to fully understand. The energy needs to be dissipated, the loop replaced, ignored, weakened.

  50. Ill keep that in mind next time my mind starts spinning. Thanks

  51. Diagnostic criteria are just the ways therapists talk to each other. So, sadness is not a diagnosis, and depression is a diagnosis. The more important question is, when should one seek help? The rule of thumb is when a person feels stuck. Emotions ebb and flow due to life events. When that ebb and flow becomes destructive, therapy can be helpful. Also, it is well known that some people have more resilience to difficult life events. Therapy stops when a person achieves what Martin Seligman calls normal miserable. When one is as unhappy as everyone else, according to this view, or unstuck, then the problem is over.

    Of course, Dr. Seligman, and many other psychologists, have pointed out that there are ways to increase resilience and support a more satisfying life. A recent example is Emotional Success, by David DeSteno. What we need now is more English majors writing novels with this skill as its plot device. It is how emotional therapy filtered into our society during the last century.

  52. A current and pressing issue is that today too often sadness--a response to the death of a loved one, or a divorce, for instance--is medicated.

    This can lead to one) a long term dependence on psychotropic drugs, as well as two) an inability to live the sad or terrible event, and process it naturally over time.

    I remember years ago when a friend's child died suddenly, in an accident, and he was encouraged to take psychotropic drugs 'to get through it." He refused, from the first day, saying: ' I have to get through this on my own or I never will.'

    It took a long time. It was a terrible thing. It made sense to be very very sad. But he functioned, with his personality intact, and while that sadness won't every go away, he is himself. And not addicted to anything, as so many people are now.

  53. A long time ago, in response to painful life events, I slipped out of reactive sadness into a very dark depression that lasted for years. Friends and even family could not understand why I could not "snap out of it" first when it was just sadness and then when it spilled into a long black and hopeless depression. That made it worse.

    All this happened before anti-depressants, but I did have a remarkable and patient therapist. Needing to at least keep up appearances for my children helped. Acting "as if you are ok" is powerful. And cherishing small things that gave me my first glimmers of pleasure helped me to climb out of the velvet darkness: my funny crazy cat who licked my tears off when I was crying (as if I were her kitten), walking in the woods, and my garden. Particularly some red and white tulip bulbs I finally roused myself to plant. I could almost feel myself emerging as they did. Seeing green and growing things under a blue sky, and feeling the quiet acceptance of a pet can help you feel that renewal is possible--that the beautiful things in the world are still there.

    One coda: I finally realized as I recovered that depression was a life-long issue for me--the way I was wired--and got help, coping skills, and eventually medication. I stopped seeing suicide as romantic and brave.

    I send understanding to all who may be struggling with reactive sadness or a deeper darkness and support to all who love them.

  54. Psychotherapists (I am one) refer to "situational depression" which can include sadness and grief when we experience loss, also when we feel powerless to change a situation which is uncomfortable for us. And there is SAD, seasonal affective disorder caused by lack of sunlight. Then there is bipolar mood disorder unrelated to one's circumstances. This kind of depression is amenable to pharmaceutical treatment. The best way to handle sadness is to take ownership of it and cry and speak your sorrow to someone you trust who cares about you.

  55. I add to my post, each evening at sundown I experience sadness, melancholy, missing all the people I ever loved who are no longer here for me. And then night falls and I engage in various activities, and then sleep, and when the sky lightens in the morning I am restored. "When the morning wakens, then shall I arise...pure and fresh...."

  56. Beauifully written. I take an antidepressant and thyroid medication. Without them, I fall into a black holt of numbness. Thirty-five years of talk therapy has helped too.

  57. William Styron's "Darkness Visible" is a firsthand account of the depths of suicidal depression, written by one of our finest authors. It is still with me 30 years after I read it. If everyone read it, we might all be better able to recognize and help those who are suffering, including ourselves.


  58. William Styron’s “Darkness Visible” is the best book that I have ever read about Clinical Depression.

  59. The Beast by Tracy Thompson is told from a woman's experience, which is often different than a man's experience.

  60. This book helps one in the depths to know that others have been there and survived.

  61. Life is joyful? Living it has some issues... not all things, but some things. I am a veteran of foreign and domestic wars. My health escaped while I was on a plane home from a much more foreign and friendlier place than any other, decades ago. I take the meds that modern science, such at it is, prescribes. I drink coffee and munch bran flakes like chips. My mind erupts in joy and wonderment, occasionally. Mostly, I sleep. Call It Sleep, that book said. I believe others can help me and I can help others. I need to, even if I am not In The Mood. I am stuck on this planet, ya know?

  62. Very well written, very helpful. Thank you Jennifer.

  63. The difference between "sadness" and "depression" is about more than simply "feelings" or feeling sorry for yourself.

    Depression for many is a mental disorder, like having autism. It can be caused by extreme trauma like PTSD but it's also something you can be born with through no fault of your own, which cannot be fixed with happy thoughts.

    Drugs help. Exercise helps. But for those who suffer under it, it can be debilitating to the point of despair.

  64. Yes, severe recurrent "depression" has a strong genetic link. In these cases medication literally saves lives.

  65. What about despair, hopelessness, and total denial of self worth as descriptions instead of sadness? Single mothers in refugee camps do not even have the luxury of suicide if they want their babies to survive. In the deepest stage of depression, the person can become vegetative and not even have any energy to commit suicide.

  66. Depression is to burnout as sadness is to compassion fatigue - One is numbness while the other is an uncontrolled burn in the "deep heart's core."

  67. Thank you for addressing this. As a (now retired) nurse psychotherapist, I was often struck by the conflating of these two different emotions. There were sometimes referrals for therapy by primary care physicians of people who were grieveing losses: actual deaths of loved ones or losses of symbolic things. The sadness of grief is not treated by medication, but by time and a willingness to "go through" rather than around.

    And a desire to maintain some control in one's life in the face of an impending fatal outcome should not be called suicide with all the societal negatives that implies.

  68. True. However the recent DSM changes make normal grief pathological and now endorse medication for treatment.

  69. Sadness is an emotion; depression an existential condition.

  70. exactly.

  71. I have suffered from lifelong post traumatic stress, depression and anxiety caused by trauma at age 11 which included a brain injury. Throughout life, I've felt miserable, experienced anxiety and panic seemingly connected to nothing. Yet I worked every day, went to college at night and tried to "act normal." Learned helplessness, often caused by enculturation, is a great cause of depression. (Psych majors still torture lab rats to prove this obvious conclusion.) Learning how to help ourselves in the moment, if only for a moment, can empower us to be less depleted by both our past experiences and the way those experiences have programmed us. Sometimes, "letting go" is the only way to deal with situations over which one had/has no control. Acknowledging that others had/have power over us is painful. It's a step. Name the problem.

  72. In the movie 'The Doctor', the titular character's wife, feeling alienated and cut-off from her husband, wonders aloud about what is making her sad, even depressed.

    "Am I happy? Am I sad? Am I depressed? Am I too hot, or am I too cold? All I've done is beat myself up over it. Until it occurred to me:

    "I'm just lonely."

  73. ....because The Doctor is forced to experience shocking news resulting in the behavior triggering many of the feelings in his wife. She is not the one he is leaning on to get through the initial phases of the challenges he now faces.

    Life is upside down for all involved, including their child, and even the doctors colleagues are at a loss as to how to deal with a man is his “situation” based on past behavior. History and experience control so much of what we see, think and feel.

    What this film gets right - I know from my own experience with depression and physical illness - mind and body are connected more than we realize and even the most difficult people can change if they want to/need to. It’s never easy, but it’s possible. And it’s worth it.

    Important to note that when it comes to depression, one cannot “will” it away; I’ve tried. I can find ways to cope, manage and keep going. I don’t have the kind of depression that’s transient although not every day is “black dog” it is always there.

    So understanding the difference between changing a behavior and a true medical condition is vital here. If you’re unsure of how to do that, contact a therapist (LCSW; PhD) Doctor or local NAMI chapter or if you feel in immediate distress, call 800-273-8255, 24/7, 365 - always confidential.

    Believe me, it gets better - still work, but far, far better.

  74. Oh yes, depression lies. And it distorts every day reality. And while in its grip, one is unable to see the lies and the distortions. They are the only reality. It's only later, when I've come out of the morass that I can see just how warped my thinking had been. It's often shocking.

    I've learned how unreliable my judgement is when I'm depressed. I may not know what's wrong with my thinking at the time, I just know that I can't trust myself.

  75. Two of my friends committed suicide, one in his late teens and the other in his late twenties. Both had been severely depressed. The first went down hill slowly during years of heavy dope smoking, the second quickly when a relationship blew up. But they had one thing in common. Both seemed much better, even elated, starting a couple of weeks before they died. This was a relief for their friends and relatives, but it was short-lived. It turned out they had both made the decision to end their pain, and it brought them peace.

  76. Well written article and many thoughtful comments. I would add or emphasize: depression seems to have many causes (anger turned inward, chemical imbalance, hormonal imbalance, side effect from drugs, etc.) and each of us may find a different path out, reflecting the cause of our depression and our individuality. While medication for depression or its root cause is helpful for many, there are other things that are also valuable. Exercise, drink lots of water, and give to others. I learned how useful it was to get outside of myself by giving to others when I was caring for an aunt in a nursing home. I discovered that when there, assisting her and the other patients, my depression lifted.

  77. ...sadness and depression to me seem intertwined, separated only by our own definition of each. I find there is a distinction between not wanting to live, and wanting to die. Isolation is paramount along with addiction - it gets dark for those who have no lifeline to hold onto...no one to turn to. It's important that we begin to talk about mental illness openly, and to be able to recognize the signs of depression in those at risk.

  78. JMS, " I find there is a distinction between not wanting to live, and wanting to die." I agree with you. I often find myself in a place where I do not want to live. I often say, "I want to stop breathing." When I slip to the edge and want to die, it's a whole different scenario. In my head I start flipping through scenarios and plans. Usually I take some meds to stop the rumination, but the danger still exists. Then I reach out to someone.

  79. What is happiness, and what is satisfaction?

    That all depends upon your age, gender, color aka race, ethnicity, national origin, faith, socioeconomics, politics, education, health and history. The same holds true for sadness and depression.

  80. Blackmamba, I couldn't disagree with you more. Sadness and depression are not exclusive to the oppressed, the non-believer, the poor, the under-educated, etc. We can assume that everyone feels sadness, since it's an emotion, and that people often define deep or prolonged sadness as "feeling depressed."

    In reading the responses to this article, it seems there is a common misconception that feeling depressed and clinical depression (also called major depressive disorder) are the same thing. Clinical depression is a mental health condition that can be managed but not necessarily cured. The great difference between the two is that 'feeling depressed' has an end date. Clinical depression can last a lifetime.

  81. I've always thought those who say they don't hear voices were being disingenuous. Regardless of their motive, I now know that they are.

    Learning how to listen to our voices can go a long way in creating either a beautiful relationship with oneself, or a very tortuously lived one.

    I would not dismiss medication for some help.

  82. Thank you for distinguishing between normal feelings (sadness) and abnormal feelings (depression). The general public doesn't understand that "depression" is a severe, chronic medical condition that is not normal. We say, "I'm depressed. My football team lost today." "Depressed" colloquially describes something common that we all feel at times. I think we should use a different term - melancholy. Most people do not feel melancholy. Saying, "I'm feeling melancholy", would get people's attention that you are not feeling normal and something serious is deeply troubling you. Melancholy is not temporary, caused by a character flaw or a sin. We don't ignore melancholy. We do ignore people who say they are "depressed".

  83. Depression is a condition, while sadness is mainly a reaction to things going very badly - the death of a loved one, the loss of one's ability to make a living, lack of success in something one loves, a romantic break-up, etc. One usually recovers from these things in the course of time, but depression lingers without a necessarily definable reason. That seems fairly simple to me and wouldn't seem to require yet another Times article to define it (which it doesn't anyway, despite the title of the piece). If you're very sad for even a short period of time and can think of no cause, then its probably depression and you should seek help. This isn't clinical and in no way a professional diagnoses. It is simply based on what appears to be an increasingly rare diagnostic tool - common sense!

  84. I want to add one more comment to this discussion. Both marijuana and alcohol have depressive effects. Both are used extensively to reduce stress. And dehydration can mask as depression. If you feel down, drink a glass of water. It won't hurt and it may well help.

  85. The description was very sharply drawn. But sadness and depression differ. Everyone I've ever known has felt sadness- they've had losses, they cried, they grieved. They assume that means they know depression. Most do not. But Some of us depressives - of whatever ilk - can't really imagine the world their way.

    Depression can include a constance deep heart and gut ache - but it can move on to emotional numbness - a complete lack of the life force - which removes the sufferer from the community of human beings. Or animals. From other living things.

    In depression, I was a dead woman talking: wearing a rigid mask. Music became noise. Nothing had beauty. Others' apparent enjoyment of social gatherings was incomprehensible.

    There are forms of depression which include acting out, seeking attention, or engaging in public displays of anguish. That wasn't me. What might have been visible to others? Aloofness, irritability, lack of playfulness. Lack of participation. The negative signs. the ones that go unnoticed.

    For me - music and other enjoyments mentioned ARE supports and preventative - but I needed professional help. With years of self help behind me (corollary: do not hate yourself for not improving if exercise, et al, don't work), I accepted treatment that included meds. W/o meds and attuned therapists (not all qualify), I would have given up.

    IF you cannot enjoy music or a beautiful sunset, or anything you can recall once loving, it’s an emergency.

  86. There is a distinction between sadness and depression that the author weaves into her story. Standing on the edge of a cliff, ready to jump, is depression. It's when the dark, black veil has gained controlled and whispers in your ear that no one will miss you anyway. Staring at a kitchen knife, obviously contemplating many different options, is depression. Darkness, once again, prevails. Depression takes hold of you and it erases any good or positive thoughts - and yes, riding a bike may help, but most severely depressed people cannot get out of bed. They are trapped in this other work and have no energy. Yes, getting the wheels moving, breathing in fresh air and socializing are all steps in the right direction, unfortunately, at times, they are monumental tasks to someone buried deep within another world.

    Sadness is the heart break or feeling that overcomes you when someone is hurt or you feel upset about something. I was very sad last weekend as I mourned the lost of one of my former students who was murdered. It was a deep, harrowing sadness. I was very sad on Monday, my Dad's birthday, which no one in my family likes to talk about. I am sad when I think about the family of my former student.

    But, I feel sadness can morph into depression, especially with those of us who already suffer from depression. If the sadness runs deep, it can burrow it's way into the deep crevasses of our soul. A lot of people just assume depressed people are sad which is not true.

  87. "Dark, black veil": perfect metaphor

  88. The hardest thing for me is being aware of how non-sufferers have such freedom of movement and engagement. They tell me of their full days of interests, and action and giving while I lay in my bed, scrolling through the iPad that sits on my stomach. Kind of participating in what’s going on in the world around me, but not really. I’ll emerge for the dogs needs but that’s about it. I look wistfullyat those participating in life and I feel very happy for them. No resentment, just acknowledgement of their good fortune.

  89. Here's another take.

    Everybody knows what sadness is.

    Sometimes, sadness can cause you to modify your behavior.

    For example, you sleep less, eat less (or different foods), exercise less (or more). You may start drinking more alchohol or consuming drugs.

    These behaviors modify physiology. Then. you have real depression, well beyond sadness. In fact, it may not even involve sadness. It basically shuts down your mind. Suicidal ideation becomes a compulsion, not a passing idea.

    At that point, anti-depressants may or may not help. There are certainly drugs that can cause you to sleep, no matter what your mental state. And there are drugs that can cause you to feel happy, no matter what your circumstances. But the condition may very well persist no matter what drugs you take or therapy you obtain, unless you change the underlying physiology.

    Of course, the problem is that, as you undergo all these changes, life moves on. Ordinary setbacks become insurmountable.

    The state of practical psychotropic pharmacology is very bad. Doctors routinely prescribe drugs whose drug/drug interactions are severe, without even knowing what those interactions are. They continually disregard the insight available from genetic testing, which offers little information about what will "work," but at least offers some suggestions about what will not work and what dosages are necessary to be effective.

    But I'll stop here. Just one person's opinion.

  90. There are some key truths about Depression. One is that the afflicted is unlikely to be able to get better without help. Another is that metacognition, having insight into why one is feeling hopeless or contemplating self-harm, is a critical "success factor".A third is that a combination of pharmacotherapy, talk therapy, and aerobic exercise is most likely to be effective in combating the disorder. And most important is remembering that being depressed is like being in a car wash, a lot of noise, banging, splashing, water etc. but one does eventually emerge.

  91. I agree with your first key truth but not the second. Having "insight into why one is feeling hopeless" implies there is a rational reason a person is depressed. I was afraid of the laundry. I'd break down sobbing as I fed my baby, because I knew it was important to talk to him and I just couldn't. At my older son's little league games I felt like there was a huge, clear dome over the entire scene. I was an outsider looking in. I agree with your third truth. It is what set me free. I cannot relate to your fourth truth. I imagine losing all hope that the immense pain will ever end is what drives a person to suicide.

  92. It may be hard for lay persons using everyday language to differentiate between sadness and depression but when it comes to clinical diagnoses which is what physicians treat, there is a marked difference.
    For people to have a diagnosable depression, they not only must have symptoms such as sleep and appetite changes and lost of interest in things that they are usually interested in (anhedonia), all which can occur with sadness, but the symptoms must also markedly interfere with the person's ability to function.

  93. There are two types of depression, and having both I see the difference. One is a downward spiral of negative thinking, recursive, self-amplifying. This can be broken by examining negative thoughts as they arise and looking for a factual basis. There isn’t one. A person can work to break the chain. The second is when an unfortunate chemistry descends on the brain. It turns on switches for thoughts of despair and helplessness for no reason. These feelings seem to beam down from the sky and come up through the ground. They can’t be reasoned with because there is no reason. The level of irritation can be like having dental work done except its never going to end. It can make your gut squirm without stop. It follows you everywhere. This is the type that I think drives suicides. If such a person has a belt, a rope, a gun or a bottle of pills can make it end whenever they want. In order to not be a suicide, it requires the second-by-second decision to choose to live without faltering. The one thing people do, maybe the only thing that works, is continuous distraction. The person that is continuously scheduled beyond their ability, continuously busy, continuously in motion, continuously pushing each day until collapsing in “happy exhaustion” at the end of the day may be keeping the beast at bay. The problem is that when the body or the mind becomes too tired to keep up the pace, and the distraction stops the person is alone with the beast.

  94. Those without depression cannot even begin to imagine the amount of effort and energy it takes to manage each day. The unfortunate consequence is we become "fully functional depressives" if not "highly functional, hyper productive depressives" . To the outside world, this is a feature, not a bug. And then, when exhaustion and loneliness finally win, and it is a lonely existence, the world ends up surprised.

  95. What a beautiful piece. Thank you for baring your soul and sharing your experiences, your lows and highs and the things that allow you to navigate between them. You showed to some of us simple ways to deal with great distress.

  96. There are different varieties of depression, some of which can descend at the same time or at different points in your life. It can be like being smothered in cotton wool, with all your emotions blunted and your motivation snuffed out like a candle. You go through the motions, but nothing is right and you can’t explain how or why. Then you miss the grayness when acute depression comes along, because suddenly everything hurts, feels hopeless and you can’t stop the crying jags. You may not be able to get dressed or get out the door. It’s an illness, not a character flaw, but other people get tired of dealing with the depressed person because nothing they say or do seems to make a difference. I assume a lot of people self medicate and the depression coincides with other disorders that people get tired of dealing with. It’s also hard to function when you feel that way in a society obsessed with appearance and career success and social media. We need better mental health care in this country and less of a stigma.

  97. "Cotton wool" and "snuffed candle"--powerful images

  98. Depression for me, lately, has altered my thoughts to the point that I do not recognize myself. I walk into my home and it contains art work that I used to be able to do to make myself feel better - not any more. It is very scary and cannot be explained to others because the pain is so personal. I feel so guilty about being depressed I want so desperately NOT to be depressed. I am now in my 60's and have dealt with depression since my teens (psychiatrists and medication). I feel like such a failure because I have not been able to conquer it. I know that my negative thought patterns are irrational but my body still reacts to the negativity as if it was real. It really hurts. I do not want pity.

  99. Some of us have a melancholic character. All the photos of me as baby and child show me serious, frowning, glum, poker faced or thunder on my brow.

    Usually, at my independent boarding school, I had a minor part in our annual school pantomime. One year, I did not — I can't remember why not. Instead, I sat in the audience in the second or third row, I think. I was about ten at the time. Afterwards, almost the entire cast asked me what was wrong.

    'What do you mean'? I asked.

    Apparently I had been frowning or glaring throughout the whole pantomime. While everyone else, of course, was smiling, laughing and clapping, I sat there looking miserable. But I had no idea that that was how I looked. I hadn't felt miserable; in fact, I'd enjoyed the show.

    Some years ago, my wife recorded me talking to my daughter and her. Afterwards, my wife was upset, because, she said, when she played back the recording, I sounded so unhappy. Except at that time, I was feeling fairly good — for me!

    I've learned that a person like me can depress others. Hence, often I try to avoid company in order not to bring a person down to my level of misery.

    Usually (not always), I can function well enough. After sixty years, I've developed various strategies to help me keep plodding away despite how I feel. And sometimes, when energised, I can sound exuberant, enthusiastic, vibrant, dynamic and cheerful — or so I have been assured by non-family members — even when I don't feel that way.

  100. Sadness is usually about something. It can be profound, long and extremely painful, but it passes and it is anchored in real events and rational thought. Sadness often brings tears; depression simply brings self-destructive immobilization, without tears and with no perception of light at the end of any tunnel.

    Depression sits in the core of the soul. It defies rationality and rejects external comfort. It is black. It, too, may pass, but not without an external intervention that is typically very hard to find.

    On one's own, sadness is scalable toward healing. Depression rarely, if ever, is. I've been in both places. Forced to make the choice, I'd choose sadness any day.

  101. Very well said, John. Thank you.

  102. America is such a terminally superficial society, where everyone is enjoined by the media, social media like Fakebook and our peers to be unrelentingly smart, pretty and rich. And if one falls short of any or all of these attributes, one is basically done for socially. A society based on the worship of money would be so crushingly shallow. Those who succumb to negative emotions are those who took a dive into the shallow pool and hit bottom.

  103. What a beautifully written article.

  104. Sadness is a fact of life, especially for people who have endured tragedy ( losing a child for example]. Depression is what puts you on another planet. The grey, hopeless, barren landscape.

  105. I've wondered about this a lot. Any rational person would be sad about what has been happening in America and in the world recently. I think I have been sad about world events since 2001. Before that, I felt reasonably hopeful for two decades; but before that, I was sad during the Vietnam War.

    I think that sadness can become depression, though, if by depression you mean the loss of pleasure in small things, and a lack of motivation to make things, do things with people, etc. That's why I try to limit my exposure to news these days. I follow a few issues closely and I work on those issues as well. That makes me feel less helpless.

    For example, who is not saddened by all these school shootings? But joining a group of gun safety activists makes a huge difference in one's ability to stay sane, when children are being gunned down in their classrooms.

    Nevertheless, long-time gun sense activists have told me that sometimes they are overwhelmed by the sadness of it all, particularly when they work with survivors of gun violence. Self-care for activists is a must.

  106. I never associated anger, anxieties, or psychotic episodes with depression. The word is bland, there’s depression all over, a lawn with a depression, malformed objects with depressions, so the term implied a flaw.

    The term is accepted by others in conversation but it not just a flaw which can be vanquished by sunshine or activity. Suicide is not an ultimate goal of depression nor is someone’s suicide caused by long time depression. There are many reasons for suicide, including legitimate ones for extreme illness.

    Medication doesn’t do much without self aware techniques to see a rabbit hole spiral in progress. Mindful meditation is surprisingly effective because the object is to confront the feelings rather than avoid or distract from them by constantly doing activities. Regular good sleep, and I stress the regularity more than the quality, is essential along with cutting out or reducing alcohol, limiting screen time to prepare for sleep with quiet time.

    Finally, I had equated the word trauma with severe life threatening events. Ultimately I accepted the word realizing that it actually means an event that caused a distortion of values. That had set life in a hopeless alternate dimension which alienates others thus propagating a vicious cycle of disengagement, worthlessness and shame. Seeing trauma as a cause allows a more reasoned view of feelings which create so many problems.

  107. Your image of a "rabbit hole spiral" is very apt.

  108. Ms. Boylan:

    Concerning the thoughts in one’s head, and who it is that hears them, I suggest that you read Eckhard Tolle’s “The Power of Now.” It is a life changing book.

    We all think too much and many of our thoughts are silly, harmful judgmental and hurtful.

  109. The “dark mind” shields itself from light. It hides. It justifies and nurtures and feeds on itself. It is a chemical imbalance. The “dark mind” will automatically and inevitably consider suicide. I am not one to automatically medicate, but antidepressants tipped away my dark mind, better late than never, and for that I am grateful.

  110. Depression is a chemical imbalance in brain. It doesn't always look like sadness; anxiety is a form of depression and its symptoms can include sleeplessness, loss of appetite, and obsessive thinking.

    Depression isn't anger or worry turned inward--only the ignorant buy that victim-blaming trope.

    Depression is chemical. For millions of people, antidepressants offer fast and effective relief from the symptoms.

    For me, antidepressants literally worked overnight. I guess my "anger and worry turned inward" just disappeared while I slept? Please.

  111. Anti-depressants work quickly for some, and they are to be envied. For some, recovery takes many tries on different medications and a long road. Just as medical research is helping us understand that there are many separate diseases under the general rubric of cancer, there are many agonies under the general rubric of depression.

  112. Thank you for saying that. For many of us medication does work well. The problem, as you said, is ignorance, including willful ignorance. Too many people refuse to recognize that clinical depression is a brain disease, not a personal failure. The difference that the correct (not always the first) antidepressant can make is amazing. And antidepressants aren't 'addictive' any more than insulin is addictive to a person with diabetes.

  113. The psychic pain that comes with severe depression is excruciating; when helplessness and hopelessness hijack mind and brain, the struggle to survive is waged minute by agonized minute...

  114. Depression is cold. Sadness is warm.

  115. This is helpful. I recently had to say goodbye to my beloved Borzoi, she had a fast growing tumor on her spine and I lost her in 3 weeks. That was 4 months ago and I ask myself daily if I am sad or depressed. I worry because I cry everyday. Yet, I believe I'm only sad, because joy can peek thru sadness... and I can still feel that it's out there somewhere. I think Depression is too opaque for joy to show through. I will use the thought of cold vs warm now too. Knowing the difference makes all the difference.

  116. As one who has experienced depression, I fall for click-bait about it every time. Some of it is useful some of it is not, you believe what you want to believe. All my reading has led me to form an opinion that depression is an adaptation that allowed creatures the time needed to heal from assorted illness, injury and stress. This also explains why so many people manifest physically what are psychological issues. In the modern world, with the absence of real threats, the mind turns on itself to fill the vacuum created by the risks having been eliminated in the First World. Getting outside, exercising and taking chances with my physical self has helped me enormously.

  117. Having spent many years living with a spouse who suffered from bipolar disease , diagnosed as baseline depressive and who for at least 10 years was morbidly depressed , i've still had a very hard time wrapping my head around the suicide of Anthony Bourdain. Which I note too has left me deeply saddened .
    What I have been wondering drove him to that irreversable moment and what saved my spouse from that fate.? To say that my spouse was profoundly depressed is an understatement . For years I would tell those few people who I could talk too about this that it was like living someone in hospice . But yet this person who is a physician, and had the means to committ suicide did not . And so I ask myself , is there a difference between refractory depression / bipolar etc and suicide ....is that a distinct diagnosis and one that should be isolated and treated distinctly from the others ?
    My thought leads me to think of the many people who suffer from Drug Addiction. Why do some people succeed in controlling the disease after years of significant usage and dependence and others fail despite multiple efforts at recovery ? Link I think....

  118. To me, sadness and depression feel very different. Sadness feels like a feeling, but depression feels like my feelings are unavailable. Sadness feels like it will eventually pass, but depression feels like it’ll be there forever (even though it does go away when it’s good and ready.)

  119. Sadness and depression feel very different to me also. Sadness allows me to open up. Sadness means tears and those tears are almost refreshing because then I know I'm sad, and not depressed. Depression is a deep hole that cuts me off from myself and other people. Unlike the author of this article, music does not help. I know I am sinking into depression when I prefer silence. I know the difference.

  120. This is exactly right, SADNESS is a "feeling" you can vividly sense and perceive (you'r still alive); DEPRESSION (in my experience) you loose that sense and perception altogether and completely, and your feelings are sequestered by an instance or period of time (a living-dead type of robot with no feelings). BTW, usually that robot becomes an phenomenal actor that performs -impeccably- covering the real situation to others...like wearing an invisibility cloak where the "real" you disappears.

  121. In the medical world it is critical to distinguish between sadness and depression. In the conventional psychiatric lexicon the essence of depression is its physical dimension. Strictly speaking, in accordance with the diagnostic criteria of depression, one need not be sad or unhappy to qualify as depressed (though for practical purposes, that feature is almost always present). If someone isn’t showing sleep or appetite changes, loss of pep, or psycho-motor retardation, it is unlikely to be useful to apply the D-word, which is another way of saying, turn to medication for help; even if they are profoundly sad.
    Another feature distinguishing sadness and depression is mood reactivity; when something experiential can cheer a person’s spirits, those are unlikely to be cheered by antidepressants.
    The failure to respect these facts can lead to inappropriate prescribing, hence personal and societal injury. And in the flurry of the non-psychiatric medical practitioners’ practices, the fact is, those facts do often get lost.

  122. Sadness isn't that hard to understand, from a distance.
    Harry Harlow, the researcher at Wisconsin who made a living torturing primates depriving them of affection, wondered how depression worked.
    So he set up a lab, and built a series of inverted pyramids, blacked out and slippery, and put one in. He theorized that healthy ones would be ok, but depressed ones would get worse. He was surprised to find that all primates, who are isolated in a painful situation with no way out, only sliding back to the bottom, coped by shutting down their own brains, and the effect lasted a long time.
    So maybe what we experience is our own "depression box" of family, work, school, military, etc., and what a friend needs to do for a depressed person is help them free themselves from the very real emotional prison that they are encased in.
    Not drugs, or meaningless labels, but real revolutionary work in social interaction and community.
    You remember community, tribes that humans absolutely need, that thing that cutthroat capitalism and cutthroat meritocracies in grade school, have worked so hard to destroy.
    Check out Harlow's "Love at Goon Park".
    Hugh Massengill, Eugene Oregon

  123. Deborah Blum wrote "Love at Goon Park" which is about Harry Harlow.

  124. Mr Massengill you are on the track of a better understanding of how we get stuck in depression and then stricken by hopelessness or something like it, move on to suicide or even homicide. Harlow’s work helps us see how our earliest experiences can set us up for depression. These experiences can be so far back that we only have memory traces of them. Our vulnerability is complete. We are utterly dependent on our caretakers. Woe unto us if those caretakers are themselves depressed and/or traumatized. No one stuck in the quicksand of a depressed early childhood can pull themselves out. It requires reaching out and finding support, lots of it, maybe for years. There is no quick fix.

  125. The Times has offered this and a number of other opportunities for readers to discuss suicidal ideation and its antecedent, depression. It is an important service, educating, connecting, diminishing the dread feelings of hopelessness and helplessness. Perhaps Trump and the GOP will hear the cries for help. There is much that a safety net can do to mitigate depression and suicide. The pull yourself up by your own bootstraps is romantic nonsense. Americans should have financial security, access to proper housing and treatment for their mental and physical illnesses.

  126. I agree with you on much of this. However, help and medication alone cannot completely cure you. Hopefully these things will get you to a point, a moment, when you can decide to take that first step from darkness back into the light. Never underestimate the personal bravery of those who recover.

  127. The problem with depression is how we treat it: with drugs and talk therapy with a therapist who's incentivized to convert your you or your loved one into an annuity stream. As the effects of the anti-depressant wear off, the sadness returns and stays. What we need to do is acknowledge sadness and depression and start teaching how to deal with it -- hands on, practical, coping skills in grammar school.

  128. As much as I wanted to jump, something held me back. As much as I wanted to stand in the middle of the street, something made me run. As much as I wanted to down that whole bottle of pills, something pulled back my hand.

    What saved me from those moments of compulsion?

    I read, I wrote, I cried. I railed. I screamed. But I still don't know the answer.

    On the edge, I was alone and swallowed in a dark place. I still don't know what pulled me back. Grace of God? Stubbornness? Fear?

    I don't have any answers. So many of the things I read are well-meaning. But they have a rationality that can barely make a dent in a deep depression.

    I was ashamed of my feelings and couldn't bring myself to tell even my shrink because I felt I had to put on a brave face and assure people that I was just fine.

    But I have a wonderful psychiatrist and she coaxed it out of me. "Let's work on this thing." She has saved my life.

    As I write this, I find it hard to reconstruct my path out, a path with many almost imperceptible detours. It usually takes me awhile to understand what is happening. But I can now tell concerned friends how I am feeling. Whatever their response, it is good to be able to tell the truth, to admit to depression, to say why I can't get something done.

    I'm not exactly sure why I'm writing this in the NYTimes, except to say to sister and brother sufferers, "You are not alone."

  129. Thank you for writing this. I have been so uplifted by the beauty and honesty of the stories so many have been sharing. Each is unique but each has a commonality... the recognition that we are not alone in this internal battle with ourselves.

  130. There are so many people afflicted with similar problems that it is quite appropriate to write about it anywhere. I believe most if not all of the evils currently plaging us are a product of Patriarchy, a system built on rivalry, conquest, militarism, wealth and subjugation. We have lived about 10,000 years as patriarchal societies, and the results are quite horrific, both in terms of wars, poverty, and environmental destruction. It is only natural that people, particularly women, would accumulate trauma growing up in such cultures. We have to add to that the ability of the mind to split itself in order to deal with trauma, and we can understand why we end up working against ourselves. It might help to read about Mara, the evil version of ego in Buddhism.

  131. James Hillman had an interesting take on depression. He claimed that depression is like a mine, a place you can go to get raw materials out of which you can refine, or distill the silver and gold of consciousness. So rather than treat depression as something to be rid of, you can think of it as a resource. In other historical conceptions the mood was called Melancholia, and the Romantics and others actually sought the state as a place for inspiration and repose.

    Our Saturday, a day of free play after payday, is named after the god of leaden depression. Mythologically, before the era of Zeus and man, the Titanic age was ruled by Saturn and was considered a time of plenty. Since Saturn/Cronus eats children, Saturn is also the god that ends childhood, that Titanic time of "no worries."

    Americans would do well not to banish depression. We should see the pathology as a corrective to American Exceptionalism and our death-denying youth-oriented Pop-culture.

  132. Also, one of the Romans’ greatest yearly festivals was the Saturnalia.
    As for the Romantics, they had totally different takes on lots of things. They approached and defined “terror” and “terrorism” way differently than we currently do. Interesting article on that in the current issue of The New York Review of Books.

  133. I like your reference to Hillman. But deep and intractable depression is a black hole where creativity dies. Those lucky enough to recover may bring back significant insights, but at a very great price.

  134. Thank you for this article. I've read through the comments. None of it answers the basic question I've always had about suicide. How can a person willingly subject their loved ones to the lifelong pain their suicide will cause, sometimes without even an explanation? Are depressed people somehow unable to parse how cruel this is, even on an intellectual level?

  135. There is often a component of anger and resentment associated with depression (its source an injustice or trauma, real or perceived, without resolution; a disconnect between reason and feeling). It is as if these feelings take on a life of their own separate from conscious awareness. This unconscious "psychic entity" then attacks ones being with the same violence and injustice suffered sometimes amplified and exacerbated by the daily struggles, highs and lows, and misunderstandings inherent in human relationships. Misplaced projections of blame flowing both outward and inward, but mostly inward. Maintaining a facade of "normal' can be exhausting, painful, and blinding to to any perception other than the cruelty and pain of existence itself and the failure of anyone to ever understand or ever hope to understand, "even on an intellectual level". The intellect is conscious, depression is not. It is hard to see the light of awareness when trapped in the blackest night without stars, forever alone in a shroud of fog harassed by a relentless voice of accusation and despair.

  136. A seriously depressed suicidal person truly believes that their loved ones will be better off without them. Deep depression makes the act of suicide seem a kindness, a lifting, not cruelty at all.

  137. Twenty years ago, caught in depression's relentless undertow, suicide started to seem to me inevitable. It wasn't a question of my wanting to to die. I didn't, but it seemed out of my control. In that way, I was perhaps like a condemned man awaiting execution -- it didn't matter what I thought, death was coming.

    Luckily, my then-girlfriend managed to get me to a therapist at the county health service. That wise woman didn't try to correct the flaws in my thinking or convince me that I had a lot to live for. She mostly talked about what suicide does to the people left behind. She described it in blunt, matter of fact terms. I decided that, no matter what, I couldn't do that to my mother. A bit of volition was restored.

    But not everybody has a smart, courageous partner and a savvy therapist. And sometimes even those are no match for the demon. When I hear about a suicide, it breaks my heart, but I can't judge the person. They simply lacked what I, inexplicably, had.

  138. A doctor once told me that everyone feels sad and down occasionally. Many even feel a sense of hopelessness in this dreary world. A lot of people even think about death, and the their own death specifically.

    Up to that point, there is some ambiguity on whether there is clinical depression, or simply a swing in your outlook on life. Talking to your doctor or a therapist would be helpful and likely a good thing.

    However, she also said that once people start thinking of the ways to end their life, that once they start planning their own death, that is when there is certainly problem and that seeing a professional is a necessity.

    Certainly not medical advice since it is coming from a random account on the internet, but perhaps someone will find some use for it.

  139. Ms. Boylan, I appreciate your sense of humor. This is a beautiful essay, in no small part thanks to one sentence: "When I was 8, I accidentally crashed through a glass door on my way to something called Aquarama in Philadelphia."

  140. For me it's almost a coping mechanism - My earliest memories are of my mother saying: "you should never have been born" to the point where it became the mantra of my existence.

    When people ignore or dismiss me, I assume that those rejections are all I was ever to expect. Since I don't expect anyone to accept me, on those rare occasions when someone does, it is unexpected.

    Of course, I do know that when I do cease to exist absolutely nobody will be bothered or sad.

    Music and exercise do help but in the end I'm just an unwelcome guest in a universe that never wanted me in the first place.

  141. Thank you for sharing your comment, George. Your voice is very important and you are welcome here.

  142. For those of us in that tragic space with no name, surviving the death of a beloved child, sadness is far too mild a term to describe the unrelenting hell that becomes the "new normal".
    But is what's left depression? I feel lost every day and yet, have managed to work, travel and make new friends. I often wish I could just disappear, but is that suicidal if I have never looked over the precipice or wielded a weapon? One definition bleeds into the other mostly invisible to the outside world.

  143. This is just me, and I have no expertise. But I think profound grief (like your experience, Noa) is a different thing than sadness or depression. It is its own thing. Grief has its own boundaries and is invisible and unrelenting. You look normal as you walk around but you are bleeding from every pore at every minute.

  144. Who would miss you? WE would miss you. Thank you for being here - and thank you for your finest piece of writing in these pages ever. This sad, sad week you're needed more than ever.

    A lot of pain is surfacing this week. For people who feel like they DON'T have it all, some are wondering 'how do I make it if people who looked like they were on top of the world couldn't handle it?'

    Please talk to someone - volunteer at a pet shelter or bring an elderly person food - go for a massage for human contact - take your medicine and vitamins if you've been forgetting them - get more sleep - and heed Ms. Finney Boylan's chosen song lyrics:

    "Here's hoping all the days ahead
    Won't be as bitter as the ones behind you
    Be an optimist instead
    And somehow happiness will find you
    Forget what happened yesterday
    I know that better things are on the way...
    I hope tomorrow you'll find better things
    I know tomorrow you'll find better things"

    If you don't feel like YOU know - if you're having trouble seeing that tomorrow or next week can be different and can be better, please call the suicide prevention hotline at 1-800-273-8255 so they can help.

  145. I've been battling depression my whole life. Sometimes the battle seems like just too much effort. Unfortunately the music I turn to during my cycles of depression is always really sad music that enforces the emptiness and hopelessness that I think is the reality of my life.
    For me there's been no magic bullet, and I've tried everything. Sometimes I define depression as a decoupling of the soul from the body, sometimes it's just like being in a boxing ring with no way to defend myself. I do think that depression often comes from a history of being physically or emotionally abused. I had a boss who abused me verbally for 15 years. Why didn't I quit? Because I thought he was right about how useless and stupid I was. I thought he was the boss I deserved. And why would I think that? Because my father used to stick his finger in my face and tell me how stupid I was. People say, "just get over it," but this attitude is internalized after a while and you become, in a sense, your own abuser.

  146. The "get over it" advise comes from profound ignorance of how emotions work. Likely there is nothing in your present to warrant such level of suffering, therefore the source must be in your past. The problem is that those evil roots are submerged deep in the subconscious, they are bubbles of negative experiences from long ago, true emotional time machines that color everything in your present. The voice that the writer refers to is what in Buddhism they call Mara, an evil representation of ego, and is in reality a false identity that was created at some point out of a childhood trauma. This identity of pain and inadequacy, although fake, does not want to die. It needs to feed to exist, and since it is not real, it feeds on things also not real: the past and the future. Pain from the past, anxiety about the future. That is why that voice never stops. It is feeding on your vital energy. We all have Mara in us, the challenge is learning not to feed it. You are not alone in having this enemy. It is the source of all evil in our world.

  147. There's some evidence that ketamine works for depression that doesn't respond to other treatments.

  148. There's some evidence that ketamine works for depression that doesn't respond to other treatments

  149. I would submit that sadness has a strong exogenous component; it is a natural and even thoughtful response to external events, like the illness of a friend or the death of a family member. Depression is mostly endogenous; a chemical storm in the brain that often has a strong genetic source but can also be caused/exacerbated by trauma.

    But the upshot is this: when a depressive episode hits your brain does not work. Over and over, my life has been completely derailed by months and months of depression that left me barely able to feed myself. Just the repetition of it can make you want to end it all. All of it. What's the point of working hard to build your life when this black dog comes around, again, often for no discernible reason, and shreds and defecates upon all that hard work? No one understands

    I like the way the writer ties in music. Music is engineered sound, organized around rhythm, melody, harmony and dynamics. It becomes this eloquent therapy that allows the brain to recognized how the disorganized our thinking is but how to find a way back by listening to something adaptive and rebuilding your thinking. Remember that Plato said the critical middle step in education was musical, between the physical and philosophical. But I would suggest the writer also found that writing was another important path. The blank page/screen is a difficult taskmaster, especially when you can't think. But the writer knows how to go one word, one sentence at a time towards the light.

  150. I would recommend this a hundred times if I could. I'm recovering from an extended dance with the black dog, at least the sixth of my adult life. Happiness is that I was only hospitalized once this time. The rediscovery of hope and optimism is hard-won. Now I need to reconnect with friends and family I've been hiding from for the last two years.

  151. Depression is a state of being not an emotion. Depression is when a person is unwilling or unable to feel whatever feelings you may have about what is happening in your life. The feelings may be comfortable or uncomfortable and can be being repressed or held back for any number of reasons. Stop calling feelings positive or negative. Feelings and emotions are only indicators of how you are interacting with the world whereas positive and negative are terms used in electronics to describe types of electrons and their possible attraction or repulsion to each other. Feelings create a type of energy within us that gets to act in a certain way. Anger (which gets a bad rap) is and energy that comes up when we believe that we are being abused. The energy gets us to act in such a way to stop the abuse. Unfortunately we have been taught wrongly that we should scream, yell, hit and throw things to resolve the apparent abuse. Not that there aren't times when such actions aren't appropriate but more times than not, they aren't. The question is how do you get out those emotions and feelings?

    Science by design has chosen to ignore the more metaphysical causes of life's interactions. But try this. The web site " OurPsychicLives.com" has a story about music that will help immensely. Simply play any music of your choice and pray asking God to put into the music whatever God wants to put into the music that will help you to heal. Skeptics are welcome to try as well.

  152. Depression and sadness are different as chalk is to cheese, c We overcome sadness by many means - not least of which is realizing that sadness is only (only!) an emotional mood. Moods change mercurially all through our days and nights. One moment sad, next happy as a tot with cheerios on our high-chair trays. Depression is like a dark cloud that never lifts. We go to sleep depressed, dream weird dreams, and wake up to depression no matter how sunny and bright the day is outside. Great paean to moods, Jennifer Boylan. You write well. Basically, to change our moods, we have to get up and get out of ourselves and seek community with others of our tribe. To change depression, we need help in the form of psychogenic drugs and helpers from the medical or shaman world. Recovering from depression takes a long time, but realizing "I'm not depressed any longer!" is a eureka moment in our brief candle lives. Sadness lifts with a good book, a movie, a walk or bite to eat with friends. There are hot-lines to phone for depression and the feeling of worthlessness and wishes for suicide. We all feel different emotions about the lives we are living. Sadness passes. Depression, too, passes.
    And of course we all pass..and face the big void -- death -- at the end. Be of good cheer and read Ecclesiastes. The old guy knew whereof he spoke!

  153. "for when you gaze long into the abyss. The abyss gazes also into you.”. Not that unusual to get that feeling when standing on a cliff. The sane ones don't jump.

  154. Good question! If a loved one dies or is ill, or you are ill, have faced a tremendous loss, it is entirely reasonable and sane and healthy to be "sad"... there has, I think, been a tremendous amount of pitch made about "depression" and "mental health" or "mental illness" bantered about, mostly in a markety way to seek medications or other "treatments"... fact is: bad things happen in life, and to suggest that someone experiencing sadness is "depressed" or "mentally ill" is very, very unhealthy. People are not supposed to be happy 100% of the time: to suggest otherwise is very Stepford Wives-esque. This especially since being told to ignore wars and head to the malls...

  155. The world’s surfaces are full of contours and textures that children spend their early years mastering. It takes skill of the hand to enjoy a cat’s soft fur properly. “Sadness” is an emotion we all learn to use to explore one of life’s essential gamut of textures. We use it to help bring out the world’s harmony and beauty, like painters scanning the view for a good place to set up their easels. Like all human talents, sometimes sadness overwhelms our powers of control for reasons we will never fully understand and turns into what doctors call “depression.” It is the human condition never to be fully in control of our lives—a cause for sadness, not necessarily a reason to search for a “cure.”

  156. Having experienced both, I think the biggest difference is the loss of hope in depression.

  157. Neither voice, the manic or the depressive, is telling you the "truth". Both are equally plausible and equally deniable.

    What changes is receptivity and, as you yourself concede, mood is the product of the influences and intoxicants of the moment -- like music.

    Mutability ends with death, but not before.

  158. Puppy therapy helps tremendously. Dogs in my opinion are absolutely divine.

  159. Depression is a brain disorder. From the many comments here it seems that people still don't understand this. It's not something you "just snap out of" as suggested by a mature well educated family member regarding his mother with 20+ years of clinical depression. Book suggestions by the author perhaps speak to the problem. The article, despite a good first person description of her experience, doesn't emphasize this is an - ILLNESS.
    There are many good suggestions in the comment section. However, you can't philosophize or exercise your way out of serious depression, tho this and playing comforting music or sharing your "sadness" with there can help.
    I hope more people will research the facts about this disease that affects one in six Americans.

  160. Depression is very hard to explain to someone who has no personal experience with it. It is an ineffable state of being that simply can't be adequately described. Much like other phenomenological experiences that defy description, depression, too, simply cannot be put into words. For example, how would one describe the taste of chocolate, or any food, to someone who has never tasted it and, therefore, has no experiential frame of reference for the feelings and sensations it produces? Or, how does one thoroughly convey the experience of deep, romantic love to someone who has never felt it?

    Of course, most people understand the psychological experience of sadness, but to liken clinical depression to mere "sadness" (or feeling "blue,” "down," or "unhappy") is to liken life-threatening pneumonia to a case of the sniffles.

    Unlike typical reactive sadness, depression is a state of tremendous, neurochemical imbalance. Brain physiology is altered, stress hormones are constantly surging, and almost all bodily systems are affected. This is why the symptoms of depression usually disrupt a person’s regular rhythms of mind and body. For instance, disturbances with appetite, sexual functioning, energy, concentration and memory, sleep, loss of interest and pleasure, sobbing and/or anger outbursts, feelings of guilt, loss of self-esteem, pessimism, and hopelessness are some of the more common symptoms of clinical depression (or what is technically called major depression).

  161. Add Peter Gabriel’s Don’t Give Up to the list of songs. Play at preferred volume and listen to the words and feel what music can do.

  162. It is getting increasingly difficult for many people to feel optimistic about the future.

    Wherever one looks, there are so many trendlines that point to dreadful futures - environmental destruction, political repression, financial collapse.

    One doesn't have to be clinically depressed to feel depressed in today's world. Reality is very difficult for many people to manage. We tend to focus on the individual's mind and this leads to an individual diagnosis. We should also focus on the social reality - a world spinning out of control and into the abyss.

    Focusing on reality can be very depressing. Human society - and therefore individual humans - are facing existential threats in every sphere. And the social connections humans used to have to help them cope have eroded. The threat is greater and the defenses are less.

    So it should not be surprising that millions are at the end of their ropes.

  163. Sadness a temporary emotion. Depression is a neurosis. Anxiety can be both.

    I have complex PTSD, with depression and anxiety as the main symptoms. Sadness and fear are natural, biological, evolutionary emotions of the psyche. Depression and anxiety are chronic, unnatural constructs of the psyche. Freud and Jung called them "neuroses". A core aspect of them is the repetitive negative thought processes known as "looping".

    To stop the looping, one must have tools with which to combat it. These can take various forms, but I will relate what works for me, and after 46 years of looping, I am now into my 5th year of having the upper-hand on depression and anxiety. Here is what has worked/works for me:

    Cannabis use (preferably higher CBD lower THC)
    Being outside at least 3 hours a day
    Moving your body around a lot (whatever form that may take)
    Reading (keep news intake to a weekly minimum)
    6+ hours of sleep (7 or 8 are much better)
    Blueberries, raspberries, and good water intake

    Last but not least: Understanding that most people are neurotic and unaware, and that our collective society and culture are highly neurotic, verging with psychosis in many regards.

    My 2 cents, and thanks for sharing your story Jennifer.

  164. I usually say "sadness" or "clinical depression." The clinical depression is a medical condition that is treated by medication and said treatment is mostly effective. But the depression sometimes breaks through the meds and I get the kind of thoughts being discussed here. I think the difference between that and my pre-diagnosis depressions is that I know what this is and that it will pass.

  165. Sadness is waiting for the next shoe to drop. Depression is knowing deep down that the next shoe is dropping in horrific fashion, with your foot still in it.

    When in doubt, seek professional help immediately. We'll never know how many wonderful souls left this earth needlessly.

    We are all divine, and our lives are valuable beyond measure.

  166. To me what defines depression is very clear: it's the sense that I am a bad person, defective, unfixable. It does not have a biochemical origin, but a cognitive origin that results in biochemical response, similar to how the perception of fear results in the release of adrenaline. Exercise, good nutrition, and quality sleep are key for health, but the fundamental fix is learning that thoughts are not reality. Meditation is a cornerstone for awakening this awareness. If synaptic structures are like roadways and pathways, it follows that even long unused roads and paths may still exist, though weed-covered from disuse. This would explain why vigilance and continued practice is required to not fall back into old thinking patterns.

  167. Don"t kbow which comes first. It doen't matter. Get help. Call that 800 number. The Times is doing a good thing by getting it out there for readers to see it.

  168. I've often asked the same question.

    Sadness is a normal part of most people's lives. There is disappointment, loss of companionship, and regret for missed life altering possibilities.

    Depression happens to be a disease category of the list of psychiatric conditions, something objectified with the implication that professionals can ameliorate or cure this condition. Now part of the treatment is the professional not become emotionally involved, in other one be like a friend, but not a real one. Paradoxically, when the sad person, perhaps longing for human friendship realizes this, it can be emotionally devastating.

    This why the pharmaceutical or therapeutic treatments for this condition are so variable, with none being anything close to a magic bullet. Sadness is what gives happiness meaning in its absence.

    Let's leave the word "depression" for the DSM manual, as we strive to live rewarding lives, playing the cards we were dealt.

  169. Heavens. Another person who says you should take a bike ride or bake bread or something. The author seems to say that people don't get the difference between depression and sadness (I do like the "common border" image) but how many times must it be said? Depression is not amenable to a brisk walk around the block. If it could be addressed that way, no doubt there would be armies of people walking as briskly as possible. More painful and well-meaning advice.

  170. I think the point of the column is
    "Do whatever works for you" once you've made it thru a severe episode of depression & you feel it creeping up on you again. And reach out and get help when you are severely depressed. You can be helped. Don't let feeling ashamed hold you back from seeking help.

  171. Ms. Boylan makes the same point here that I made on the topic of suicide: we have a word, and apply it to different things. It's not only that sadness is confused with depression. Depression is not a "one thing" but probably a group of different disorders with different causes.

    Kurt Lewin said, "If you want to understand something, try to change it." Are you sad or depressed? If you're depressed, you can't easily change it. It lasts for years, decades, a whole life. It has no center except yourself.

    The terrifying image from Ingmar Bergman: it's like feeling you need to hug someone for solace, and realizing you have no arms.

    We have inherited from a superstitious religious tradition the idea that depression -- and suicide -- is a moral failure, a lack of will, a weakness of spirit, an insufficiency of grit, a malingering indulgence. The best place to start is not with words but with attitudes: depression is a medical disorder and like diabetes or alzheimer's, it comes with no shame.

  172. Beautiful thoughts.

    As with Peter Coviello who is mentioned in this essay, my marriage dissolved recently as well, leaving me sad and, based on screening instruments, depressed.

    I am better now. What has saved me? Some of the things mentioned in this essay. Getting outside in nature, keeping busy with work and other projects, spending time with family and friends, weekly sessions with a well-trained therapist. I have also been helped immensely by practicing Buddhist meditation and receiving support from members of my local Buddhist community.

    Even in the depths of serious depression, there are ways out.

  173. For once I would like to read a piece on depression that isn't written by a high achiever. One of depression's tactics is to make you compare yourself with other, more successful people so you can bathe in your own failure to accomplish anything significant.

    As a result, the well-intentioned thoughts of successful people who struggle with depression become another opportunity to make invidious, self-destructive comparisons.

    Hence, instead of absorbing the message that even a lifetime of accomplishments isn't enough to keep depression at bay, the low-achieving depressed person will ponder the bleakness of his or her own life, made all the bleaker by not having made a mark in the world.

    In a similar vein, I recently read a piece by someone whose depressed husband had committed suicide. Among other things, she noted that her late spouse wasn't even a substance abuser, as if having a drug or alcohol problem would make a loved one's suicide easier to understand.

    Writing off individuals who are dealing with the twin (and often interrelated) problems of depression and substance abuse this way and creating a moral hierarchy among suicide victims is a cruel and harmful thing to do.

  174. Thank you for this deft and touching writing

  175. In America people are depressed about not having the material things they think they need. So they go to the store--or now online--and try to import those things by indemnifying their negative feelings with a transaction. We are incessantly told that we must be good-looking, smart, rich by Fakebook and other media. So few people have the intellectual depth necessary to resist the shallow "culture" they find themselves immersed in. Depression and sadness set in, to be cured by--drugs, drink, spending, gambling...

  176. I joined a running group to combat depression thinking physical exercise and social connections would buoy me. It worked wonders. Then, my running group, which had previously charged a nominal fee, was bought out by a large running outfit that eliminated coaches and pace groups and jacked up the price. In short, they cleverly found a way to provide less and charge more while, with a straight face, stressing the importance of becoming a "self-sufficient" runner. The community spirit died.

    So my question is this: When can we stop with this nonsense that independence, self-sufficiency, and individual liberty are pinnacles of virtue and don't come without a price? A 30% increase in the suicide rate is currently what we are paying for all this wonderful individualism. Can we get over ourselves and acknowledge it is not a sin to be a follower, and wanting someone to help you, coach you, or just be there for you sometimes is not character weakness? It is called being human and a social animal.

  177. I've been watching for good, meaningful articles talking about depression and suicide, hoping that perhaps, eventually, the conversation will improve in terms of explaining these phenomenon. And that's been happening, but not this article.

    In saying early that you're "stronger" than depression now you disqualify yourself from speaking as an "expert" on the topic. Not that you couldn't still remember, but by using "stronger" terminology you are insulting those of us still struggling, suggesting that we're not "strong."

    Please stick to other topics and let people who can speak better discuss these.

  178. Why does the Times continue to romanticize a life threatening illness - major depression- by publishing these meandering self-reflections that are opinions unencumbered by any data? Depression has clear concordance in identical twins, runs in families, has a clear disease course, and is associated with clear biological signs and symptoms. Conflating "sadness" with "depression" is like comparing "hunger" to "diabetes." The Times must do better in discussing mental health, and this sort of tripe doesn't help.

  179. If you're truly depressed your own mind is your worst enemy.

  180. If this wasn’t a public forum, I’d give you my phone number & tell you to call me, day or night, 365, when you’re down. Since I can’t, know that we are all in this together & I’m sending you powerful thoughts from the flyover part of the country.

  181. The normal human response to sadness, sooner or later, is to find the inner strength to carry on and, eventually, to heal. When a person loses or lacks the capacity to do this; that's depression.

  182. If going for a brisk walk makes you feel better you are sad, not depressed. I can describe what depression feels like physically to me, it comes on in waves and is a physical weight on my body. I know this feeling well. This is in addition to the sense that it will never end, regardless of the fact that it does and the absolute certainty that there is no point in being alive.
    As I have aged these episodes have become less frequent, in my teens and twenties they were near constant. Maybe it's the knowledge that death will be coming soon to releave me of this burden.

  183. No, it’s a diminution of hormones, the reproductive hormones more specifically. Their combination creates a sense of urgency in the body that diminishes with their loss. At 65, I ask myself if the trade off is a fair one.

  184. I recall my depression as the inability to get out of bed, to dress, shower or wipe crumbs from the kitchen counter. I recoiled at first light and the dread of another day. Tears were my constant companion. When I looked at myself in the mirror, I saw blankness staring back. I was not there.

    When you are in a true depression, there is nowhere to turn, nothing seems to help and no one can take the pain away.

    My depressive episode is now eight years removed and lasted only two months, but I will never forget the total disorientation I felt in my own life and the disconnection from my sense of self. It felt like a stranger was inhabiting my body.

    My depression lifted thanks to a combination of medication, strong support from loving friends and a willingness to look at truths in my life that previously seemed too painful to bear.

    My heart goes out to anyone suffering from the dark and endless despair of depression. It is the one thing in my life that was truly terrifying because it was so dark and so difficult to overcome.

  185. The message from Big pharma, targeting an extremely vulnerable population, is that a pill(s) will significantly reduce or eliminate feelings of sadness and/or depression.
    Remember, big pharma is motivated primarily by big profits.
    Ms. Finney Boylan remarks that music and exercise have alleviated feelings of sadness and depression.
    The medicine cabinet is less likely to quell these emotions.

  186. sadness is a natural reaction to loss. and there are different kinds of sadness, just as there are different kinds of loss. sadness might be thought of as a sprained heart/soul. in time it will heal, although the injured heart/soul will probably never be quite the same.

    depression is like cancer. there are many types, some more dangerous than others. sometimes treatment helps, and a depression or a cancer can be cured. sometimes, regrettably, the treatments cannot stop the disease, and we succumb.

  187. @butlerguy

    I really like your analogy, describing the differences between sadness and depression. It brought a refreshing clarity to the topic. Both are concrete examples I can personally identify with. A very sincere thank you for sharing your thoughts.

  188. I wish I understood depression better. I’m almost always happy, and if I’m sad it’s usually, my wife says, circumstantial, not existential. For example, it could be Sunday night, and I have a whole work week ahead of me, and I get “depressed.” I think it might help the truly depressed if incorrigibly happy folk like me took some time to understand their problem, but—not to be flippant—the topic is so “depressing” that we avoid it, in the same way we avoid the sick or dying, as if the malady might be contagious.

    My difficulty understanding depression is heightened, ironically, by my liberal arts education, where free will and self-determination are foundational assumptions. I tend to see depression, in other words, as a spiritual and intellectual failure, rather than as a disease or a neurological disorder, a symptom of brain chemistry. Perhaps it is so difficult to understand precisely because it lies uncomfortably within both the both scientific and spiritual realms of human life. I don’t think this article helped clarify it for me, but after Bourdain’s suicide, it got me thinking I should make a better effort to understand.

  189. For me, it is a scientific bonafide medical condition. i go into a black dog depression after a manic episode. It's definitely a biochemical imbalance in my brain. After finding the right combination of antipsychotics, the depression would lift almost immediately. I've stayed on this right combinatiin for several years so as to not go into the horror of either mania and depression.

    I had to suffer a number of episodes before I would admit that mental illness is as real as diabetes. I am and always have been a happy person unless I was manic ir depressed. Depression is a real medical condition.

  190. Good article. For me, sadness is a temporary emotion that will pass, like a thick fog in the early morning hours until the sun appears and it burns off. Depression is more like one continuous frightening blizzard with no end in sight, leaving one feeling completely alone, isolated, scared and hopeless.

    I learned a long time ago to NOT listen to music that would feed into my depression. “Adagio for Strings” by Barber is one of the worst pieces of music to listen to if one finds him/herself in a dark place for that beautiful yet haunting and melancholy music has pulled me into that deep, scary abyss.

    When I find myself leaning towards the beginning of an episode of depression, I take physical steps to keep from sinking. I do not indulge in that adage “misery loves company”. I do not watch sad movies (“Marley and Me”), I do not eat sugar for those few seconds of “happiness” quickly turns against me as my sugar level drops; I don’t want to commiserate with other depressed or sad people.

    What helps keep me on an even keel & grounded are my cats, especially Fred. He appeared a year ago, literally knocking on death’s door. My husband and I saved his life. During his recovery, I promised Fred I would take care of him and protect him from harm every day of his life and mine. It’s that promise that helps keep me from free falling into depression, even on my darkest days. Depression will always lurk in my life, finding solutions that work for me has kept me alive.

  191. Jennifer... My Gratitude for your beautiful, sensitive, and touching words.I am 81, a long-Retired Lutheran Pastor and Licensed Family Therapist. I counseled many for years in the grips of Depression and situations of Sadness. Five years ago, we moved, after 41 years in Nowthen, Minnesota,
    to live a few minutes from our 50 year old skilled and beautiful Daughter,
    because she was diagnosed with Early Onset Alzheimer's. She is today in
    an Alzheimer's Care Center here in Minnesota. I am most grateful, in this
    Sadness, that we, her Parents, are able to be where we can be With her
    Every day. I have known Sadness, Depression....and Suicide....as a Pastor, Therapist, and Friend. As we approach another Father's Day, I am grateful that she still, at least, in her clouded awareness, Knows me. I thanks you, Jennifer, in this broken World, for your Awareness and sensitive Words.