Cindy Aaronson, MSW, PhD, is an Associate Professor of Psychiatry at Icahn School of Medicine, secretary of the Board of Directors for ADAA, a clinical researcher and practitioner specializing in generalized anxiety disorder, panic disorder and major depression treatment using cognitive behavior therapy.

Everyone has bad days when things just aren’t going well and we just feel off. This can be in response to some bad news like getting a grade that is less than stellar or your friends are too busy to hang out. Sometimes when we find our bad day seems to last day after day, then that may mean something else is going on.

Depression is a term that covers a great deal of meanings and references. In economics, depression refers to a “sustained, long-term, downturn in economic activity in one or more economies.” In kinesiology, depression is “an anatomical term of motion that refers to downward movement, the opposite of elevation.” In weather, depression refers to “an area of low atmospheric pressure characterized by rain and unstable weather.” In terms of mood, depression refers to a sustained mood that is low, sad, down, blue. When the mood continues for two weeks or more and occurs for most of the day that may indicate an illness called major depression.

In addition to the persistent down or low mood, major depression also includes a change in interest or lack of pleasure in usually enjoyed activities where the individual just doesn’t feel like going out with friends, going to parties or even eating favorite foods (they just don’t taste as good anymore). Sleep is often altered or changed, like having trouble falling asleep, waking up one or more times in the night or awakening a few hours before normal and not being able to fall back to sleep. It can also include the opposite—sleeping more than usual. Frequently someone who is depressed also feels tired, exhausted or has no energy, stating that it’s hard just to get up at times and move. S/he may find his/her concentration is off, what used to be easy becomes difficult, like reading, following conversations or the plot of a movie.

When the mood is low it can color lots of perceptions, including feelings about ourselves, making us feels less than or even worthless. Sometimes depressed people find their thoughts focused on past mistakes or bad experiences that they usually don’t think about or haven’t thought about for a long time which may create lots of guilt and shame. It’s not too difficult to follow that thought path down to the point where the person thinks about dying, wishing s/he were dead or thinking about ending his/her life.

The good news is that this condition is temporary and very treatable. There several effective treatments for depression including cognitive behavior therapy (CBT), interpersonal psychotherapy (IPT), behavioral activation (BA), acceptance and commitment therapy (ACT) and antidepressant medication. Find more information about these treatments on the ADAA website as well as how to find a clinician who can practice any of those therapies. Everyone has down periods, but if yours goes on and on, it may be time to get some help.

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