Depression – Its Forms and Impact

The Pain in Depression

My interest in helping others with this mood state begins with members of my family. Decades ago, several of them suffered long-term unipolar and bipolar depression or post partum depression. Back then, there was almost no help available. Back then, the stigma of poor mental health was strong. As a result, untreated depression was not only publicly humiliating and lonely, it took a heavy toll on the person and their family.

Further, we know depression is widespread. The Corona Pandemic with its isolation, anxiety about the national situation, and personal events on top of that can cause depression.  Depression is so widespread, for example, that its alleviation is one of the State of Oregon’s central mental health goals.

Now, thank goodness, we know more about depression along with the life of the mind and the connection among body, soul, and mind. We have choices about finding help. As a result, people who work with their depression to diminish or banish it often live fuller lives. Also, they can be prepared if there is a next onset of this mood state.

Symptoms of depression differ for each of us.  Scroll down for a fuller symptom list.

If you feel you have depression, I urge you to get serious: seek help for your depression symptoms as soon as you can.

1.  Find medical support.

a) Ongoing depression is complicated and it can hurt you.

b) Each adult depression is different; your depression is different.

c)  There might be unseen biological contributors.

Examples of unseen contributors: Low Vitamin D — a silent, common Northwest problem. Thyroid problems — a silent medical condition. Post partum is a natural phenomena but sometimes very difficult.

d) Other — These situations can bring on depression: intergenerational trauma, ongoing stressors, adolescence or midlife, both of which are significant mental and physical periods of life and may affect your psyche deeply.  Also, shocks, a surgery or injury, a war, a bad job can set us up for depression.

A doctor can help to rule out physical contributors.  Not attending to depression can “hurt” the brain.  Please consult your doctor and or a therapist.

2.  Find therapy support.  Talk to a licensed therapist who understands depression.


Because “depression” needs to talk, regardless of its cause. Talking helps. Humans are social creatures. Talking with a person who is trained to follow how you feel and to support you can help immensely. Whether it is in a group, one on one, or in a class. Find someone to speak with.  Talking helps the brain and it helps the depression.

Mental health coverage is now part of your insurance coverage.

Depression Is No Longer a Social Stigma

About 19 million Americans suffer depression. That’s almost ten percent of us, in any one year. Six million men suffer depression. Depression, however, is twice as common in women.

Thankfully, more adults and young adults reach out for help with their symptoms. Men, and anyone else not encouraged to ask for help,² I especially encourage you to reach out. You may feel embarrassed or shamed.  Don’t let these feelings stop you from locating therapy/medical help that fits what you need.

In depression, some of us feel lost. Some of us feel loss. We don’t feel rational.  We may try to keep looking “ok” on the outside or self-medicating. That won’t help.

While depressed, you may feel that your sense of self, your morale, or sense of courage wanes. Despair may set in. Hopelessness, loss of self worth, and feeling unable to help yourself are common for both men and women. Disbelief that this is happening occurs.

  • Withdrawal, inactivity occur. Sleep can be interrupted or extended. Exhaustion may prevail. We feel disabled, unable to carry out life as before.  This is serious.
  • Appetite changes.  Mental rumination or brooding thought may start, especially in women.  This is serious.
  • Vitality temporarily leaves. Concentration may be difficult. Morale drops. Negative thoughts emerge more often.
  • Medicating with alcohol or drugs makes things much more difficult.  Alcohol is a depressant.  Cannabis will not make depression go away.
  • Don’t wait, seek help.  Call a depression or a mental health hot line or a therapist in your community.

The Way "It Feels" Varies From Person to Person

Depression has been with humans a long time. The word depression was used in the 14th and 15th centuries:  dipremere, from the Italian verb, to press down, depress; or the Latin depressionem:  dejection, depression of spirits (15th century).  Yet, each of us experiences it uniquely.

Depressions can be relatively short or long-lasting, and anywhere in-between.  You are an individual, so your age, your gender, recent or past events, such as acute trauma in family history or returning from war — all of these experiences need to be considered regarding your depression. Then too, personal events, the time of life you are in, and other circumstances are in helping to understanding how you experience your depression. In women, depression may feel quite different than the way men experience depression.

Allowing time to understand the nature of your depression — both positive and negative aspects of it — can make this difficult time more productive for you.  My goal is to help the understanding of your depression become a way for you to achieve a healthier state of being.  I work to help you find a way to be in the world in a new way.


Psychiatrists, medical doctors, and psychologists still argue about cause.  Here, we need to notice some elements of depression.

  • Biological.  Your family members may have had non-situational depression, meaning for some reason, it came with their body state.  Men have biological causes of depression too. Life-long hormone fluctuations in some women can contribute to it. Many women have depression following enormous hormonal changes after the birth of their baby or babies (post partum aka baby blues) or in midlife menopause. This is natural.
  • Trauma Aftermath. Depressions can occur following trauma or shock. The mind and body work hard to adapt to tremendous shock and change.  Trauma can be a one time event or an ongoing threats or events.  Ongoing stressors set many people up for depression because ongoing stressors wear on the whole person — body, soul, spirit, and mind.
  • Nutrition Problems.  Lack of certain vitamins or minerals impact your gut’s ability to produce certain needed brain hormones such as serotonin.  Birth control pills with synthetic progesterone can trigger depression in women.  Lack of proper gut bacteria from processed food diets actually cause gut bacteria to die off and contribute to depression.
  • Grief and Loss.  Symptoms of depression may follow grief from death and loss, or surgeries such as heart surgery, an injury, or other insults to the body and soul.  I definitely include sexual, emotional, and physical abuse in this latter category.
  • Early Depression.  Oftentimes depression begins early in life, meaning in infancy, childhood, youth, or in young adult years.  Sometimes these experiences make us more vulnerable in adulthood.
  • Yearly Seasons.  Even the annual onset of winter in gray, rainy Portland can bring on a kind of depression called seasonal affective disorder (SAD).
  • Sometimes, we say we just don’t know the cause but we need to get help anyway.

Not all depressions emerge from biological bases but all depressions have biological impact. This is why I want you to reach out for help as soon as you can.  

A Time of Inner Change

For some, a depressed mood emerges as we emerge into the world of work and or family. Sometimes a depressed mood comes over us later in life.  For instance, young people facing new responsibilities or feeling like they are not measuring up can become depressed.  Adults can experience mid-life crises when entering the second half of life, regardless of their specific age.  Elders may feel depression as temporal limits develop.

Here are other examples for people of any age:

  • A difficult outer situation occurs.  For example: people can feel trapped in a situation — a job situation or a job loss, a bad marriage, a role in life, or a war they can’t influence.
  • Social or spiritual events.  Example: over whelming loss, rejection, or deeply distressing interpersonal situations.
  • Current loss or shock that reaches back.  It somehow links with early trauma or difficulties and produces depression.  One examples is being in an industry where job loss occurs and you lose your sense of meaning or purpose.
  • Events push us too far.  These push you beyond what you are physically, mentally, or spiritually unable to change or endure — in some cases, years after these events occur.
  • Continual self-medication with alcohol or drugs.
  • A hidden medical condition such as blood sugar instability, thyroid, gut issues, Vitamin D deficiency, or something else.


Often my patient and I agree that a physical assessment by a doctor, mental health nurse practitioner, or a qualified naturopath is a first step.  We try to sort this out at the beginning of therapy.  However, we may choose to accomplish this later as we get to know each other better.

Borrowing from Dr. David H. Rosen, M.D., ¹ oddly, a depressive response can serve as protection when certain kinds of life events surprise us or cannot be avoided (see above).  These events are just too much to be borne by our psyche. Depressive loss of energy can also signal a state of saving energy as well as a chance to better heal.  Possibly, it can help you get to know a new reality in your life.  It is however initially quite hard to see what this “new” reality may be.

Rosen also offers that we need to work. Not moving from being enclosed in an “adaptive” or protective depression can create pathology. Progressing through the depression is key (pp. 4-5, 1993).

  • Allowing time to understand the true nature of a depression — both positive and negative — can make this unproductive time more productive, leading the way as you journey back in spirit and in the brain and body to a healthier state of being.
  • I work with my clients to help them find a way to be in the world in a new way.


I’d like you to seek help if you feel any or a number of these feelings and reactions pressing down on your body, mind, and spirit.

Sadness, continuing sleep difficulty, and decreased energy are hallmarks of depression, but some of these other symptoms often appear and stay around.  I urge you to get help for these:

  • Prolonged hopelessness or helplessness/pessimism.  Loss of interest in daily activities. Mental pain.  Those are serious.
  • Emptiness, despair, and or feelings of unworthiness, particularly in women.  This is quite serious, a rising of a darkness, feeling morose.
  • Changes in eating patterns — too much, especially too little food or a loss of appetite — this is serious.
  • Rising irritability, touchiness seen in all people but often seen in teens.  Persistent anxiety or restlessness.  Loss of interest in sex often occurs in both men and women.
  • Sleeping too much or too little.  Middle or the night or very early morning waking.  Out and out insomnia.  All serious.
  • Difficulty concentrating.
  • Physical pain not easing with treatment, such as cramping, indigestion, headache, backache, or sexual dysfunction, anger, loss of interest, or reckless behavior for longer periods, especially in men.  We note that physical pain is used to describe depression in particular cultures.

The National Institute of Mental Health provides descriptions for men and women. Having someone with experience and training in treating depression can be supportive and that can help you.  I encourage you to call me or to go see your doctor.

How Can I Deal with My Depression?

The condition of our society is such that nowadays when depression is mentioned, an antidepressant pill is immediately offered or recommended.  Please read on to find other approaches…

Click to Read More About How to Deal with Symptoms…

¹Transforming Depression.  David H. Rosen, M.D.  (1993).  Nicholas-Hays, Maine: York.

²The Masculine Self by Christopher Kilmartin (5th ed., with Andrew P. Smiler) and  Overcoming Masculine Depression: The Pain Behind the Mask, also by Kilmartin.

To Reach Carol,
Call 503-287-1526

Prefer to Email?

Please type in your email below and I will contact you.