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Depression – Its Forms and Impact

The Pain in Depression

Depression sometimes feels like an inner storm.

Stormy Sky

My interest helping others with this mood state begins with members of my family of origin who suffered long-term unipolar and bipolar depression decades ago. Back then, help was minimal. As a result, untreated depression was not only stigmatizing, it took a heavy toll on the person and their family.  Now, thank goodness, we know more about the life of the mind and about the connection among body, soul, and mind. We have choices in terms of finding help and support for depression.

Depression is widespread. Its alleviation is one of the State of Oregon’s central mental health goals.  People who work with their depression and help to diminish or banish it often live fuller lives, and they can be better prepared if there is a next onset of this mood state.

Symptoms differ for each of us as unique people.  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) Because an ongoing depression is complicated and it can hurt you, and

b) Each adult depression is different. There might be biological contributors.

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

c) Other —  intergenerational trauma or ongoing stressors.  Also, adolescence or Midlife times are significant mental and physical periods of life.  They may affect your psyche deeply.  Of course 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.

Why? 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.

Mental health coverage is now part of your insurance coverage.

Depression Is No Longer a Social Stigma

Did you know? 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 care for their depression symptoms. Men, and of course anyone else who is socialized not to ask for help or who feel uncomfortable asking for help,² I especially encourage you to know that depression is important.  You may feel embarrassed or shamed.  I strongly encourage you not to let these feelings stop you from taking steps to locate therapy/medical help that fits what you need.  LGBTQQQ individuals also are vulnerable.

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. That won’t help.

While depressed, many feel that our sense of self, our morale, or sense of courage wanes. Despair may set in. Hopelessness, loss of self worth, and feeling unable to help oneself 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.  Rumination may start especially in women.  This is serious.
  • Vitality temporarily leaves. Concentration may be difficult. Morale drops.
  • Medicating with alcohol or drugs makes things much more difficult.  Alcohol is a depressant.
  • 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 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.  As an individual, 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 important in 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.  Members of our family tree may have had non-situational depression. Life-long hormone fluctuations in some women can contribute. 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. Men have biological causes of depression too.
  • Trauma Aftermath. Depressions can occur following trauma as the mind and body work 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 impact the whole person — body, soul, spirit, and mind.
  • Nutrition Problems.  Lack of certain vitamins or minerals which impact your brain’s and gut’s ability to produce certain hormones.  Birth control pills with synthetic progesterone can trigger depression in women.  Lack of proper gut bacteria from processed food diets actually cause gut bacteria die off and contribute to depressions.
  • Grief and Loss.  Symptoms or the full condition may follow grief from death and loss, from 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 depression called seasonal affective disorder (SAD).
  • Sometimes, we say we just don’t know the cause but we need help anyway.

Not all depressions emerge from biological bases but all depressions have biological impact. This is why we 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 as we get to know each other better.

Borrowing from Dr. David H. Rosen, M.D., who really understands depression¹, 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.