What's the difference between unhappiness and depression?

March 28, 2009 6:06 PM

I wish I could tell the difference between unhappiness and depression.

Are my unpleasant, unhappy thoughts curable? Are they susceptible to medication, or am I just the type of person who is chronically unhappy?

I don’t think I impress people as being especially down in any way. And I don’t have the signs of severe medical depression: I get up every day, I go to work, I have friends who clearly don’t suspect there’s anything wrong. And furthermore, I am pretty sure I am seen as a wisecracking, legitimately funny type of guy generally – when people laugh at my jokes, I am as sure as I am of anything that people aren’t just humoring me.

I am just not happy. But there’s little objective reason for this. I am reasonably successful career-wise, I have a wonderful wife and three great little kids all of whom I love very much and have every reason to think it’s reciprocated (perhaps this sounds like denial, but it seems to me that we really all do like each other greatly), and financially I am reasonably well off.

I just have a lot of crappy associative thoughts. When I see my wife helping my son, I start thinking about what a poor parent I am, what with me spending time on the Internet rather than helping him with his schoolwork. When I read about a classmate from college, I start comparing his success to my squandered potential. When I see a movie that is reminiscent of a former stage in my life, I start ruminating about past failures. It just seems to turn into a scenario where I beat myself up in my head.

And I don’t seem to get anywhere near as much pleasure as I used to from anything.

Is this just real life? Am I supposed to be this gloomy in my mid-forties? Is this the sort of thing that Zoloft or one of its pharmaceutical cousins is supposed to be used for? Should I consider talk therapy instead? Should I just be exercising 7 times a week rather than 4? (Since I feel better when I do so, the answer to that is probably ‘yes’.)

I know this sounds somewhat over-intellectualized, but I don’t even know what depression really *is*. I tried pill/talk therapy briefly, about 12 years ago during a real crisis (bad breakup) in my life, when I was in a very different situation from my current suburban establishment lifestyle. Having very mild depression has been a theme in my life, but I think it’s getting worse. The treatment didn’t seem to do me much good, and I was worried that focusing on the problem in that way was just making matters worse.

So should I just accept the fact that fortyish men have midlife crises generally – that sadness is going to be an established part of my human condition – or should I call up a shrink and get a scrip for pills or an appointment for talk therapy?

posted by anonymous to Health & Fitness (17 answers total)

Should I consider talk therapy instead?

Yes.

This sounds more like existential angst than clinical depression, but IANAD. I think you can learn to be a happier person. I don't think Zoloft will teach you that. Anti-depressants, in my experience, don't make you "happy." Illegal drugs do a much better job of that (not that I am recommending that). Anti-depressants just make you able to get out of bed and function so that you can do the things that DO make you happy.

You can learn to be happy.
posted by desjardins at 6:24 PM on March 28, 2009

My experience- depression to me isn't a level of emotion, but how one reacts to it. I'd call it being emotionally burnt out, to the point that someone conditions themselves to no longer feel anything. Which makes them sad, but in a way that seems irreparable.

My crackpot theory- there are multiple kinds of depression. Depression of motivation, depression of mood, depression of will to live, etc. (By theory, I mean that I imagine that someday this is how depression will be viewed. It can't stand up to the scrutiny of current research.)

Treatment: yes, it's normal for some people to feel this way at some points in their lives. In the same way that getting the occasional cold is normal. Just because its normal to experience something doesn't necessarily mean it doesn't need to be treated. Whether to seek treatment, and what kind, depends on how it's affecting you- is it disruptive to your life? Are you missing out on things because of how you feel?

Choices- if it was me, I'd see a psychiatrist and explain how you are feeling and see if you and the doc can come up with a treatment plan. Perhaps your symptoms track with a chemical imbalance that can be treated with medication. Or maybe it's something that some sessions with a psychologist or therapist might help. My reasoning is that a psychiatrist is a "brain" doctor, where a psychologist is a "thoughts" doctor. Hardware versus software, if you will.

Good luck!
posted by gjc at 6:35 PM on March 28, 2009 [1 favorite]

Seconding some form of cognitive behaviour therapy to help you second-guess your dark thoughts. Otherwise, start with some reading. A friend found Alain de Botton's The Consolations of Philosophy helpful when she was experiencing similar feelings. I think it's a good read too - very approachable, sometimes funny, lots of 'aha' moments. Ditto his other book Status Anxiety.
posted by obiwanwasabi at 6:36 PM on March 28, 2009

You have some symptoms that can fall under the banner of "depression." As far as I can tell, depression is a set of symptoms listed in a big book with no single cause and no clear picture of how they come about or how to consistently correct them. If one were to classify you as depressed, it sounds like you would fall on the mild end of the spectrum. I wouldn't worry too much about whether you call it depression or not, or even whether or not it's normal, though. You have certain behaviors or feelings that you would like to change.

Pills might help; they help some people (worked well for me); often they have side-effects.

Therapy might help; it also helps some people; side-effects are minimal, but it requires far more time, effort, and money than pills.

Finding the right book with the right set of ideas or exercises for you might help.

Talk to a professional or two; see what they say.
posted by whatnotever at 6:37 PM on March 28, 2009 [1 favorite]

I (late thirties) have thoughts like yours from time to time. The difference is that I don't have them all the time, and they pass after a few hours, or at most a good night's sleep. If you're having them all the time, and are unable to find happiness in anything, then yes, I think professional treatment is warranted.

Whether psychotherapy, medication, or both are appropriate for you, I don't know. I will say that my experience with antidepressants, when I was depressed many years ago (admittedly more severe than what you're going through now) is somewhat different than desjardins's. While I'll agree antidepressants don't "make" you happy, they do (or did, for me) allow you to experience happiness in the sorts of things that usually make you happy, not merely give you the energy to get up and do stuff. On my better days when I was depressed I was able to do things which previously had made me happy, but before the antidepressants I found no pleasure in doing them.
posted by DevilsAdvocate at 6:43 PM on March 28, 2009

Can I recommend the book "Feeling Good" or "The Feeling Good Handbook" for, like, the third time this week? They are cognitive behavioral therapy books with exercises that you can work through to help change some of these thinking patterns that are making you unhappy. If the books don't do it but the ideas seem right, then you could seek out a therapist who does CBT...
posted by wyzewoman at 6:43 PM on March 28, 2009

For what it's worth...I don't think what you're describing is depression with a capital D and I don't think it can be addressed with medication. But I do think it should be addressed. My husband goes through periods like you're describing and he had a therapist label it as dysthymia, a mild form of depression that should respond well to CBT. I think you need a therapist who can, among other things, help you decide if you need a psychiatrist.

Good luck.
posted by orsonet at 8:46 PM on March 28, 2009

For what it's worth, I'll second that what you're describing sounds a whole lot like what I got diagnosed as chronic dysthymia. I did talk therapy for quite a few years and I can say without reservation that you can change the way you think substantially, feel better and accomplish more in life as a result, though I think people like us will never just be carefree, happy-go-lucky types.

I also tried drugs (paxil) and while I don't think it was without effect (most of all, when I was on it negative thoughts just didn't seem as persistent - it took a lot less effort to change the focus of my train of thought) it wasn't worse the side effects, the weird physical-feeling symptoms I'd get if I accidentally skipped a day or even just took it well off schedule, and there was an (again, mainly physical-sensation-like) withdrawal period after cessation that sucked pretty bad. If I had that to do again I'd skip it.

I don't think there's anything wrong with doing CBT exercises from a book like the one by the guy described above, but I do think extended talk therapy drilled pretty deep into some issues of why I think the way I do and sort of reprocessing my personal history in a way that led to some of the more lasting effects that I don't think you could ever get from just reading a book. A lot of people swear by that one though.
posted by nanojath at 9:36 PM on March 28, 2009

Is there a reason why you -shouldn't- seek professional help? From my experience, the first session with a therapist isn't one in which they screen you to see whether or not you "Have Depression" and are therefore there for a valid reason; rather, they'll want to know what brought you to them, and will go from there. Heck, I've shown up to therapists before and just said that "I feel like something isn't right with me; I feel sad but I don't know why," and they've been more than happy to work with me - and more importantly, after multiple sessions I've always ended up feeling like going to them was worth it. There's always SOMETHING that can be uncovered and confronted, even if you might not have a clinically diagnosable condition like depression.

What you described doesn't sound to me like something that everyone has and just has to bear; personally I would add my vote to those who think you ought to at least try therapy. Look at it this way - if they DO simply say that what you're experiencing is normal then you'll be no worse off than you are right now, so the worst-case scenario is that you'll end up in the same position you're already in ... but there's also the chance that they might be able to offer SOME form of help. Having a proper 'label' isn't as necessary as sometimes it might seem; you deserve to address what's wrong with you whether it has a name or not.
posted by DingoMutt at 9:49 PM on March 28, 2009

I just have a lot of crappy associative thoughts. When I see my wife helping my son, I start thinking about what a poor parent I am, what with me spending time on the Internet rather than helping him with his schoolwork. When I read about a classmate from college, I start comparing his success to my squandered potential. When I see a movie that is reminiscent of a former stage in my life, I start ruminating about past failures. It just seems to turn into a scenario where I beat myself up in my head.

You sound like a poster child for Cognitive Therapy - or, as I like to call it - an Attitude Adjustment. Yes, there is a science behind it, but you can also work on it yourself. Before you call in the big guns (a therapist) try making a Gratitude list. Learn to lose your resentments and see the good things that are happening in your life! Your description of your state of mind is telling - you compare yourself to everyone else in your life and see yourself wanting. Your wife helps out your child and all you see is your personal failure. This is self centered, self defeating talk. Appreciate your wife and congratulate yourself on landing such an awesome mate! Get out of your head and into the real world. It's not all about you, and you are no more or less of a failure than anyone else on this planet. Learn to see yourself and the world from outside yourself and your self-talk and you will be much happier.
posted by The Light Fantastic at 1:18 AM on March 29, 2009

Unhappy thoughts lead to depression. Essentially, you're in a Catch-22, creating your own depression and the chemicals that go with that (your pay-off) with the negativity. It's how you were conditioned as a child. This is most definitely a generational thing - passed down the family tree. The only way I know how to break the cycle is to begin a new way of thinking. It will be a new habit - it takes roughly 28 days to do this. You must stop the thought before it fully takes root - and this is best done with a *cancel*. You must be fully self-aware to do this - and mindful of your thoughts - as they filter through your mind. Whenever you find yourself thinking something *bad, negative, catastrophic, fearful, hateful* you stop in mind thought and say *CANCEL*. And repeat this throughout the day - just cancel. Also make a deal with yourself that every thought that is negative you will automatically switch it to a positive one - consciously.

So instead of the thought *that bitch is trying to control me*, you turn that around with a positive and say *no one can control me and I am grateful for that*. Always leave the thought *UP and HOPEFUL*. The depression will lift on its own. It is merely a mirror of your thoughts. This is not just positive thinking btw - it's transformational re-framing of thoughts and entrainment of the mind towards expansion, inclusiveness and connectedness.

Be well.
posted by watercarrier at 4:15 AM on March 29, 2009 [4 favorites]

This is actually my first sign of impending downward slide - the repetitive negative thoughts. In my case, they are absolutely chemical in nature. I can usually correct course by addressing diet/sleep/stress factors, and there's been a couple of occasions where they tipped me off to a problem with other medications (allergy, in one case), but if those didn't work and the symptoms persisted I would look to antidepressants for the next step.

It is absolutely beneficial to work on your responses to these thoughts, to stop beating yourself up, and CBT is great for that, but if the thoughts themselves persist you should investigate a two-pronged attack.

(First order of business should be a physical with bloodwork, if you haven't had one lately. Blood glucose, thyroid, and other endocrinological issues can also cause these symptoms, and you want to rule those out before you start adding chemicals to the mix.)
posted by Lyn Never at 6:15 AM on March 29, 2009

When I see my wife helping my son, I start thinking about what a poor parent I am, what with me spending time on the Internet rather than helping him with his schoolwork.

When this thought crosses your mind, what is it that stops you from getting off the Internet and helping him with his schoolwork? Are you physically unable too? Is it lazyness? Fatigue?

Next time this happens, force yourself off the computer and into your son's space, and be the dad you wish you were. Kinda like exercising - the very act of making yourself do it can bring about a change. Doing the right thing usually isn't effortless - it usually means not doing something else.

Now, maybe you're actually depressed and this kind of exercise isn't going to help. But as someone who has felt this way in the past (not with parenting, but with fitness), I sure would try every non-medicine approach I could first.
posted by jbickers at 8:07 AM on March 29, 2009

I disagree with jbickers. You should consider the thought, but don't assume that your failure to run over and help as well means you are doing the wrong thing. Instead consider what you really care about, what your wife really cares about, and what your son really cares about.

If they are perfectly happy in that moment, resolving the immediate need and still see you as a loving father, you should let your self-imposed guilt go. We are all human, and that means we have limits. It sounds to me like your challenge is mostly a combination of not be willing to accept your own limits and not being sure of what you really value enough to focus on. These are big existential questions.

You aren't going to find an overnight answer, but conversations will be part of the solution. This is up to you in the end, but it isn't something you solve by yourself in your head. Talk with your wife, your son, your friends. Get a therapist and talk with them as well.

Give yourself time to explore the question of what you really care about - what, in your personal definition, makes a meaningful life. Hint: if you keep coming back to something and claim you care about it but do nothing about that you need to ask for help. Either you need to ask for assistance to work on being more effective there, or you aren't being honest about what you really do care about and you need to let it go. Just don't let anyone else tell you what the answers should be, and don't make your own stumbles along the way into a personal moral failure.
posted by meinvt at 8:41 AM on March 29, 2009 [1 favorite]

I was worried that focusing on the problem in that way was just making matters worse.

Actually, a lot of research is showing that you're exactly right. A lot of the ways that we try to fix depression actually make it a lot worse. We try to pull ourselves out of it by kicking ourselves, which makes us feel bad for being depressed, which adds to it. We feel tired, so we cut our activities, which removes our outlets for stress and our social supports, which makes it worse. We feel vaguely guilty and think "well, I should feel guilty, I'm letting them down", and that makes it worse. We think "Why do I suck at this so much? Why can't I handle these little things?", which sound like questions with real answers, but they're just cleverly disguised self-hate that make us dwell on it even more.

I just have a lot of crappy associative thoughts. When I see my wife helping my son, I start thinking about what a poor parent I am, what with me spending time on the Internet rather than helping him with his schoolwork. When I read about a classmate from college, I start comparing his success to my squandered potential. When I see a movie that is reminiscent of a former stage in my life, I start ruminating about past failures. It just seems to turn into a scenario where I beat myself up in my head.

Sounds familiar! :) A lot of what I'm reading lately seems to say that these reactions are exactly what makes the difference between sadness and depression. There are lots of strategies for learning to react differently. E.g. to automatically think "Wow, I'm glad my wife is such a great mom. I'm gonna get off the Net and go hang out with my 2 favourite people!" instead of "Crap, she's a better parent than me. I suck." Or to think "Huh, his success bums me out a bit. I'm gonna acknowledge that and not let it take over my brain." instead of following it down into the black abyss of self-loathing.

I'm reading a book right now called The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness and it talks about this a lot. It combines mindfulness meditation with cognitive behavioural therapy to give you the tools to avoid those "fixes" that exacerbate the problem. You can preview it at Google Books. The first chapter talks about how we try to fix our own depression and how those strategies usually make it worse. They have two examples in the first chapter, and you'll probably identify more with Jim, who has chronic low-level depression. I haven't finished the book yet, so I can't really recommend it, but it's sounding awfully familiar so far.

The go-to book for cognitive behavioural therapy is, of course, Feeling Good, which you can find at practically any used bookstore. It teaches tools to help you recognise and get out of the usual thought patterns.

As for medication, we're finding that it helps pull you out of the darkest depths, but doesn't teach you how to stay out of the rut, so most people relapse. Apparently each relapse makes you 16% more likely to relapse again, since you learn thinking patterns that make you more prone to depression. The combination of mindfulness and CBT seems to help a lot of people break those patterns. I'm hoping it'll help me not need meds again in the future.
posted by heatherann at 11:29 AM on March 29, 2009 [1 favorite]

"And I don’t seem to get anywhere near as much pleasure as I used to from anything."

This is a key sign of depression. The pros call it "anhedonia."

Since you are able to get up and function each day, your condition is probably not severe. But one of the nasty things about depression (or dysthymia, which is more like mild, chronic depression) is that it tends to come back again and again, and if it's not treated, it gets worse. This sentence of yours is breaking my heart: "Having very mild depression has been a theme in my life, but I think it’s getting worse." Please, please take care of this. I am worried about you.

Like many of the responders here, I've been there. Here's what you can do:

Let me be the nth person to recommend "Feeling Good." The book deals specifically with the gloomy thoughts that are popping into your head and bringing you down, and it will give you practical advice for getting them under control. This is what cognitive behavioral therapy (CBT) is all about.

I understand your reluctance to work with a therapist after having had a previous experience that didn't seem to help. I saw a psychiatrist when I was 29, and she didn't help me much. If anything, talking about my problems seemed to make me feel worse. I didn't seek help again for 15 years, when my husband insisted that I get help. I wish I had done it sooner.

There are all kinds of therapists, and finding the right one for you can take some trial and error. CBT is really effective for many people, so IMHO, you should find a therapist trained in CBT. My first two therapists were not trained in CBT, but the third was. For me, it made a big difference. A good place to look for referrals is The National Association of Cognitive-Behavioral Therapists. These therapists are generally clinical psychologists and many don't take insurance. You say you are reasonably successful so you probably do have health insurance that will cover some of the expenses. You will probably have to pay out of pocket and your insurance will reimburse some part of the expense. (If you have a Flexible Spending Plan at work it can help with the remaining cost.) Do keep in mind that CBT is usually brief by therapy standards-- a matter of months.

Some people try medication first and then go to therapy when they are feeling better. Some people do it the other way around. I don't think there's any consensus about which should come first. In my own case, I was so down, it was better to do the medication first. I really couldn't focus. For you, I don't know. It's up to you. But you should do something.

If you are considering medication, see a psychiatrist. Any MD can prescribe antidepressants, but matching patients and drugs is what psychiatrists are good at. Even so, it takes a while for drugs to work and you may have to switch to find one that works well for you, so save yourself time and aggravation, and see a psychiatrist if you want medication.

Other things you can do: There is some scientific data supporting the benefits of regular exercise for people with depression, and as others have mentioned, mindfulness meditation may also be beneficial. A leading writer and researcher on mindfulness meditation is Jon Kabat-Zinn. He's been teaching meditation for many years to seriously ill people to help them deal with stress. I like his books "Wherever You Go, There You Are" and "Full Catastrophe Living." Another poster recommended his book "The Mindful Way Through Depression," which I haven't read. If you look on Amazon, he also has audio books that can guide you through the first steps of meditation.

Some posters here have recommended a physical. It's true that there are medical conditions that can mimic depression and dysthymia, and there are also medications that can cause depression as a side effect. But--and this is my opinion and IANAD--that should not be your first step.

One of depression's cruel tricks is that it can make you so unmotivated that it's hard to do what you need to do. So please, before it gets any worse, call a psychiatrist or find a therapist and tell them exactly what you posted here. In fact, why don't you do this first thing Monday morning? Please don't put it off.

You posted your question because you are concerned and I think your concern is justified. For your own sake and for the happiness of your wife and children, please get help.

I am sending you a huge hug.
posted by FoHockney at 8:34 PM on March 29, 2009 [1 favorite]

From what you've described, it sounds like you might have mild depression. I felt the same way years ago and didn't think I was depressed, but then it got worse. I agree with everyone else saying you should just see a doctor and find out just what is wrong. Whatever steps you can take now can only help you.

I, personally, went on medication and one day realized that I hadn't had those dark thoughts in a while, and when I did have them, I didn't feel so bad about them and could easily push them from my mind. YMMV. I'm starting to have those thoughts and feelings again and now I'm talking with my doctor about what I can do to manage them on my current treatment plan. I'm starting by taking supplements my doctor recommended before I try any prescription drugs. The other suggestions here are really good and you should explore the options after you see a doctor. The main point is, life isn't always like this and you can make it better. Good Luck! :)
posted by CoralAmber at 1:39 PM on March 31, 2009