| Are You Stressed, or Depressed?
By Becki A. Hein, MS, LPC
"How are you?” It’s a question we ask as we greet one another. “Fine.”, we answer, almost automatically. But is
that the truth? How are you, really? Are you exhausted, yet unable to sleep or do you sleep too much? Is it hard for
you to focus or make decisions? Maybe you feel sad and on the verge of tears much of the time. Do you head back to
bed after taking the kids to school and wake up later, just in time to get dressed and give the impression you’ve been up
all day? We all have our ups and downs in life, but if you find yourself feeling “down” and unable to function for weeks
or months at a time, you could be suffering from a common, serious illness – clinical depression. According to the
National Institute of Mental Health, more than 19 million people in the United States – 1 in 10 adults – experience
depression each year.
Chances are that at some time in your life you have experienced some depressive symptoms. With the loss of a loved
one, you may feel sadness, helplessness, or a disinterest in regular activities. Living with the stress of heavy workloads,
potential layoffs, or financial or family problems may cause you to feel irritable or to get the “blues”. It is when these
feelings increase in duration and intensity and you are unable to get through the day that what seemed to be a
temporary mood may have become a clinical illness. If you are depressed, you may have some of these symptoms
nearly every day, all day, for two weeks or longer:
• Feeling sad, anxious, irritable, or “empty”, or crying a lot
• Losing interest or pleasure in activities you used to enjoy, including sex
• Feeling guilty, worthless, helpless, or hopeless
• Sleeping too much, or not being able to fall asleep or stay asleep
• Losing your appetite and losing weight or eating too much and gaining weight
• Feeling very tired or slowed down
• Thinking about death or suicide
• Having trouble paying attention and making decisions
• Having aches and pains that don’t get better with treatment
If you are a woman, your risk for depression is higher. In fact, women are twice as likely as men to experience
depression. Female bodies are constantly adjusting to changes in the levels of estrogen, progesterone, and other
hormones during the menstrual cycle. This fluctuation can disrupt the function of brain chemicals that control mood,
such as serotonin. During pregnancy, dramatic hormonal changes can affect your mood and in some cases may trigger
depression. Issues such as infertility, miscarriage or an unwanted pregnancy can also lead to depression. You may
have been one of the nearly fifty percent of new mothers who feel sad, angry, tearful, and irritable following the birth of
your baby. These feelings usually subside within a week or two, but occasionally linger. If they become severe and you
become unable to care for your baby, or if you have thoughts of harming your baby, feelings of anxiety, agitation or
thoughts or suicide, you may have postpartum depression. Perimenopause and menopause are times when estrogen
levels are significantly reduced, resulting in increased risk of depression. If your sleep is disrupted by menopausal
symptoms, or if you have had a hysterectomy with the removal of your ovaries, or you have a history of depression, you
are particularly vulnerable.
Certain social and cultural stressors also contribute to the higher rate of depression in women. Women tend to bear
the burden of both work and family responsibilities. You may be dealing with the challenges of single parenting, caring
for young children and/or sick and older family members. Unfortunately, women still generally earn less money than
men do and so you may be struggling financially and have less access to community and health care resources. Racial
discrimination is also a real, ongoing stress for many women. The feelings of passivity, negativity and lack of self-
esteem which can result from these issues can increase your risk of depression. Studies also show that if you were
emotionally, physically, or sexually abused as a child, you have a higher risk of depression in adulthood.
The good news is that depression can be highly treatable. Symptoms can be alleviated in over 80 percent of cases. In
fact, it is the misconceptions and beliefs about depression which are the major blocks to relieving symptoms. A survey
conducted by Mental Health America revealed that more than one-half of women believe depression is a “normal part of
aging” and that denial, embarrassment, or shame keeps them from getting treatment. Believing that their depression is
“incurable” often contributes to the hopelessness that holds people back from seeking help.
Depression can be treated with counseling, medicine, or both. It is important to see your doctor first, to rule out any
physical illnesses that may cause depressive symptoms. Your doctor may recommend medication and/or counseling.
Counseling or a combination of counseling and medication has been shown to be the most effective in relieving
depression. Much of the distress you feel when you are depressed is caused by negative thought patterns and beliefs,
and a good therapist can help you discover and change the thought patterns, beliefs, and behaviors that are keeping
you from a happy peaceful life. You can also follow these suggestions to help you when you are depressed:
• Set small, achievable goals for yourself. You will feel encouraged as you complete them.
• Eat balanced meals and healthy food.
• Exercise every day to make yourself feel better and to get more energy.
• Start a journal in which you write every night about the things for which you are thankful, even if they are very
small things at first.
• Reach out for contact; stay in touch with loved ones and friends.
• Get as much information as you can about depression and its treatment.
• Take your medicine and/or go to counseling. Your medicine won’t work if you only take it once in a while and
consistent help and support from your therapist will help you to change your thinking and your mood.
• Learn to recognize and change negative thinking.
• Be patient with yourself, don’t give up.
• Don’t make major life decisions (for example about separation or divorce). You may not be thinking clearly right
• Call your doctor or the local suicide crisis center right away if you start thinking about suicide.
• Believe that there is hope and that you CAN feel better.
Many people chalk up their low energy, sadness, irritability, or exhaustion to stress and believe that it is “normal” or
“inevitable”. The truth is, if you are experiencing these symptoms, you may have developed clinical depression. The
hardest part is taking that first step and reaching out for help. Once you do, you can become part of the eighty percent
of people who feel significantly better with treatment. You can become someone who answers the question “How are
you?” with “Fine!” and you will really mean it!
This article was first published in McKinneyWoman.com magazine.
Becki A. Hein, MS, LPC is a counselor in Allen, TX. For more information, see her website at www.rheincounseling.com.
© 2007 Becki A. Hein