Part of my work as a therapist is exploring with clients the very nature of their emotional experiences – learning about their emotions and being able to identify and put a name to the ones that come and go. In the realm of emotions, sadness and depression are two terms often used interchangeably. But understanding that these two human experiences are different, and how so, is crucial for both those experiencing them, and for the ones supporting them through it. Let’s take a look at how these two experiences differ.
Emotions have many purposes including giving context to our experiences in life and alerting us to things in our inner landscape that need our attention, to things that might need to be processed. Sadness is a natural response to various life experiences and challenges; it is a transient state that arises in response to specific events or circumstances, i.e., loss, disappointments, setbacks. Sadness is a normal and healthy part of the human experience, serving as a signal that something meaningful has been disrupted or lost.
Sadness is often accompanied by a range of emotional and physical experiences; it often walks closely with grief or sorrow. However, as all emotions are, sadness is time-limited and typically resolves as the individual is able to process and adapt to the triggering circumstance or event.
Depression, on the other hand, is a more complex, pervasive mental health condition that encompasses symptoms beyond mood. Unlike sadness, depression is not always linked to a specific event or circumstance (although an event can certainly precede the onset of depression), and it often persists for an extended period of time, even after a related event is resolved. It represents a disturbance in mood and normal, global functioning that extends beyond what would be considered a typical emotional response or experience.
While sadness is often linked or used interchangeably with depression as a term, it is important to note that depression does not even always look like sadness. Depression can look and feel like anger, or irritability; it can also present as an emotional numbness, a lack of emotion. It's becoming more common knowledge now that from the outside looking in, depression can often be masked - outwardly, people who experience depression often can be very skilled at putting on a happy face. It is a very subjective state, one that can be influenced by different factors such as gender (men are more likely to experience anger or irritability within depression than women) as well as cultural factors and whether or not certain emotions are culturally acceptable to feel or express.
Depression is a clinical diagnosis characterized by a persistent and pervasive disturbance in mood, loss of interest or pleasure in previously enjoyed activities, changes in appetite and/or weight, sleep disturbance, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating and in severe cases, persistent thoughts of death. One key distinction between sadness and depression lies in their duration and intensity. Sadness is generally time-limited and proportional to the event or circumstance that triggered it – a natural and adaptive response to life’s inevitable ups and downs. In contrast, depression persists for weeks, months or even years, particularly without adequate treatment, and it is more of a pervasive, global decrease in overall functioning. An individual experiencing depression may see impacts in all areas of their life – in their physical health, relationships, job performance and ability to remain engaged with the outside world.
Root Causes
As stated, sadness typically has an identifiable root cause. But depression may have multiple and more complex causes. While it can be triggered by life events such as trauma, loss, or chronic stress, it is influenced by biological, genetic and environmental factors. Imbalances or deficiencies in specific neurotransmitters in the nervous system, such as serotonin and dopamine, are believed to play a critical role in the development of depression. Pervasive negative thought patterns is one of the things we can most successfully tackle in therapy through approaches like Cognitive Behavioral Therapy - how we think effects how we feel and how we behave and engage in and with the world around us. If we can work on identifying the thoughts that are not serving us well, research shows us we can have a significant impact on how we're feeling. Additionally, a family history of depression, a personal history of trauma, and certain medical conditions can all contribute to an individual’s susceptibility to depression.
Cognitive Patterns
The close relationship our thoughts have with our emotions provides another lens through which we can differentiate between sadness and depression. Sadness often involves specific thoughts related to the event or circumstance that triggered the emotion. Individuals may ruminate on the loss or disappointment, reflecting on what went wrong and how it has affected them.
Depression often entails pervasive, repetitive negative thought patterns about oneself, the world, and their future. This cognitive pattern is commonly referred to as the “negative cognitive triad”, where individuals consistently hold negative beliefs about themselves, interpret the world through a negative lens, and anticipate a bleak future. All of our thoughts influence our emotions as well as our behaviors and getting stuck in a negative thought pattern can have significant consequences on how one feels and in their behaviors and the ways in which they show up in the world. These distorted thought patterns contribute to the persistence and severity of depressive symptoms.
Physical and Emotional Symptoms
Both sadness and depression involve a range of physical, emotional and cognitive symptoms, but the depth and duration for both differ. Sadness may lead to a temporary loss of appetite, difficulty sleeping, and a general sense of malaise. Emotional responses may include tearfulness, a subdued mood, and a sense of longing.
With depression, we often see a manifestation of more pervasive and persistent symptoms. Changes in appetite and weight, disrupted sleep patterns, fatigue, and a persistent low mood are common physical symptoms. Emotionally, individuals with depression may experience a profound sense of emptiness, hopelessness (as well as other emotions such as irritability or anger), and a loss of interest in activities they once enjoyed. The emotional numbness that can accompany depression further distinguishes it from the more acute and time-limited nature of sadness.
The impact of sadness and depression on social and interpersonal functioning also sets them apart. Sadness, being a normal and adaptive response, often elicits empathy and support from friends and family. Social connections and support systems play a crucial role in helping individuals navigate through the challenges that trigger sadness. However, depression can strain social relationships and isolate individuals. Loved ones can become exacerbated by the chronic nature of the individual’s depression and the persistent low mood, low energy, irritability and changes in behaviors associated with depression may lead the individual to withdraw from social interactions. The social isolation can exacerbate the symptoms of depression, creating a cycle that further deepens the sense of despair.
Seeking Help and Treatment
Recognizing the differences between sadness and depression is essential for seeking appropriate help and support. While sadness can benefit from the passage of time, support from loved ones and coping strategies for managing specific stressors, it’s never a bad idea to seek help to address the disturbance in your life that has led to the sadness and to process that emotion. Depression can often require more targeted interventions. Therapeutic approaches, such as cognitive-behavioral therapy (CBT), interpersonal therapy, and medication such as antidepressants are commonly used in the treatment of depression. It is important to note that seeking professional help is not a sign of weakness but a proactive step toward regaining emotional well-being.
As we navigate the depths of our emotions, it’s essential to recognize when the hues of sadness transform into the more encompassing shades of depression. By acknowledging these differences, we can collectively work to reduce the stigma surrounding mental health, promote open conversations, and create a supportive environment where individuals feel empowered to seek help when needed. I enjoy working with anyone that is struggling with depression, however that feels to them. There is hope and there are things that we know help when we implement them - improving our thought patterns and our behaviors as well as increasing our support system. In particular, I enjoy providing therapy for infertility and therapy for first responders – two populations that can be more susceptible to these experiences. Please feel free to reach out today to learn more about what starting therapy with me looks like – I offer a free 15-minute consultation so you can determine if I feel like a good fit for you! This is a second part in a "This or That" series I am writing about to help build understanding between adaptive emotional experiences and how they differ from more significant clinical experiences warranting more attention in therapy. To read about the when to seek therapy for anxiety that has grown beyond "worry", see my blog post here.
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