Many people occasionally experience times of sadness, lethargy or loss of interest in everyday life. Major depression differs from normal sadness in that it lasts at least two weeks, impairs everyday functioning or causes severe distress, to the point that some people commit suicide to alleviate the pain. Aside from the emotional suffering depression inflicts on sufferers and their loved ones, the disease has widespread negative impacts on the U.S. economy. In May 2006, the Depression and Bipolar Support Alliance reported depression causes around $70 billion in medical expenditures, lost productivity and other costs to U.S. businesses annually.
Cognitive Problems
Problems with thinking trouble many people who suffer from depression. From simple forgetfulness to inability to remember how to cook a meal involving several steps, the range of cognitive deficits in depression span the gamut. In his 1990 autobiography "Darkness Visible," acclaimed writer William Styron describes the impaired thinking he experienced in severe depression, writing about how his thoughts slowed to a crawl. Usually a verbose communicator, when depressed, Styron spoke only in response to questions and in a word and a whisper. Common cognitive difficulties in mild to moderate depression include impairments in concentration, creativity, memory, decision-making and processing speed.
Depressive Stupor
In extreme depression, depressive stupor can occur. A person in this state, entirely unresponsive, rocks back and forth, urinates or defecates on herself and mutters incoherently.
Depressed Mood and Anhedonia
Almost always present to some degree in depression, a sad, hopeless, discouraged mood and anhedonia--the inability to experience pleasure--exact a great toll on people with depression and their loved ones. The 2000 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides a thorough explanation of the loss of pleasure occurring in depression: A person experiencing anhedonia often withdraws socially and neglects or has less interest in sex, hobbies and other activities he formerly found pleasurable.
Physical Problems
Often seen in more severe and biologically based depressions, physical problems may significantly impair depressed individuals. In middle insomnia, the most common form of sleep disturbance associated with depression, the person can fall asleep initially but then wakes up in the middle of the night, unable to fall back to sleep. Many people experience loss of, or decreased, libido and appetite. Constant tiredness, fatigue and loss of energy also pervade the picture. To a severely depressed individual even the smallest of tasks, such as taking a shower, require substantial effort, and if accomplished, may be done less efficiently or slower than usual.
References
- Depression and Bipolar Support Alliance: Statistics on Depression
- "Darkness Visible: A Memoir of Madness"; William Styron; 1990
- "Diagnostic and Statistic Manual of Mental Disorders: Fourth Edition"; American Psychiatric Association; 2000
