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The Difference Between 'Clinical' and 'Situational' Depression

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When my doctor upped my antidepressant per my request last month, within a few days, I started feeling completely numb and icky. I emailed him and said I was going back down to my regular 150 mg. He replied and said, “Peachy!”

Not really, he just said OK.

There are two distinct kinds of depression I’ve learned about from my experience — clinical and situational. It’s not that simple for me to separate the two. As I’ve grown older, I have found that each share some basic characteristics.

  • I cry often and without much provocation.
  • I am more anxious than normal (ha!) and my compulsions/obsessions are more prominently seen by others and interfere with my daily life.
  • I lose interest in beloved activities like writing, reading and listening to music that isn’t thoroughly gloomy.
  • I’ll start to have suicidal thoughts.
  • My appetite disappears.

But when my medication(s) aren’t working properly for whatever reason, there are a few major symptoms missing from the above list.

  • I feel haunted. Doomed.
  • I watch the pulse in my wrist with disdain.
  • I dream of demonic beasts that hunt me for the sheer thrill of it, just to watch me shriek in terror.
  • Nothing ever feels right or seems to have any real meaning.
  • I cannot function properly or at all.
  • My sense of humor evaporates, and I can’t crack a funny for anything.
  • I can’t pull myself out of it and neither can anyone assist me in doing so.

That is when I know I need medication intervention ASAP. But right now, my mental health is primarily tenacious and 79 percent situational. (Give or take, I’m not into math.)

My present suffering is personal, it has reasons, it’s palpable. It makes sense to me, which is something that reaffirms I am not in any real harm to myself, unless someone decides that wine causes deep forehead wrinkles.

Clinical depression doesn’t care if holding your dog at 1 a.m. while you sob in bed for the lost years you’re never going to get back, brings you true comfort.

Clinical depression doesn’t allow you to laugh your ass off at a joke a friend tells you with the hope of cheering you up. Clinical depression doesn’t ebb and flow like the ocean tide, as situational depression does, but it will adhere to you like barnacles on the bottom of a fishing vessel.

At this precise moment in time, I have the strength to yank the salty suckers off of myself before they can maintain the upper hand. Regardless of my arduous past, I shall persist.

Unsplash photo via Matheus Ferrero

Originally published: November 3, 2018
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