Within the past couple of weeks someone asked if one could function normally and have severe depression. I responded with an emphatic “No!” There is no way one can go about his/her day without “a change from previous functioning” if they have a major depressive disorder. Even a person with dysthymia or a mild-to-moderate depressive disorder will have some impairment. However, severe depression is in a different league all together. In no way am I trying to minimize depression in whatever form it may take, but by definition severe depression severely interrupts one’s routine. According to the Diagnostic Criteria from the DSM, severe depression is marked by “several symptoms in excess of those required to make the diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others.” In order to meet the criteria of a major depression diagnosis, one must have at least five of the nine symptoms for a minimum of two weeks and have a change from previous functioning. Severe depression requires eight or all nine symptoms to be present. A depressive disorder is not to be equated with sadness, grief, or a “terrible, horrible, no good, very bad day.”
Four years ago this month I wrote the following attempt at a poem.
Ode to Despair
What can you say when there are no words to express The pain, the sadness, and the foreboding hopelessness. Statements, remarks, and speeches reverberate like a round That goes on and on without end in meaningless sound.
“Due despair and agony on me, deep dark depression, Excessive misery,” is an all too common sad expression For the weary and worn who go through life damaged, Hidden, misunderstood, in anguish, wounds un-bandaged.
“Who can deliver me from this body of death?” I shout, But only an echo returns with scorns and mocks all about. “There is no help for him in God,” I hear as trouble multiplies, Gloomy and cheerless, I want not to live and am afraid to die.
“It is enough! Now LORD, take my life,” I earnestly pray. “What are you doing here?” the LORD whispers in the fray. “Forsaken, torn down, killed all the day through,” I reply. GOD listens with compassion HIS grace ready to supply.
Strong winds tear at mountains and break rocks into slivers. Earthquakes alter the contour of the land and courses of rivers. Fire purges the grass from the field and fells the trees. But, the LORD passes by gently and speaks to my needs.
As you can infer, I was severely depressed. As a Christian I could not end the poem in absolute despair, so I included a stanza of hope. To be truthful, it was not how I felt at the time. Death, I thought, would be a relief.
I had all the symptoms – depressed mood, diminished interest in activities, weight gain, hypersomnia, psychomotor agitation, fatigue, diminished ability to concentrate, and recurrent thoughts of death with suicidal ideations – of a major depressive disorder. To put it succinctly, I was a mess. Depression had been hounding me for a year as I spiraled downward into a bottomless free-fall. And, for the next eighteen months I trudged through a morass of thick, endless darkness with no hope of escape. Normal functioning? That was an unknown cloud in cuckoo-land. Severe depression destroyed everything I spent my life building and it very nearly destroyed me, too.
Thank the good LORD I have been in partial remission for over two years. Although I have accepted the fact that I will never be “normal” again, I find that life is well worth living. I have hope, fulfillment, happiness, and contentment. If you can function normally, thank God, address whatever is troubling you, and march on toward health and wholeness. On the other hand, if you are falling and cannot seem to right yourself, there is hope. Reach out to a professional who will help you begin to heal.
The peace, mercy, and grace of our LORD be with you. Amen!
*image from 123RF.com