Depression, it ain't no joke!

"When you're weary, feeling small,
When tears are in your eyes, I will dry them all" - Paul Simon, Bridge Over Troubled Wate

Hello Everyone!

Today's gonna be a beautiful day! I can feel it in my bones. I know it's Sunday and the weekend's almost over, but Carpe Diem folks! Enjoy what you've got left of the time you have.

This blog is about depression and how it shows up differently in everyone. It's a tricky thing and can be a real pain and a challenge to my day, but it hasn't beaten me yet. Let's take a look:

Depression is a complex medical illness that alters how you feel, think, and handle daily activities. While a "depressed mood" or "loss of interest" are core features, it is highly individualized. Depression manifests differently across ages, genders, and biological subtypes, making its outward appearance unique for each person. [1, 2, 3] 

Depression can vary widely from person to person through several key factors: [1, 2]

1. By Biological Subtype:

• Melancholic Depression: Classic presentation featuring severe loss of pleasure, feeling worse in the morning, waking up early, significant weight loss, and intense, unyielding guilt. [1, 2, 3, 4, 5]

• Atypical Depression: Often has "reversed" vegetative symptoms. Instead of insomnia and loss of appetite, individuals experience excessive sleepiness (hypersomnia), overeating, and a heavy feeling in their arms or legs (leaden paralysis). Their mood can temporarily brighten if a positive event occurs. [1, 2]

• Persistent Depressive Disorder (Dysthymia): A milder but chronic form of depression that can last for years. [1, 2, 3, 4]

2. By Age:

• Children: May manifest as refusal to go to school, clinginess, vague physical aches, and extreme irritability rather than sadness. [1]

• Teens: Often presents as behavioral changes, including poor school performance, anger, self-harm, sensitivity to being misunderstood, and the use of drugs or alcohol. [1]

• Older Adults: Depression is not a normal part of aging, but it is often missed because symptoms are less obvious. It frequently manifests as memory problems, personality changes, or physical, unexplained complaints. [1, 2, 3]

3. By Gender:

• Women: Have higher rates of depression and tend to show classic emotional signs like tearfulness, persistent sadness, excessive guilt, and sleep or appetite disturbances. [1, 2]

• Men: Are often socialized to mask their emotions, leading depression to manifest as anger, irritability, aggression, risk-taking behaviors, and increased reliance on alcohol or drugs. [1, 2, 3, 4]

4. Physical and Behavioral Variations:

Depression is far more than an emotional struggle; the mind and body are deeply connected. [1, 2, 3, 4]

• Physical: Chronic pain, digestive issues, or headaches that do not improve with traditional treatments. Some people experience slowed movement and speech.

• Cognitive: Brain fog, inability to make decisions, and severe concentration difficulties.

• Behavioral: Some individuals suffer from "high-functioning" depression. They go to work, attend school, and meet responsibilities, but endure intense, internalized emotional pain and fatigue. [1, 2, 3, 4, 5]

Because depression presents uniquely in everyone, there is no single "right" way to experience it. If you or someone you know is experiencing persistent symptoms for more than two weeks, professional support is vital. To learn more or to explore available resources, visit the National Institute of Mental Health. [1, 2, 3, 4, 5]

It develops through a complex interplay of genetic, biological, environmental, and psychological factors. Rather than a simple brain chemical imbalance, it typically stems from a combination of family history, life stressors, and unhelpful cognitive habits that become a vicious cycle. [1, 2, 3]

Development of Depression:

• Biological & Genetic: Variations in genes can predispose someone to the disorder. Physical factors, such as hormonal shifts, faulty mood regulation by the brain, or chronic illness, alter how the nervous system processes emotions. [1, 2, 3, 4]
• Psychological: Learned thought patterns—such as "discounting the positive" (brushing off good things) or dwelling on perceived failures—shape a person’s view of the world and can drive depressive symptoms. [1, 2]
• Environmental: Acute trauma, chronic stress (like financial hardship), or a lack of social support can trigger these underlying biological and psychological vulnerabilities. [1, 2]

Reputable Resources:

In Print:

• The Feeling Good Handbook by Dr. David Burns – A classic, highly practical guide to recognizing negative thinking and applying Cognitive Behavioral Therapy (CBT) principles. [1]
• The Upward Spiral by Dr. Alex Korb – Explains the neuroscience behind depression and offers small, actionable steps to alter brain chemistry. [1, 2, 3]

Online:

• National Institute of Mental Health (NIMH) – Offers evidence-based guides on depression types, symptoms, and clinical research.

• Anxiety and Depression Association of America (ADAA) – Provides educational resources, expert-led webinars, and up-to-date treatment strategies. [1, 2, 3, 4, 5]

Audio:

• The Happiness Lab – Hosted by Yale professor Dr. Laurie Santos, this podcast explores the science-based tactics for managing negative emotions and improving overall well-being. [1]
• The SelfWork Podcast – Hosted by Dr. Margaret Rutherford, this series discusses the various faces of depression and offers practical, stigma-free advice. [1, 2]

Connecting with a Therapist In-Person & Virtual:

• Psychology Today: You can use the Psychology Today Directory to find local or virtual therapists. Filter your search by zip code, accepted insurance, gender, and specific therapy approaches like CBT. [1, 2]
• Open Path Collective: If you are uninsured or underinsured, the Open Path Psychotherapy Collective is a non-profit network that provides heavily discounted in-person and online therapy sessions. [1]
• Virtual Care: Studies show that seeing a therapist virtually is just as effective for treating depression as face-to-face care. When using directories, simply toggle the "Online Counseling" filter to view providers licensed in your state. [1, 2, 3, 4]
• 

• For Kids:

• For pediatric mental health therapy with both in-office and virtual options, families can turn to flexible, hybrid national networks or specialized regional providers. Providers like Brightline or Little Otter offer robust virtual care and in-person clinics that remove geographic barriers for kids and teens. [1, 2, 3, 4]
• National Virtual & Hybrid Platforms:
• If you need immediate or flexible scheduling, these services provide licensed child therapists and psychiatrists directly to your home: [1, 2]

• Little Otter: Highly rated for young children and toddlers, offering parent training, medication management, and custom care teams entirely via telehealth. [1, 2, 3, 4]
• Brightline: Features a hybrid approach with both virtual sessions and select physical clinics (including locations in NY) for therapy, psychiatry, and psychological testing.
• Amwell: An ideal choice for families taking insurance, providing child and family therapy starting at age 10. [1]
• Emora Health: Combines youth-centered therapy with diagnostic testing and medication management in 100% online, HIPAA-compliant sessions. [1]

• 
• How to Start

1. Check Your Coverage: Verify your in-network benefits. Many platforms, like Grow Therapy, accept a massive variety of commercial insurance plans. [1]
2. Determine Modality: Research shows that treatments like CBT (Cognitive Behavioral Therapy) are just as effective online as in the office. However, younger children may benefit more from physical, in-office play therapy. [1, 2, 3]
3. Parental Consent: For virtual visits, parents or legal guardians must create the account, schedule the appointments, and be available for the initial intake consent. [1, 2]

If your child is experiencing a mental health crisis, immediate help is available. Contact the 988 Suicide & Crisis Lifeline by calling or texting 988, or text HOME to 741741 to connect with the Crisis Text Line.

Here's my perspective:

I was diagnosed with bipolar disorder 2 and generalized anxiety disorder (GAD) in my late 40s. It was a relief and also devastating. I was relieved because I finally understood why I'd been feeling and acting that way for so long. But it was devastating because I couldn't ignore it anymore.

Anyway, I had so many different diagnoses over the years, from my teens through my 40s. The professionals kept changing their minds, going between Double Depression, Dysthymic disorder rapid cycler, bipolar type 2 disorder with rapid cycling, and ADHD. They changed my diagnosis so often, it made my head spin.

Unfortunately, it gave me an excuse to keep behaving badly in my 20s and 30s. I took a lot of different medications for a long time. Almost none of them really helped even out my mood, stop my depression, or stabilize my hypomania even a little. I was a mess and had no idea how to fix it.

I was in the hospital twice in a row, first for suicidal thoughts and then for sorting out my meds. Honestly, it was a total waste of time because I was so emotional and just not thinking straight or being responsible.

That changed when I hit my late 40s and found this amazing psychiatrist. I was a bit hesitant to agree with his diagnosis since I'd been labeled so many times before. But he was spot on, and the medication he gave me worked wonders (and still does!).

He saw the real problem under all the drama and disorganization, and the low level of real functioning. What I liked about this doctor is that he explained why I behaved the way I did, why my emotional well-being was like it was, and why the other diagnoses were wrong, but understandable.

My life got better after that. I went to even more therapy, but this time I actually paid attention and did my research on my diagnoses, their characteristics, and how to manage them. It was a lot of work, but you know what they say: knowledge is power. So, slowly, my life started to get better. I learned a lot of wellness techniques and methods that helped me live a more substantial life.

So there you have it. Some useful information and a little about my struggles with mental illness.  If you care to share, I'm all ears(eyes!). Email me and we can talk. I'd love to hear from you.

Tina

My quote for you:

"Keep searching for the colors when everything turns grey." – Christy Ann Martine

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