Depression is not Sadness
Updated: Nov 8, 2020
[Originally written in 2017; updated in 2020]
Ever noticed that an unexpectedly high number of comedians suffer from depression? Robin Williams is an obvious one due to his tragic death in 2014, but others include (limiting the list to those I remember seeing on TV): Stephen Fry, Jack Dee, Sarah Silverman, Jim Carrey, and Owen Wilson. I, myself, have been described by a friend as "the happiest depressed person I've met" because I was laughing and joking through the tears; the contradiction for this friend was underpinned by a presumption that to be humorous is to be happy, and that to be depressed is to be sad.
This is an anecdotal observation, of course, but it's an observation striking enough to spark formal study into the contradictory association between comedy and depression. It has since been given a name: The Sad Clown Paradox, referring to the use of light-hearted humour in professional settings, despite inner turmoil.
And even non-comedians can have what is sometimes referred to as “smiling depression”, where they appear happy to others at the same time as suffering many of the symptoms of major depressive disorder.
In the face of these facts, people with clinical depression are most often depicted as inconsolably sad and uncontrollably tearful.
When I’m open about managing depression with a combination of medication, therapy, and self-care, there’s always someone who says something along the lines of “you shouldn’t be relying on medication” or “you should stop hiding from the problem”, the assumption being that I should be able to cope with all the normal life events that they assume are making me sad. Much of the time, as far as they can see, there’s nothing for me to be sad about.
The thing is, though, depression isn’t sadness.
Sure, depression can involve sadness, but depression and sadness are not synonymous. Sadness can be anything from a normal reaction to an event, to a generalised symptom (rather than defining characteristic) of depression, or perhaps a recurring over-reaction to situations due to the depression.
Depression and sadness are related but essentially separate concepts. Let me try clarifying the difference in a more structured way:
What is sadness?
Sadness is a passing emotion. It is something you feel, like happiness, anger, or fear. Sadness takes many forms and can vary in intensity, but it typically arises in response to a situation or experience. I feel sad when I upset a friend, or when someone says something mean to me, or when I didn’t get the job I hoped I would. When these things change or when I adjust to the situation, my sadness subsides.
What is depression?
Depression is a disorder. It is an abnormal emotional state that affects how you think, perceive, and behave in the long-term. Unlike sadness, depression, being an illness, is chronic: it typically persists and resurfaces throughout a person’s lifetime. It tends to run in families and often starts in a person's adolescence or early twenties, haunting a person regardless of the situation.
This is not to say that depression cannot have external causes. As well as being inherited and/or brought on by upbringing, depression can arise following a traumatic or stressful event, such as the end of a relationship, a death, a medical illness, or losing a job.
For some people, specific losses such as these can trigger more than sadness, sparking a depressive episode – a period of time (more than two weeks) characterised by the symptoms of depressive disorder (commonly shortened to 'depression'), that may or may not persist for longer (turning into clinical depression). Such triggers are typically some sort of serious loss, and the response may be better described as grief.
An episode will typically dissipate over time, when the loss becomes less profound or when something takes its place. It is possible, however, for normal grief, characterised by a depressive episode, to evolve into depressive disorder. [This happened to me at the beginning of 2019.]
Sadness is a common but not a necessary symptom of depression.
Depression can instead (or additionally) be characterised by feeling numb, having blunted emotional responses, and/or having a lack of pleasure in previously enjoyable activities. Depression also often involves a sense of helplessness, hopelessness, worthlessness, and guilt, which may or may not trigger sadness.
It can also be characterised by distorted thinking, extreme fatigue, difficulty concentrating and making decisions, headaches, sadness at particular points in the day, and insomnia or over-sleeping.
My experience and distinction:
Though persistent crying and feeling sad are clear symptoms of depression (for me at least), I'm more likely to describe it in terms of feeling hopeless and worthless, and in terms of the effort that seems to be required for the simplest things.
For me, depression is the swim against the current. In the water, you have two choices: keep swimming or drown. Every day that I don’t drown is a decision to keep swimming.
In its milder form, depression can hasten a breakdown and slow down my ability to bounce back. In its severe form, even talking about happy things couldn't be done without crying because it took effort not to cry. When the effort had to be diverted to forming sentences, regardless of the topic, the water gates opened.
And these tears are different from those I experience in sadness.
Crying in sadness tends to give me more relief than crying in depression; negative emotion can feel as though it is leaving my body through tears of sadness, but crying with depression seems to push me deeper into the darkness. I also often find that the things that make me smile when I’m not depressed are the same things that make me cry when I am. The non-depressed mind sees a happy child and feels happy too; the depressed mind sees a happy child and cries at the innocence of it.
If I'm forced to summarise: normal sadness is an experience you have, and is temporary; depression is something that has you. It is something separate from you that threatens to consume you, like the turbulent water you are trying to keep your head above.
Equating depression to sadness minimises both experiences -- giving people the sense that depression should pass quickly and making sadness seem like a self-indulgence. "You’re not trying hard enough. You’re selfish. You’re playing the victim. Etc." These are sentiments that only make things worse. At the risk of spelling out the obvious, no one wants to be sad or depressed.
I now see having experienced depression as good for being able to recognise sadness for what it is. When bad things happen, it is easier for me to tell myself that these emotions might be intense, but they have a cause, they are normal, and they will pass.
I also find that it is important for longer-term management of depression to keep this distinction between the illness and the person. When we see depression as something separate from ourselves, we are better able to tackle it, even if it will always be there in one form or another. Regardless of the symptoms, we have an underlying character -- our own knowledge, abilities, and experiences that are unique to each of us.
Who you are shines out from within, even if some onlookers can’t get past the “depression” label.