What Is Depression, Really? Separating Everyday Struggles from Clinical Reality.
In recent years, the lasting effects of the COVID-19 pandemic, combined with social and cultural unrest, have led many of us to experience a collective sense of loss: loss of routine, connection, and the activities that once brought us joy. When the things we rely on for happiness disappear, it’s easy to feel stuck in a cycle of hopelessness.
While many aspects of pandemic life have since returned to normal, this kind of prolonged isolation and emotional exhaustion. What often feels like an unstable world has also fostered widespread feelings of sadness, loneliness, and disconnection. For many people, it’s resulted in them becoming clinically depressed. While everyone experiences ups and downs, when the bad days start to outweigh the good, it may be a sign of something more serious and a sign to seek support.
Understanding depression—what it is, how it manifests, and how to navigate it—can help reduce stigma and empower those who are struggling to seek support. While terms like ‘depression’ are often used casually in everyday conversation, it’s important to distinguish between fleeting sadness and clinically diagnosable depression. Let’s explore the different types of depression, their symptoms, and what’s happening beneath the surface.
Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD) is more than simply feeling sad—it’s a persistent low mood that lasts for at least two weeks and significantly interferes with daily functioning. It can impact basic activities like eating, sleeping, and concentrating, and often brings intense feelings of hopelessness, sadness, and irritability.
One of the hallmark symptoms of MDD is anhedonia, or the loss of interest or pleasure in activities that once felt meaningful or enjoyable. This isn’t just a rough week or a fleeting low mood; MDD is characterized by the presence of at least five symptoms, which may include changes in appetite or sleep, fatigue, difficulty concentrating, feelings of worthlessness or excessive guilt, and, in some cases, thoughts of death or suicide. These symptoms must cause clinically significant distress or impairment in key areas of life, such as work, school, or relationships.
If symptoms of depression are disrupting your daily life, reaching out to a mental health professional is a vital step toward support and healing.
Persistent Depressive Disorder (PDD)
Persistent Depressive Disorder (PDD), also known as dysthymia, is a chronic form of depression where feelings of sadness, hopelessness, and loneliness persist for at least two years (or one year in children and adolescents). Unlike Major Depressive Disorder, PDD symptoms may not be as intense, but they create a lasting, underlying sense of sadness that is difficult to shake.
People with PDD often describe feeling a sense of “stuckness” in their lives. They’ll typically still go about daily responsibilities—work, school, and socializing—but with a persistent sense of feeling that “something is off.” Symptoms can include:
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Changes in appetite (overeating or loss of appetite)
- Sleep disturbances (insomnia or excessive sleep)
- Feelings of hopelessness
Since the symptoms are long-lasting but often milder than Major Depressive Disorder, PDD can sometimes go unnoticed and have a sense of “this is just how I am.” However, its chronic nature can make it just as debilitating over time. Seeking professional support can help in breaking the cycle and improving overall well-being.
Adjustment Disorder with Depressed Mood (Situational Depression)
Situational depression deserves a special mention—it occurs when a specific life event triggers depressive symptoms, and these symptoms typically improve once the situation resolves. Unlike Major Depressive Disorder or Persistent Depressive Disorder, situational depression is directly tied to a stressor and does not persist long-term.
For example, imagine you’ve worked at the same company for six years. While you’re unhappy, you wouldn’t describe yourself as depressed. Then, suddenly, you lose your job. Over the next several months, you struggle with uncertainty and stress while searching for a new role. You may experience biological and emotional changes, such as:
- Changes in sleep (insomnia or excessive sleep)
- Appetite fluctuations (overeating or loss of appetite)
- Weight loss or gain
- Loss of interest in previously enjoyable activities
- Feelings of hopelessness or despair
However, as soon as you secure a new job or even gain confidence that things will turn around, the depressive symptoms gradually lift. This type of depression is common, though often frustrating to manage because, in many cases, the “cure” is simply a change in circumstances. While temporary medications may help with anxiety or mood symptoms, the primary focus in treatment is often on coping strategies and adjusting to the stressor until it passes.
Situational Depression is more formally known as Adjustment Disorder with Depressed Mood, which is included in the DSM-5. This diagnosis applies when emotional or behavioral symptoms develop within three months of a specific stressor and cause significant distress or difficulty functioning.
Situational depression can be unpredictable, and while it often feels permanent in the moment, it does not last forever. While we may not always control our circumstances or the events that trigger emotional distress, we can navigate these challenges by focusing on small, manageable ways to get through each day.
Seeking Help for Depression
In my work as a therapist, I’ve walked alongside many people struggling with depression, and together, we’ve faced the challenges it brings. When someone feels truly hopeless, simply saying, “It’s going to be okay!” can actually make them feel worse—it can feel dismissive and like their pain isn’t being taken seriously.
What does help? Being there. Listening so they don’t feel alone. Offering small moments of hope, not in grand gestures, but in gentle, approachable ways. Suggesting activities and behaviors to counteract the tendency to isolate – a short walk, a creative outlet, or small acts of self-care. These acts aren’t a quick fix but they add up.
If someone you care about is struggling with depression, making sure they have support is essential, and you might encourage them to seek therapy. If they’re not ready for that step yet, simply being present can make a difference. Talk with them, listen without judgment, ensure they feel safe, and remind them they’re not alone. Invite them for a walk, suggest an activity like coloring, drawing, a puzzle, or yoga – things that are engaging and invite connection.
Depression is complex, but understanding it—both in ourselves and in our communities—can make a meaningful difference. Whether you’re navigating your own struggles or supporting someone else, remember that depression is not a personal failing, and no one has to go through it alone. Seeking help is a sign of strength, not weakness. With the right support and tools, you can work through even the darkest times and find moments of light along the way. If you or someone you know is struggling, take the first step—reach out, talk about it, and know that healing is possible.
LINDSEY WASHINGTON, LMSW (she/her)
Lindsey Washington helps individuals and couples break free from unhelpful patterns and move toward more fulfilling lives. She draws from trauma-informed modalities, AEDP, and CBT, tailoring care to each client’s unique needs. Lindsey also specializes in couples therapy, supporting partners through challenges with communication, finances, jealousy, and intimacy.
