The Hidden Costs of Clinical Depression

Clinical depression is a very common and very misunderstood disease, probably because everyone feels "depressed" (sad) sometimes. Clinical depression is nothing like "having the blues" or having a "bad day", or feeling "sad", and it is very different from the loss you feel when you grieve the death of someone you love. In this article I attempt to shed light on some of the things that aren't normally considered or discussed regarding depression, although the list is endless.

Clinical depression can be financially very expensive in addition to the doctor's bills and prescription costs.

People with depression miss a lot more work than those without it and, even when present, are often not working as efficiently as they could be. They may miss so much work time that they are fired or their paychecks are greatly reduced. Depression patients often have a hard time getting out of bed in the morning, so they are often late to work no matter how hard they try to be on time.

Other costs of depression are less obvious. Missing personal deadlines, such as paying bills on time, reading the mail regularly, attending parties and other social events. People with depression also pay more late fees for library books, videos, and paying bills late. Also, if there is an error in a bill or in a product they ordered and had delivered, a person with depression is less likely to troubleshoot the problem because making the phone calls and filling out paperwork and meeting deadlines may be overwhelming.

"I'm too tired to open the mail today, and it's always bad news anyway. It can wait until tomorrow."

Relationships of all kinds are very difficult for the person with depression to form and maintain. Explaining depression (major depressive disorder) to someone who has never had it, or had a form different from yours, is nearly impossible. Right away, communications between the depressed person and others is broken down because of this inability to find the words to describe a disease that is so complex and all-encompassing.

"It hurts so much to live, can't they see that? Why can't they understand? I can't 'just snap out of it' any more than someone with cancer or asthma could."

Relationships are also difficult because depression is an invisible disability that, unlike breast cancer or diabetes, has not yet had the media coverage and attention to make the public more aware of the signs, symptoms, and treatments. Instead, the stigma of mental illness is attached to the afflicted person, and the disease is either ignored or ridiculed by most people, who confuse clinical depression (Major Depressive Disorder) with having a bad day or having the blues or even of having someone die and going through the bereavement process.

"Killing myself isn't a 'choice' I can make, and it's not to punish anyone. It's just something that happens, like a sneeze or a hiccup, and I don't have any real control over it."

Romantic relationships are hit particularly hard by this disease because both the disease and most of the common treatments for it reduce the person's interest in sex. A person without depression may even try to help the person snap out of it by trying to entertain them with comedy or get them out to fun parties, whereby the person with depression feels even less understood by their partner and like they are alone in a room filled with strangers.

"If depression is 'just my way of getting attention', it's a pretty ineffective strategy since I've pushed away everyone I care about."

Many people with depression cannot maintain relationships for long periods of time, even with family and close friends, and yet this is what they need desperately to help them survive.

Attendance at school or work or other activities typically suffers greatly if a person has depression.

"It's not that I don't care, I just can't get out of bed. I just want to stay safely under the covers today. Maybe I'll be better tomorrow."

The person may show up late or not at all, and may not even feel well enough to call in sick. The person may miss 20-25% of school or work days due to depression-related symptoms, or they may be totally disabled and unable to go to work or school at all.

Another common reason for school/work absence is the increased need for doctors' and therapists' appointments, which invariably occur during business hours. After such appointments the person may not be able to return to work because they may be too upset, they may need to go to the pharmacy and switch medicines quickly (which makes them sick or unable to drive), or it's just not practical given traffic and distances involved.

Most people don't realize that a person dealing with depression likely has many physical symptoms, too, either due to the disease itself or due to the medicines prescribed to treat it.

"I hurt all over, head to toe. Nothing's wrong specifically, I just hurt really bad."

Some common physical symptoms of depression are:

• exhaustion
• failure to eat regularly or eating too much
• sleeping too much or too little (being exhausted in either case)
• greater susceptibility to other illnesses
• shortened life span
• osteoporosis (bone density loss)
• leaden paralysis (heaviness of the body)
• crying
• lowered ability to exercise to maintain minimum fitness, even though exercise has been shown to be helpful in reducing symptoms of depression in many people
• unspecific feelings of pain
• moving slowly or in slow motion

"Here I am again, waiting to die. Hoping the pain will stop."

Some common physical symptoms of depression treatments (psychotherapy and/or prescription drugs) are:

• tiredness or exhaustion
• fuzzy and/or slow thinking
• nightmares
• dry mouth
• headaches
• drowsiness
• dizziness
• gastrointestinal distresses
• impaired ability to drive or operate dangerous machinery
• reduced or complete loss of sex drive/interest
• inability or unwise to get pregnant while taking certain medicines
• "Roller coaster" symptoms as medicines begin to wear off and before the next dose is taken
• Major longer-term roller coaster symptoms as one medicine is being tapered off in dosage over the course of a week or two and another type of medicine is being ramped up in dosage over the course of a few weeks

Social relationships and activities are very difficult for someone with depression.

"They're my friends and I want to go see them, but I just can't. I just don't want to, even though I know I'll have a good time when I'm there--it's just way too much work to get from here to there and back again safely."

The person with depression may want to have people around for support while, at the same time, pushing those supporters away because of the symptoms of their illness.

Other reasons for strained or broken relationships are broken promises, missed activities, showing up late when it really mattered, being unsupportive of those around them (because they have enough trouble supporting themselves), and showing up but exhibiting an "attitude" that turns people away.

A person with depression may have trouble keeping a clean house and tidy appearance, therefore they may be hesitant to have guests, even for a short while, because they are embarrassed at how bad things have gotten and know that others won't understand.

Finally, the person with depression is typically consumed by it--it's all they can think about--therefore conversations with friends and family are either very limited or very depression-focused, making it seem like the person with depression only cares about themselves when in fact they may be calling out for help.

The person with depression may have few of what others consider "lifetime successes", such as buying a house or having a family or even maintaining relationships for more than a few months.

"Do they have any idea how much energy it takes just to get out of bed every morning, and to keep breathing in and out, let alone accomplish anything?"

Often the depressed person is accused of not "living up to their potential" or "not trying hard enough" or even of "being lazy". These accusations are doubly hurtful since that's what the depressed person is striving with all of their energy to do--stay alive and be successful--while at the same time realizing that they are "failing" by common standards and their life is slipping away, day after day.

"The dark

in the morning

covers the world around

and I wait

for the sun

to come

to life."

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.

.

If you liked this article, you might also like How can a person help someone with depression? and What Is an Invisible Disability? Is It a Physical Disability?. Leave me a comment, and if you like my work, let me know: become a fan and follower, subscribe to my RSS feed, and/or put my widget on your website.