Naming it

The first time I went looking for the word, I was sitting in my car at lunchtime in a Bunnings carpark, eating a sausage I didn't want and crying about a piece of plywood. I had not been sad about anything in particular for weeks. I'd been getting up. Going to work. Coming home. Feeding the kids. The plywood was the thing that made me realise I hadn't actually felt anything about anything for two months.

This module does one job. It tells you what depression is. It tells you what it isn't.

What depression actually is

Depression isn't sadness. Sadness is a response to a thing. You feel something proportionate, you feel it for a while, it lifts.

Depression is the mechanism not working. It's a sustained state, usually two weeks or longer, where the wiring that gives life its colour has been turned down or off. The screening tool a GP will use is called the PHQ-9. The nine markers are:

• Low mood. Most of the day, most days, for two weeks or more.
• Anhedonia. The thing you used to love doesn't feel like anything any more.
• Sleep disturbance. Either you can't get to sleep, or you wake at 3am, or you're sleeping ten hours and still tired.
• Appetite change. Either you're not eating, or you're eating without registering it.
• Energy loss. A flight of stairs feels uphill.
• Concentration problems. You read the same paragraph four times.
• Worthlessness or guilt. The internal narrator gets cruel.
• Psychomotor change. Either slowed down or wound up.
• Suicidal ideation. Thoughts of death.

Five or more of those, sustained for two weeks, and you're in the diagnostic territory.

What depression isn't

Burnout. Burnout is exhaustion plus cynicism plus reduced effectiveness, tied to a stressor. Take the stressor out, give it three weeks, burnout lifts. Depression doesn't lift on holiday.

Grief. Grief is loss-shaped. There's a thing you're grieving, and the grief responds to time, ritual, talking. Depression is grief-shaped on the inside but there's no thing.

A bad month. Bad months end. The depression doesn't.

The reason this matters is that the response to each is different.

A short safety note

If, right now, you have active suicidal thoughts (a plan, a method, a timeline, or just a constant pull towards not being here), this Journey isn't the next step. Call Lifeline on 13 11 14. Present at your nearest emergency department. Or call 000.

If you're not in that territory but you've had passing thoughts that scare you, write that down. Tell your GP at the appointment in the next module.

Why naming it correctly matters

I spent eleven weeks calling my depression "a tough patch" before I called it depression. The day I let myself use the word was the day I picked up the phone to my GP. The action followed the name.

You're not sad. You're not tired. You're not weak. You're something specific, with a specific protocol.

Name it. Stop arguing with it. Start working it.

Further watching

• Your Depression Is Lying to You: Depression Treatment Options: Depression Skills #1
• The Function of Depression: Do the Symptoms of Depression Serve a Purpose? Depression Skills #6