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Is it Melancholia, or is it Depression? Part I
by Gita Elgin, Ph.D.
Part I: Which is Which?
We live in a time of enormous technological
progress and economic prosperity. Opportunities abound — life is hectic.
But in our frenetic activity we may end up feeling lost, incomplete
and left out. Alone and alienated, we long for something missing,
perhaps we know not what. We may experience a deep sadness, even
melancholy, we know not why.
But sadness and melancholy do not equate
with pathology. Such feelings can be a natural reaction to a world
that is out of joint, to a life that has lost its meaning. That
is not to say that they are not significant, that we need not deal with
them. In fact, they should serve as a wake-up call to do something,
and do it forthwith. First and foremost: take counsel with
yourself. Take along a guide: a trusted friend, a therapist, a
spiritual advisor —someone who knows the territory, who has been there
before. Also, it might not hurt to take a vacation, to renew old
friendships, to reconnect with family. And it is probably time to cut
back on externally directed activities and commitments, to re-evaluate
your work, your relationships, and the very fabric of your life.
Depression is outwardly similar to feeling
blue, yet fundamentally different. Let us take a case in point.
The Nordstrum family lived the American
Dream. Forty years ago, Siegurd had left his native Norway as
a cabin boy on a freighter. After a long ocean voyage and several misadventures,
he wound up as a ranch hand in Southern California. He worked
his way up the chain of command, saved his money, and prospered. Eventually
he bought his own ranch, married, and had children. He became a a multimillionaire
and a pillar of the community. He now looks forward to becoming a grandfather
for the first time.
But there is a problem, one that will not
yield to hard work, or love of family, or willingness to endure. At
17, his youngest daughter, the “baby” of the family, is deeply depressed.
Julie is morose, apathetic, irritable.
She has no appetite, eats mostly sweets, and has lost weight.
She has insomnia, but at times she sleeps all day. Her movements
are slow and listless. She is always tired, even though she does practically
nothing at all. She is restless and anxious and cannot concentrate
on anything. She is not interested in anything, does not want
anything. She has feelings of guilt and has thoughts of suicide.
Julie has not used psychoactive drugs:
she has not experienced a major trauma or the death of a loved one;
and her life circumstances do not suggest severe physical or emotional
stress or deprivation. There is nothing “out there” to account for her
moods and her behavior. Yet Julie, like millions of other adults and
adolescents, is suffering from depression.
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