Understanding the Side Effects of Depression and the Role of Treatment
Despite growing awareness about depression, many people still don’t recognize the full complexity of the illness. By understanding the side effects of depression, including its emotional, cognitive, physical, and functional impact, you can gain a better sense of what your loved one with depression is experiencing and move together toward effective depression treatment.
Over the past decade, a national conversation has opened up about mental health unlike anything we’ve seen before. From social media campaigns like #HereForYou to school-based activities focusing on Mental Health Awareness Month, what was once a deeply stigmatized topic is now emerging from the shadows and entering public view. And perhaps no mental illness has received as much attention as clinical depression.
One would think that this new focus on depression would translate into widespread understanding of what those living with the illness experience. And in some ways it has—Allie Brosh’s remarkable webcomic, Hyperbole and a Half: Adventures in Depression, probably did more in the past six years to explain what depression feels like than William Styron’s celebrated memoir, Darkness Visible, did in the last 28.
But for many, depression remains half-hidden, a story only partially told. Indeed, even those whose own family members struggle with the illness often fail to fully grasp the side effects of depression. This not only leads those living with the disorder to feel alone and misunderstood, it can cause families to feel frustrated and confused when treatment doesn’t appear to be effective.
If your loved one has not been successfully treated for depression, understanding the psychological, cognitive, physical, and functional impact of depression could give you insight into what past treatments may have lacked. With this new knowledge in hand, you can seek out a treatment program that addresses the full scope of your loved one’s needs and create a true path to recovery.
The Side Effects of Depression
The World Health Organization estimates that depression now affects over 300 million people around the world. Each of those 300 million people carries with them the story of their own unique symptomatology and lived experiences with their illness. Depression can present itself and weave itself into the fabric of each person’s life in vastly different ways, resulting in an infinite number of possible articulations of the illness. But while not everyone may experience the side effects of depression in the same ways, there do exist certain common threads:
Depression is a mood disorder, which means it inherently impacts one’s emotional state. At its most basic level, depression can be thought of as enduring unhappiness, stripping one of joy and hope. However, as Tim Lott writes for The Guardian, “Depression is actually much more complex, nuanced, and dark than unhappiness—more like an implosion of self.”
Indeed, depression can cause a host of emotional phenomena antithetical to who a person was prior to the emergence of the illness, including irritability, anxiety, anger, and guilt, emotions that often become so overwhelming that they begin to inform every single thought and action. For some, depression can even lead to the absence of emotions altogether, causing sufferers to enter into a kind of emotional catatonia, numb to the world around them.
Depression isn’t only an illness of mood; it can also profoundly affect cognition. These effects can include deterioration of memory, impaired concentration, loss or hindering of decision-making ability, and difficulty processing visual and auditory information. As a study published in The Canadian Journal of Psychiatry notes,
Deficits on neuropsychological testing are well demonstrated in people with major depressive disorder, with many studies and meta-analyses showing moderate effect sizes in neurocognitive domains of processing speed, attention, executive function, learning and memory.
These effects may be explained in part by the way depression acts on the brain both physically and functionally. Researchers have observed abnormalities in the brains of depressed people, particularly in the hippocampus, cingulate, and prefrontal cortex—areas that are vital for activities such as memory formation, planning, and decision-making. Combined with irregular neurotransmitter and hormone releases that interfere with normal neurological function, the effects of depression can mean significant disturbance of cognitive function.
Though depression is a psychological illness, its effects are not confined to the mind. In fact, depression can cause a host of physical dysfunctions, including sleep disturbances, fatigue, appetite changes, chronic pain, and gastrointestinal problems. Some people also experience a deep disconnection from their own bodies and diminished control over their corporeal selves. “I start to stumble when I walk, or become unable to walk in a straight line. I am more clumsy and accident-prone,” Lott writes. “In depression you become, in your head, two-dimensional—like a drawing rather than a living, breathing creature.”
While these may be lesser-known side effects of depression, they can sometimes function as primary symptoms for some, particularly men. As Dr. Madhukar Trivedi notes in The Primary Care Companion to the Journal of Clinical Psychiatry, “A high percentage of patients with depression who seek treatment in a primary care setting report only physical symptoms.”
However, the relationship between physical symptoms, particularly pain, and depression are not simply a case of cause and effect. Depression itself may not cause physical pain, but the same neurological processes that cause depression can. Additionally, treatments that only target emotional symptoms without addressing physical symptoms are considered incomplete, as residual physical symptoms significantly increase the likelihood of relapse.
Of course, the emotional, cognitive, and physical symptoms of depression don’t simply exist in isolation. Rather, they often coalesce to produce significant functional disturbances. As Yedidya Erque writes in a moving essay about his first year of college,
I could not focus on schoolwork; I could not sleep properly; I would weep for no reason and felt completely isolated from friends and family. My schoolwork suffered because my concentration was shot; I would stare at a single page for a long time without understanding what I was reading and I was unable to remember even the titles of the books I had read only the day before.
His symptoms were so profound that he was unable to concentrate on conversations when people spoke to him. He eventually had to take a leave of absence from school to deal with his illness.
Erque’s experience, unfortunately, is not uncommon. The side effects of depression rob many of the ability to live a productive life, including the ability to work, attend school, participate in self-care, and form meaningful relationships. For some, this means the loss of independent living skills they once had, while for others it means never having the opportunity to develop such skills in the first place. This lack of function can, in turn, cause further isolation and distress, driving them deeper into the depressive state.
Toward Effective Depression Treatment
Effective depression treatment must address each person’s full symptomatology in order to produce true and lasting relief from depressive illness. Unfortunately, many forms of treatment focus primarily or even solely on the emotional effects of the disorder, operating under the false belief that if those are resolved, the rest will follow. More often than not, this is not the case, particularly when depression has caused profound functional disruption. Simply feeling better doesn’t equate to developing the skills you need to live a healthy, productive, independent life.
If your loved one has not been able to find relief from depression and restoration of function through treatment attempts thus far, it may be time to seek out a program that focuses on the full scope of the illness. By connecting with a long-term depression treatment program with an emphasis on fostering independent living skills, your family member can have the time, space, and support necessary to truly heal.
The duration and approach of such programs will allow your loved one to explore the entirety of their illness and develop strategies to cope with its emotional, cognitive, physical, and functional effects. Slowly but surely, they will be able to move toward greater levels of independence, integrating invaluable skills along the way that will allow them to flourish independently, gain confidence, and rediscover their sense of joy at last.
Hanbleceya offers comprehensive, long-term treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-based program and how we can help you or your loved one start on the journey toward lasting wellness.