By Brittany Ladson
I have high-functioning depression. When I become upset or down, I distract myself by picking up a new writing project, by starting a new volunteer activity, or by taking on more shifts at the hospital. Each is an attempt to distract myself from feeling depressed. If you stay busy, there’s no time to feel depressed, right?
These feelings, however, have become amplified during the pandemic and quarantine due to a lack of social interaction and the cancellation of events I was excited to attend. It has been challenging dealing with my long-standing clinical depression in addition to having it coupled with the COVID blues.
From afar, people probably think that I have used the time spent in quarantine to be productive. Writing articles, finishing projects, and planning new ones. No one sees the darkness that I often experience as a motivating factor to many of these endeavors. You truly never know what someone is going through, regardless of how well you know them or how much time you spend with them.
Most of the people I know think that I have it together, that my life is perfect all the time. However, things couldn’t be further from the truth. Between the immense pressure of medical school, the stressful responsibilities of starting hospital rotations, and the challenges of balancing relationships and family commitments, I can become mentally and physically worn down. Most of the time it is easier for me to block out all my issues and just focus on the next task ahead. I have always neglected my mental health for the sake of my academic commitments, which is the easy way for me to deal with my problems.
As a 3rd year medical student, I am trained to understand that depression can be a fatal condition if left untreated and can lead to the development of various other disorders, including insomnia, overeating, undereating, and, in worst cases, suicide. Clinical depression—also known as major depressive disorder—is defined as experiencing more than 2 continuous weeks of anhedonia (loss of interest) in addition to at least five of the following symptoms: sleep disturbances, feelings of guilt, decreased energy, lack of concentration, decreased appetite, agitation, or suicidal ideation.
Clinical depression, however, can present atypically. A patient could experience weight gain, overeating, and rejection sensitivity. It can also strike at unique times in life like after birth, or with specific changes in the season like during the winter months. In comparison, the hallmark of COVID blues is in its own non-uniformly fluctuating timeline. It doesn’t last for a continuous two weeks; instead, depressive symptoms come and go sporadically over time.
Furthermore, clinical depression has a strong genetic component, stemming from an imbalance of neurotransmitters in the brain that can be corrected with psychiatric medications. COVID blues, on the other hand, does not share these two qualities. It is considered a form of situational depression. This means once the situation changes—once COVID goes away—then so do the depressive symptoms. For instance, if you are a restaurant owner who has had to shut down due to the pandemic, and you get good news that restaurants have opened back up, your mood will instantly be lifted if you are experiencing COVID blues. However, if you suffer from clinical depression, it will be challenging to feel happy about it. You need to ask yourself: How did I feel prior to this situation, and does hopeful news lift my spirits? Clinical depression is not easily improved by optimistic news.
Determining whether you are affected by COVID blues or clinical depression is important in determining your treatment options. According to a study performed by Dr. Eric Lewandowski, the best activities to cure COVID blues are having virtual contact with friends and family (not just text or chat), planning intentionally fun activities, going outdoors every day regardless of the weather, and maintaining a daily routine of work or school where you require yourself to have the same hygiene routine you would if you were actually leaving the house (please, everyone, take a shower). These small steps can go a long way to making one feel better in these novel, uncertain times, beating back the COVID blues.
These methods used to treat COVID blues are also great first steps in the treatment of clinical depression, but they will be unlikely to completely resolve all symptoms. Other treatments, such as cognitive behavioral therapy (seeing a therapist), antidepressant medications (seeing a psychiatrist), and family or couples’ therapy are necessary supplements to treat clinical depression. Cognitive behavioral therapy is the first line of therapy for many types of depression. This talking therapy allows you to work through and identify negative thought patterns, while assisting you in learning coping strategies to change these negative thinking patterns to positive ones. Cognitive behavioral therapy coupled with psychiatric medication is the gold standard treatment among psychiatrists and has the highest rate of success among patients.
While there is no clear end to this pandemic right now, all we can do is accept what is and learn to move forward. Chinese philosopher Laozi said it best, “Life is a series of natural and spontaneous changes. Don’t resist them; that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they really like.” Use this time to self-assess and unpack your feelings. As you read the following questions, reflect on your responses. What was my mood like before quarantine? What has my mood been like the past month? What is my current mood? Irrespective of the type and severity of depression you are experiencing, it is important to seek quality treatment from a professional.
If you are struggling, it is okay to reach out for help. If you need help, help is available. Resources are provided below.
National Suicide Prevention Lifeline:
English: 1-800-273-TALK (8255)
Spanish: 1-888-628-9454
Crisis Text Line- 24/7, Confidential
Text HELLO to 741741
National Institute of Mental Health
BRITTANY LADSON is a 3rd year medical student at Michigan State University College of Osteopathic Medicine. She is currently rotating at Sparrow Hospital in Lansing, MI and hopes to pursue a residency in emergency medicine or obstetrics and gynecology. She is also the vice president of operations for MSU Sci Comm. Read her Instagram feed about her journey in medicine at https://www.instagram.com/mymilestomedicine/
Images from Wix