Am I Depressed or Just Deep?

I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep?

When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them to UNICEF!

Now I look back with tenderness to the hurting girl I was and wished somebody had been able to recognize that I was very depressed.

Not that I would have accepted the help. I believed, along with all the other adults in my life, that my melancholy and sensitivity were part of my "special" make-up, that they were gifts to celebrate, not neuroses to treat. And should I take meds that helped me laugh and play and design cool barrettes like the other girls, well, then I would lose my depth.

On the PBS website "This Emotional Life"--a multi-platform project centered on a three-part series documentary to be broadcast in early 2010 hosted by Harvard psychologist and bestselling author Daniel Gilbert--psychologist Paula Bloom discusses the topic of being deep versus being depressed. On her blog post "Am I Depressed or Just Deep?," she writes:

Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear "I am not depressed, I am just realistic", "Anyone who isn't depressed isn't paying attention", or "Life has no meaning and I am going to die, how can I be happy?" I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.
There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.


We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.
Peter Kramer, clinical professor of psychiatry at Brown University, devotes an entire book to this question. He wrote "Against Depression" in response to his frustration of repeatedly being asked the same question: "What if Prozac had been available in van Gogh's time?"

In a New York Times essay, "There's Nothing Deep About Depression," which was adapted from "Against Depression," Kramer writes:

Depression is not a perspective. It is a disease. Resisting that claim, we may ask: Seeing cruelty, suffering and death -- shouldn't a person be depressed? There are circumstances, like the Holocaust, in which depression might seem justified for every victim or observer. Awareness of the ubiquity of horror is the modern condition, our condition.

But then, depression is not universal, even in terrible times. Though prone to mood disorder, the great Italian writer Primo Levi was not depressed in his months at Auschwitz. I have treated a handful of patients who survived horrors arising from war or political repression. They came to depression years after enduring extreme privation. Typically, such a person will say: ''I don't understand it. I went through -- '' and here he will name one of the shameful events of our time. ''I lived through that, and in all those months, I never felt this.'' This refers to the relentless bleakness of depression, the self as hollow shell. To see the worst things a person can see is one experience; to suffer mood disorder is another. It is depression -- and not resistance to it or recovery from it -- that diminishes the self.

Beset by great evil, a person can be wise, observant and disillusioned and yet not depressed. Resilience confers its own measure of insight. We should have no trouble admiring what we do admire -- depth, complexity, aesthetic brilliance -- and standing foursquare against depression.

Kramer's words are consoling to a depressive who spends 90 percent of her energy a day combating thoughts saying she is depressed because she lacks the stamina to be optimistic. In fact, the first time I read Kramer, I experienced profound relief. However, I still maintain that some of my depth caused by depression is a good thing. Not on the days where I'm in excruciating pain, of course. But should I have been one of those nine-year-olds who got excited about which color ribbon I could use to make my barrettes and wasted her quarters on Pacman ... well, I wouldn't be writing this blog.