Do you know someone who looks and appears depressed but denies it when confronted? Do you believe their rejection of your assessment of them? Could it be that they are”hiding,” covering their true emotions, or simply telling the truth? Even as a trained therapist I have seem my fair share of clients, primarily men and adolescent males, proclaim over and over that they are not depressed even when they appear that way. I ended up second guessing myself and desperately searching for a term, diagnosis, or phenomenon that could help me make sense out of what appeared to be depression. Little did I know, it was pretty simple.
We live in a nation that fervently seeks for answers for behaviors that we do not understand or that do not meet a certain set criteria. For example, mental health professionals will often engage families in learning about depression when a adolescent exhibits traits and behaviors that seem to be depression. Rarely, if ever, will a trained mental health professional ignore other reasons for behaviors that seem like depression. We are all susceptible to mistaking certain behaviors for something way more serious than it actually is.
This article will discuss “normal” behaviors, moods, and traits that can be mistaken for depression symptoms.
When I was beginning in my field in an inpatient child and adolescent residential facility of very troubled and ill youngsters, I began to feel very tired. Every other day I felt more and more tired. I loved the work I did and I felt honored/humbled to be as close to troubled, yet wonderful youths who were mistaken to be “tarnished.” There wasn’t a day that went by that I did not have crippling fatigue or migraine headaches. I found myself developing, because of mild burn-out symptoms, a pessimistic view of today’s youths and their future. This pessimistic view most likely caused others to question whether I was depressed or not.
Trying to identify differences between depressed mood and normal temperament can be a very big challenge, especially for family and friends. It is important to learn the signs of depression so that you can decipher what may or may not be clinical depression. Unfortunately, because depression can be so very similar to other disorders or difficult temperaments, it is important to understand what is and is not a symptom of depression. Some of the following “symptoms” may be more temperament than depression:
- Isolation: Believe it or not, some people prefer to be alone. Why? Well, a few reasons may be that they “rejuvenate” through isolation (introverts), they prefer thinking over socializing, or they are avoiding social settings because of a history of social ostracism, discrimination/racism, or bullying. Some people believe isolation is not a bad thing, especially if isolating will keep them from having to be disappointment and uncomfortable in the social arena. Have you ever heard of the saying “the quietest people have the loudest minds.”
- Maturity or serious behavior(s): Some individuals grow up fast while others take a bit more time to become “real adults.” People who “act mature” are often regarded by their peer group as “depressed,” “old,” or “pessimistic.” Mature behaviors or serious thinking styles can cause others to regard the individual as depressed or sad. Many mental health professionals come across as more serious than others at times which can appear to be depression or pessimism. For example, while completing my counseling psychology program in graduate school I often had fellow-classmates make statements about me such as “why don’t you ever joke around in class” or “you do know that therapists can have fun…right?”
- Not easily amused or “moved” by things: Some people are simply calm about almost every single thing in their lives. Nothing moves them. “Laid-back” people are sometimes underwhelmed and may not react to certain things like others would. For example, a wedding announcement or baby-announcement may not move the “laid-back” person like it would someone who is more reactive. For me, I tend to be “laid-back” and will only naturally respond to events that truly moves me to respond. Individuals who tend to be underwhelmed may or may not be depressed. It is important to consider the natural mood of the individual before assuming they are depressed.
- Emotional or reactive behaviors: As stated above, some individuals are reticent and laid-back while others are not. Individuals who are reactive are often viewed by others as positive or optimistic. Individuals who are thoughtful and tend to react only when necessary, are often viewed as depressed or pessimistic. I’ve heard families of some of my laid-back teen client’s say “OMG. Just tell me already. Don’t you have any thoughts or feelings about this?”
- Irritability: One of the hallmark features of depression for men and adolescent males is irritability. For women, depression is often characterized by tearfulness, depressed mood, or mood lability (i.e., changeable moods). But some irritability is temperamental and not based on mood. Temperament is personality and an irritable personality or temperament is not depression.
- Substance abuse and use of alcohol: Self-medication with drugs and alcohol is often a “symptom” of depressed mood. But there are some individuals who will use drugs and alcohol for social purposes (i.e., engaging with others or interacting at parties) or because they are addicted/dependent. Substance abuse/dependency does not always = depression.
- Anhedonia or lack of motivation: As difficult as it may be to believe, some individuals are born unmotivated. Individuals who seem to “take things in stride” or “does not care” may not be depressed. Again, temperament is often a major influence of personality. It is important to understand that individuals who have a positive temperament will most likely lose motivation if depressed. An individual who has always been unmotivated does not have to be depressed.
- Interest in “dark” subjects such as death/dying, life challenges, tribulation, or sorrow: Individuals who like to listen to depressing or “dark” music (or read dark/depressing books/articles, etc.) does not have to be depressed. As you know, some people enjoy topics that speak about life challenges, death, or depressed moods/attitudes. This does not always insinuate a depressed mood. While many of us are drawn to things that “speak” to our challenges, primarily when struggling with some aspect of life, other individuals gravitate toward this kind of stuff all of the time.
-Tamara Hill, MS, LPC