Depression Is More Than Feeling Sad: Understanding What May Be Happening Beneath the Surface

Most people experience sadness. We feel sad after a loss, a disappointment, an argument, or when life does not unfold as we hoped.

Depression can be different.

Sometimes depression looks like sadness, crying, or feeling hopeless. But sometimes it looks like exhaustion. Irritability. Withdrawal. Difficulty concentrating. Sleeping too much—or hardly sleeping at all. Losing interest in people or activities that once mattered. Going through the motions of everyday life while feeling increasingly disconnected from yourself.

And sometimes people do not recognize that they are depressed at all.

Depression Does Not Look the Same in Everyone

One person may struggle to get out of bed, while another continues to go to work, take care of children, answer emails, and appear perfectly functional to everyone around them.

Someone may say, “I’m not depressed. I’m just tired.”

Another person may notice that they have stopped returning phone calls, no longer want to see friends, or have become unusually impatient with the people closest to them.

Depression can affect mood, sleep, appetite, concentration, motivation, relationships, work, and the way we think about ourselves and our future. For some people, it develops gradually enough that the changes are difficult to recognize.

Sometimes the Symptoms Are Telling Us Something

In therapy, we are interested not only in reducing symptoms, but also in understanding them.

What was happening when the depression began?

Has there been a loss, a significant transition, chronic stress, trauma, loneliness, relationship difficulty, or a sense of being trapped in circumstances that feel impossible to change?

Are there feelings that have been difficult to acknowledge or express?

Are old experiences or relational patterns influencing the way you see yourself today?

There is not always one simple explanation. Depression can develop through a complicated interaction of psychological, relational, biological, medical, and environmental factors. Understanding what may be contributing to it is often an important part of treatment.

Therapy Is More Than “Thinking Positive”

People who are depressed are often already trying very hard.

Being told to “look on the bright side,” exercise more, stay busy, or think positively can sometimes leave a person feeling even more misunderstood—particularly when they cannot simply will themselves into feeling better.

Psychotherapy provides a different kind of space.

It allows us to slow things down and become curious about what you are experiencing rather than judging it. Therapy may involve identifying patterns, understanding relationships and past experiences, developing different ways of coping, addressing behaviors that may be keeping you stuck, and finding ways to reconnect with parts of your life—and yourself—that have become difficult to access.

Different people need different things from treatment. There is no single approach that is right for everyone.

You Do Not Have to Wait Until Things Become Unbearable

One of the misconceptions about therapy is that you need to be in crisis before asking for help.

You don't.

If you have noticed that you are withdrawing from others, struggling to enjoy things you once enjoyed, feeling persistently discouraged or irritable, having difficulty functioning, or simply realizing that you have not felt like yourself for some time, it may be worth paying attention to that.

Seeking therapy does not mean that something is fundamentally wrong with you.

Sometimes it simply begins with recognizing:

Something has changed, and I would like to understand why.

At Prepare to Change Counseling, we work collaboratively with clients to understand not only the symptoms they are experiencing, but also the individual experiences, relationships, and circumstances that may be contributing to them. Treatment is tailored to the person rather than assuming that everyone who experiences depression needs exactly the same thing.

If depression is interfering with your relationships, work, daily functioning, or ability to experience pleasure and connection, reaching out for support can be an important first step toward understanding what is happening and what may help.

Kaneeza Lafir, PsyD, PsyD, PhD, CAMS-II

Licensed Psychologist

Prepare to Change Counseling