MH@H Depression

Depression Without the Depressed Part?

Ashley L. Peterson
Depression without the depressed part? Depression doesn't always involve sadness

Chances are the first thing that comes to most people’s minds when they think about depression is depressed mood, right? But while depressed mood is often a major part of depressive illnesses, sometimes it plays a minor role and other times it’s not present at all.

Major depressive episode symptoms

Major depressive episodes can occur in the context of major depressive disorder, bipolar disorder, or schizoaffective disorder. For a diagnosis to be made, symptoms must be present nearly all day, nearly every day for at least two weeks.

The symptoms of depression are:

  • Depressed mood
  • Significant loss of interest/pleasure in almost all activities (anhedonia)
  • Significant change in appetite and/or unintentional weight loss/gain.
  • Disruption in sleep, which can be either insomnia or sleeping excessively
  • Objectively observable changes in the speed of movements, either slowing (psychomotor retardation) or agitation
  • Decreased energy
  • Feelings of worthlessness or guilt that are out of proportion to the situation
  • Problems with concentration and decision-making
  • Suicidal ideation

Diagnosis of a major depressive episode requires at least 5 symptoms, with at least one of the first two.

For me, the most consistent symptoms over the last three years are anhedonia and cognitive effects.

Depression and mood

The many faces of depression: sad, hopeless, anxious, numb, irritable

Depressed mood doesn’t necessarily involve sadness. In the melancholic subtype of depression, the quality of mood tends to be different from the sadness that one might experience with grief. I tend toward melancholic features, and sadness generally doesn’t play a very big role in my depressive big picture.

Depression can cause feelings of hopelessness. People may also experience irritability. Depression-induced irritability happens to me occasionally, and it is not pretty.

The depressed mood criterion isn’t necessary for a major depressive episode to be diagnosed. One must have either anhedonia or depressed mood; anhedonia alone will suffice. That means that someone can have depression without any sadness being involved at all.

Depression & Emotions: Positive & Negative Affect

Anhedonia

My guinea pigs are pretty much the only thing that can crack through the anhedonia, although not always. Blogging is cognitively stimulating and meaningful, but emotionally it’s quite neutral. I’ve always been pretty cerebral, so I’m fine with cognitively stimulating.

The things that I used to enjoy doing are not the least bit appealing. Travelling used to be my passion and I was always excited about planning my next trip, but that fire has died. I went on a trip to Italy last fall hoping that it would rekindle the fire for travel, but nope. All the stuff that I would’ve been gaga over in the past were just meh.

Cognitive symptoms

I’m very organized and that allows me to compensate to some extent for the cognitive slowing, but it’s an ever-present challenge.& Decision-making is problematic. I have a very hard time processing multiple pieces of new information at once, which is something that I used to be quite good at. Spontaneous thought is difficult, whether that’s answering an unexpected question someone asks of me or formulating a thought-out response to someone’s blog posts.

I also have problems with sensory overwhelm, mostly with visual stimuli. I notice that a lot when I’m at the grocery store. Even when the store is quiet, visually it’s just a lot for my brain to process.

Effects on movement

I’ve had psychomotor retardation for the last several months, and it worsens when my mood drops. It’s like walking through molasses. It’s been a lot more consistently present this year than it has been in the past.

Depression can affect movement in other ways as well, but for me, it’s all about the psychomotor.

Overall picture

It doesn’t take much in terms of external triggers to make my mood drop, but when things are chugging along at status quo my mood isn’t all that much of an issue. It never ventures at all into good mood territory, but it’s not smacking me in the face with negativity, either. It’s more a feeling of being detached and emotionally turned off.

So yeah, I’m depressed without an especially depressed mood a fair bit of the time. Illness can present itself in many ways. Those of us with mental illness know that, but I suspect a lot of non-mentally-ill people don’t realize just how much variability there can be within a given diagnosis.

Are there ways that your illness doesn’t fit with stereotyped expectations? Do you ever experience depression without the depressed part?

Book cover: Managing the Depression Puzzle by Ashley L. Peterson, showing head made of puzzle pieces

Managing the Depression Puzzle takes a holistic look at the different potential pieces that might fit into your unique depression puzzle.

It’s available on Amazon and Google Play.

Published by Ashley L. Peterson

I'm the author of three books: Psych Meds Made Simple, Making Sense of Psychiatric Diagnosis, and Managing the Depression Puzzle. These are informed by my professional experience as a former pharmacist and mental health nurse, as well as my lived experience of major depressive disorder. My goal with Mental Health @ Home is to challenge mental illness stigma and provide a safe space for open dialogue to empower others to share their voices.

35 thoughts on “Depression Without the Depressed Part?”

  2. Off course, I have all surprising symptoms on my blog 🙂 The grocery store: 100% I avoid it as much as I can. But the struggle now for me is in all the small things – insignificant they seem to me – like brushing my teeth, doing laundry and just holding my head together. I zone out, time goes by and than I’m hyper in my mind, so weird!

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  4. My depression sounds similar to yours, although some of the things can also be due to autism, which explains why they persist when the mood part of depression shifts (although that also explains why I’ve had trouble convincing psychiatrists that I’m on the spectrum and they try to push me into the depression box). I think I’ve had anhedonia for a lot longer than any other symptom, and my sleep disruption is impossible to shift even at times when I otherwise feel OK.

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      1. Yes. The problem is that I’ve been depressed for most of my adult life, so it’s hard to find evidence of autism without depression, particularly as my parents didn’t notice anything particularly unusual, nor were there any troubles at school aside from lack of friends and being bullied. There are a few things which I need to emphasise for the autism diagnosis.

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  5. Are there ways that your illness doesn’t fit with stereotyped expectations? Sure. I’m an enigma I suppose. Because while the mental health professionals agree that my ‘primary’ diagnosis is chronic depression or dysthemia; I have a lot of elements that don’t really fit that. I’m always being presented with someone’s new diagnosis for what I got. Bipolar II. Mild (?) BPD. Social Anxiety. I mean it gets tiring not knowing precisely what I have, and more importantly how to treat what I have. It’s naive, but dang I’d like to have someone definitively tell me “this is YOU” and this is why you’ve suffered. It’s not going to happen is my own opinion.

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  6. This is sort of like me except the slow moving part. My emotions aren’t present most of the time but I eventually break down after a while and it all comes out.

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  7. I get really numb and indecisive at times to the point where I literally have to tell myself what to do, out loud. “Go to the bathroom, then get dressed.” Otherwise I might sit on the sofa all day clicking my phone.

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