What is sadness, when it becomes a health problem for a person. Symptoms and most frequent causes:
Sadness is a human emotional state that we have all experienced, probably in the face of adverse life circumstances, vicissitudes or problems that appear in life. It is normal to feel sadness as it is just another psychological reaction, like anger or happiness. When we are sad we cry, we think negatively, we are less inclined to do activities and perhaps we seek solitude. The problem comes when sadness turns into depression, terms that we tend to confuse.
Depression consists of a deep sadness never experienced before or ‘vital sadness’ that involves the person and can affect all spheres of life (family, partner, work, friends, leisure...). It is most commonly accompanied by a lack of interest or ability to experience pleasure, apathy, insomnia, eating disorders, loss of energy and difficulty concentrating.
Profile of patients manifesting a sad mood:
There is no single profile of people with depression, everyone is susceptible to it. It is estimated that in Spain one in 10 people will be affected by this illness at some point in their lives 1. It is true that there are people who feel sadness more easily, which may correspond to a more sensitive way of being, obviously when problems accumulate it is easier to feel sad.
How to differentiate between sadness and depression:
As mentioned, depression is an illness, the symptoms are more intense, limiting, can interfere with all aspects of life, cause great incapacity to perform daily activities and also tends to be recurrent and appear without apparent cause. Whereas sadness is a temporary state of emotional discomfort that is usually preceded by difficult life situations and is not considered a mental disorder. There are cases in which sadness sustained over time can trigger depression.
Are we sadder since the pandemic started, and how does Covid influence mood?
The pandemic and social restrictions have been associated with significant mental health consequences. Although exact figures are not available, it is known that the number of people with depression, anxiety and suicidal behaviour has increased dramatically.2 The current situation has led to emotional distress, feelings of loneliness, abandonment and hopelessness, especially in the most vulnerable people.
Can sadness affect a person's physical health?
Patients with depression may develop what are called somatic or physical symptoms, such as weight loss, insomnia, tiredness, fatigue, lack of energy; in addition, pains increase and the illnesses that the person was previously suffering from may be decompensated.
Symptomatology that should alert us if we detect it in a loved one
In moderate or severe cases, there may be recurrent ideas of death, prolonged isolation, abandonment of personal care, a negative view of life and a feeling of hopelessness that should alert us to seek medical or psychological care. Likewise in cases where there is physical impairment such as prolonged lack of appetite, significant weight loss or worsening of previous illnesses.
We cannot talk about depression without talking about suicide. Depression is the mental disorder most frequently associated with suicidal behaviour, with a risk 20 times higher than in the general population. Two-thirds of all patients with depression contemplate suicide, and between 10% and 15% actually carry it out3. So we need to be able to ask questions about it.
When to ask for help
If we suspect that the sadness is different, stronger than any other we may have felt before or that it has become something deeper, we should go to a doctor or ask someone for help. If the psychological pain is very intense, has lasted longer than expected and there are more symptoms accompanying it, don't waste time.
Tips for coping with sadness
Leaning on family, friends and relatives is the best way to deal with situations that cause sadness. It is advisable to look for alternatives to the problem and not fall into the trap of pessimism. Not allowing the situation to consume us, avoiding isolation and trying to maintain activities and routines can prevent the pain from progressing. But even when we are alone, we must draw inner strength that allows us to be resilient.
1. Vallejo J. Introducción a la psicopatología y la psiquiatría. 7th Edition. Barcelona: Elsevier Masson; 2011).
Killgore et al., 2020 W.D.S. Killgore, S.A. Cloonan, E.C. Taylor, M.C. Allbright, N.S Dailey. Trends in suicidal ideation over the first three months of covid-19 lockdowns Psychiatry Res., 293 (2020), Article 113390, 10.1016/j.psychres.2020.113390.
3. Almenta E. Prevention and intervention in suicidal behaviour in primary care. In: Suicidios, manual de prevención, intervención y postvención de la conducta suicida. 2nd Edition. Mental Health Foundation Spain; 2015.
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