Why Being Depressed Is Different Than Having Depression

‘French horn’ and ‘shoe horn’ sound alike but they’re nothing the same at all.

Ever wonder why things like depression, anxiety, bipolar, panic — are common emotions for some people, and debilitating disorders for others?

You’re not alone. It’s not always easy to explain to patients the difference between the “street” definition vs. the “medical” definition of ambiguous names given to mental health disorders.

If whoever named them could have been a bit more creative, there’d be less confusion — and perhaps less stigma.

For many people, “depressed” simply means feeling sad. “Anxiety” means feeling worried or nervous. And being “bipolar” means flip-flopping between happy and sad, or calm and upset, with no control over it.

The problem is — they’re right! All those terms have meaning in the real world, and we know what somebody means to say when they use them.

But, they’re also very wrong. While the names of mental health disorders contain common words, terms like “depression” mean something very different to a mental health provider.

In the DSM-5, “depressed mood” does appear as one of criteria for major depressive disorder. But it’s only one of eight other symptoms required to have the diagnosis.

Simply having a sad mood doesn’t make the cut. Mental health professionals are looking at sleep patterns, weight fluctuations, changes in interests, lethargy and fatigue — generally not the kinds of questions you would ask a friend if they told you they felt depressed.

When evaluating panic, mental health professionals might ask you about changes in your heart rate or breathing, any medical conditions or medication history, and how comfortable you feel leaving the house. They might ask if you’ve had one last month, and how many times it has happened.

Bipolar is one of the most commonly mistaken words. With bipolar, if you say your mood goes up and down every day — mental health professionals cross “bipolar” off the list. Because that’s not bipolar disorder. They will want to know how much you slept this week, if you’ve ever been hospitalized, what type of jobs you’ve held and impulsive things you’ve done, and the last time you ate.

You might be thinking – wtf?

One issue that fuels mental health stigma is the false notion that since everybody feels depressed or anxious sometimes, anybody that claims to have depression or an anxiety disorder – is just experiencing an exaggerated form of the emotion.

It doesn’t help that even among health care providers, these words can be quite confusing. “Trauma” is frequently used in emergency rooms to describe an occurring crisis. But “trauma” means something very different to a psychiatrist, and also to a surgeon.

Try to choose your words carefully when you use them. Asking why somebody is sad when they tell you they have depression – might make the person feel misunderstood or undermined. Try asking them to clarify, or to tell you what they are experiencing before you make as assumption.

Use words like “perfectionist” instead of “OCD” or “moody” instead of “bipolar.” The more time we put into what we say, is more time we put into understanding others.

How would you rename mental health disorders?

Chris Lee PMHNP-BC is a psychiatric nurse practitioner at DreamCloud Psychiatry in Miami Beach, Florida.