Good Mood: The New Psychology
of Overcoming Depression

Let's be sure that you and I are talking about the same state of mind when we use the word "depression." People sometimes say "I'm depressed" when they refer to a state of mind quite different from the established psychological meaning of the term.

The rock-bottom element in depression is the feeling of sadness. The term "sad" includes without distinction the feelings and moods one might call "melancholy," "blue," "being down," "misery," "grief," "despair," and similar descriptions of negative feeling. The prolonged feeling of sadness, plus the thought "I'm worthless", constitute depression; these two elements are the hallmarks of the depressed person.

A variety of other symptoms are also found in some depressed persons--inability to sleep, disinterest in sex, inability to work, for example. But these other symptoms are by no means universal. If we stick to a definition of depression as sadness plus low self-esteem, we will be clear and unconfused about the subject of this book. And you will find it easy to check yourself against that definition, with the aid of the detailed descriptions of sadness and the sense of worthlessness in the definitions and case histories that follow.

A sense of helplessness, often with a sense of hopelessness, accompanies or is part of the sadness and lack of self-regard in depression. The helpless attitude might be considered part of the core of depression. A rigid set of "ought's" and "musts", and a absence of pleasurable experiences, frequently are important constituents, too.

Prolonged sadness and depression felt to me -- and others have used similar language -- like living in a pool of pain, feeling helpless to escape from it.

Some sadness is inescapable and normal, of course; life without sadness would not be human. But the subject of this book is the state of sadness which does not pass as fast as it "ought" to, and the person who stays sad longer than is "reasonable." The words "ought" and "reasonable" are troublesome, and we'll come to them later. For now let us simply think of depression as a state of sadness sufficiently intense and persistent that the depressed person might consider seeking help to get less sad. And in depression, thoughts of personal worthlessness ("low self- esteem") are more frequent and intense than most people experience.

Similar descriptions of depression--or "melancholia"--have been given from ancient Roman times until now.1

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