Depression and Low Self-Esteem

We have all been sad. We have lost loves, dreams, pride, hopes, and faith. Even periods of serious depression, like Abe Lincoln's, are not rare events. About 15% of us have been so depressed that it would have been wise to seek professional help (Wilcoxon, Schrader, & Nelson, 1976). But only one third of depressed people seek treatment (and they wait an average of 258 days to do so).

A Presidential Commission on Mental Health estimated that 1 out of 5 of us (about 1 in 10 for males and 1 in 4 for females) will suffer from depression sometime in our lives. That is 20% in an affluent country. Women are twice as likely as men to be depressed; men get upset over jobs, women over relationships; married people are twice as likely to be sad as single.

Depression is not only fairly common, it can be very serious. Like Abe Lincoln as a young man, the misery can be so constant, so great, and seem so endless that one wants to die--to escape the pain. In the U.S. one person every minute attempts suicide; one person every 24 minutes succeeds. There are more suicides than murders. Even among teenagers, it is third only to accidents and homicides. Almost 500,000 teenagers attempt suicide each year, not counting suicides disguised as "accidents" (McCoy, 1982).

Suicide is so sad because it is a permanent, desperate solution to a temporary problem. What a loss to the world if Lincoln had killed himself. What a blow to each family in which an unnecessary death occurs. Indeed, if sadness is disrupting your work and schooling--and you are thinking of ending it all--seek professional help immediately; run no risk with your life.

This "common cold of mental disorders" hospitalizes 250,000 a year, the most extreme cases. It slows down many more of us and makes us gloomy. There are less serious forms of depression: sadness, disappointment, loneliness, self-criticism, low self-concepts, guilt, shame, boredom, tiredness, lack of interests, and lack of meaning in life. Most of us are or will be somewhat depressed or disappointed and could use some assistance. Overall, depression costs the country more in treatment and lost work than heart disease.

There is a long-running controversy about the cause of depression. Some say our personal history or experiences cause depression, others say brain chemistry causes depression. Both psychology and drugs relieve depression in some cases, so the treatment doesn't clarify the causes.

Like several other human disorders, there is evidence that unhappiness runs in families. Studies estimate that 15% to 40% of the risk of major depression results from genetic factors. Your genes may have predisposed you to be at a certain point on the happiness-depression scale, just as other genes may have predisposed you to be at a certain weight.

But, most psychologists believe you can influence your weight and your mood; genes don't have perfect control. In the case of both happiness and sadness, self-control will take wisdom, planning, and effort. You surely have to pursue happiness. It takes mindfulness and skills or knowledge.