Most people find it difficult to tolerate negative feelings like sadness. This task is even more difficult when you suffer from depression, because any time your sadness feels too intense or lasts too long, you worry that the depression is coming back. And if you've ever been depressed, you know how terrifying the prospect is of going back to that dark place.
Your loved ones also become hypersensitive to your sadness, which just exacerbates your fears. If you're feeling down, they ask you if you're taking your meds, or if maybe your meds need to be adjusted. Don't get me wrong--I'm all for meds. I've tried to go off them several times, and each time I got depressed again. But it's unfortunate that once you've been depressed, every feeling has to be scrutinized for potential pathology.
There's also this added sense of failure associated with relapse. Like you should have been able to prevent it this time, since you've been there before. And even though you recovered before, you fear that if it happens again, you won't be so lucky the next time.
And even if you do recover, you fear that the wait will be agony. I fear depression much more than anxiety because when I'm anxious I can take an Ativan and I feel better immediately. But antidepressants don't work that way, so there's not much I can do to feel better right away when I'm depressed.
Whenever I am afraid I'm becoming depressed, I journal about my fears, my sense of failure, and my pain. And when I look back at these entries, I realize how strong I am. There are a lot of things that suck about depression, but I have no doubt that it has made me a stronger person, even while it tries to convince me that I'm weak.
But how do I know when I'm sad versus depressed? To be honest, I don't always know. Sometimes I feel depressed for a day. Sometimes I feel sad for what feels like an eternity. The line is not as clear-cut as we'd like to think. But regardless of whether it's sadness or depression, the best I can do is to control what I can control. This includes therapy, meds, stress management, and self-care.
And most importantly, for me, it means practicing self-acceptance--of my sadness, my depression, and everything else that makes me who I am, for better or worse.