When you were 10, your parents divorced. At the end of elementary school, your best friends moved away. Your dog died two summers ago. Now, you have so much work that you hardly get out, and you rarely see your friends. Those are heavy experiences to go through in life, however they did not all happen at once. Going through any of them will make a person sad, but they will get over it with time. Sadness is not the same thing as depression, but according to Allen Leventhal it can become depression. In his 2008 report, Leventhal describes how sadness transforms into depression when people develop avoidance behaviors.
Sadness is a natural emotion that all humans experience upon losing something or someone. The death of a relative or a pet, a move to a new city or state, and the canceling of a favorite TV show can all be classified as loss, whether you have lost a loved one, some close friends, or a source of laughter. Loss connotes sadness wherein a person’s behavior is subject to change. They could have trouble sleeping, become lethargic, lose their appetite, or find it hard to concentrate. People can remain sad for days, weeks, or even months, at which point we say they are in grief. After a point, it becomes necessary to get over sadness though. It is an issue of survival to ameliorate your mind’s negative state and resume your normal behavior. The time limit is what differentiates sadness from depression. Sadness is natural, whereas depression is disruptive, unnatural, and recurring.
Someone who is sad will generally change their behavior to avoid doing things that remind them of what they have lost. If you and your best friend loved playing video games together, and then he moved away, you might stop playing video games because it reminds of you how sad you are that he is gone. This change in behavior is known as avoidance behavior. Sometimes it is a good thing. Earning poor marks on a test because you went out partying instead of studying for a few more hours may prompt you to concentrate harder on your studies and budget your time more wisely. Avoidance behavior can also be a bad thing when it transforms a person’s sadness into depression. The example given by Leventhal is a middle-aged man whose only social contact is his mother. They enjoyed reading and discussing books with each other, but after she died he stopped reading and spent more time working. Soon he was overworked, isolated, and diagnosed with depression. By avoiding reminders of loss, people forget that those things also brought them joy before sadness, and they deny themselves positive reinforcers for their normal behaviors. That is how sadness becomes depression.
Leventhal’s findings have implications for the field of diagnostic psychology. Many psychologists today prescribe anti-depressants to people who are merely sad, not depressed. The DSM-IV, a psychologists handbook, does not differentiate between the two. Sadness and depression have similar symptoms, but without taking into account the time effect for sadness, it can be diagnosed as depression instead. The consequences of these misdiagnoses are that sad people are subjected to the side effects of medication while experiencing no improvement in their condition. Leventhal believes that therapeutic sessions are much more effective in treating depressed, and even sad, patients. By talking regularly with patients, psychologists would be able to pinpoint avoidance behaviors and then correct them, thus providing more effective treatment than a pill ever could. Leventhal was able to help the aforementioned patient start reading books again and even convinced him to join a book club where he met a woman. The power of the pill is mighty in this day and age, but closer examination reveals that people helping people is more effective than popping pills might ever hope to be.
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