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Clinical Depression: What You Need to Know


Clinical depression, also known as major depression, is mild or severe depression that can occur in virtually any individual. When one is depressed, they may feel overwhelming sadness or ennui or general dissatisfaction with their life. It is one of the most diagnosed mental disorders in the United States, with symptoms ranging from severe sadness to suicidal thoughts. Many adults and youth suffer from clinical depression and do not receive treatment for it. In 2016, 60% of adolescents (in the U.S.) did not receive treatment for depression despite having a major depressive episode.

Clinical depression is a serious issue that is seldom covered in schools and with ineffective support. The current measures that governments like the American one have taken to ensure that children are not in the position where they commit suicide, although admirable, are not nearly enough to discourage such means of escaping from their reality. There is so much more that we can do, and part of it lies in recognizing the problem and learning how to combat it along with the social perception of the disease.



There are various symptoms of clinical depression. Each symptom, however, has its own conditions under which it manifests and in what capacity and intensity. For example, bouts of extreme sadness may occur only when the afflicted person is thinking about a particular topic or event. This may not be a frequent situation and therefore may remain unknown to those who know the person--even family members. That’s why it’s important for all of us to educate ourselves on mental illnesses so that we can be on the lookout.

Though this list is not prescriptive or all-encompassing, some of the symptoms that are commonly associated with clinical depression are:

  • Emotional Turbulence

  • Overwhelming feelings of

  • Sadness

  • Tearfulness

  • Emptiness

  • Hopelessness

  • Worthlessness

  • Guilt

  • Frustration with Life

  • Apathy

  • Lack of interest in things that interested the person before

  • Anxiety

  • Agitation

  • Restlessness

  • Worry

  • Concentration Issues

  • Physical Issues

  • Sleeping Issues

  • Insomnia

  • Recurring nightmares

  • Excessive Tiredness

  • Lack of energy

  • Accomplishing small tasks takes monumental coaxing or extreme effort on behalf of the person who is afflicted by clinical depression

  • Pain

  • Any sort of pain in any body part with a neurological origin

  • Any sort of pain that comes from any self-inflicted wounds

  • Any sort of emotional pain originating from memories or experiences

  • Suicidal Thoughts - (Self-Inflicted Harm)

  • Frequent thoughts of death

  • Questioning self-worth

  • Low self-esteem

  • Often times, one is unwilling to participate in normal life and cuts themselves off from the outside world

These symptoms plague those with clinical depression and are exacerbated by a host of other mental issues as well, sometimes resulting in suicidal thoughts and tendencies. Generally, teens and adults are more often confronted with clinical depression than toddlers due to the fact that their brains are more developed for reasoning and thinking abilities when compared to toddlers. However, it is never too early to become well-versed in mental wellness and maintenance. According to VeryWellMind, women are more likely to be diagnosed with depression than men, but this may be due to the fact that they are more likely to seek treatment and medical help than compared to men. On the flip side of the coin, men are 3.5 times more likely to die by suicide than women. This does not mean, however, that someone of a particular gender identity should be automatically categorized as at risk for suicide, however, because each individual’s mental health journey is different and highly variant.



Depression and clinical depression can be caused by a variety of factors. Many of these factors are environmental in nature as they originate from one’s feelings about the environment in which they reside. One may feel alienated from the rest of the people residing in that environment and they may feel that they do not have anyone who truly cares for them. This may bring in early-onset depression which, once rooted, can develop into full-scale clinical depression.

Events in which there is a high risk of trauma or sadness can, unfortunately, foster a spiral into clinical depression. Things like a death in the family, physical abuse, traumatic events (hostage crisis, terrorist attack, survivor’s guilt, etc.) are all events that could cause clinical depression. However, it is also possible to delve into a depressed frame of mind repeatedly and have that progress into full-blown clinical depression despite living an otherwise typical life. Indeed, there are also biological and cognitive factors to the onset of depression, all of which can be critical to one's mental health.



Going through any form of clinical depression is very tough not only on the patient’s mind but also on their body, their social image, their family, their friends, etc. It is like a cloud that doesn’t just hang over their head but encroaches the skies of their close companions. Think of it this way: Someone who is depressed may feel that they have a storm raging on inside. This leads gray skies in the heads of others who know them well, out of empathy, sympathy, and a desire to see that person feel better again. This is not an easy task. However, it is possible for one to somewhat alleviate the suffering of a depressed person and contribute to their journey of rehabilitation.

First of all, it is important to realize that you are not there to solve their problems, nor should you feel responsible to "cure" the illness on their behalf. The problems that someone may have are not yours to solve because, at the end of the day, we don’t and can’t feel what they’re feeling. Instead of being their self-appointed sword and shield, you should be their map or guide and ensure that they get to a point where they can work through their struggles and feelings themselves, ultimately emerging better at the end of the experience for having accomplished something with the strength they had all along.

When dealing with depression, Letters to Strangers has a uniquely-crafted, tried-and-true strategy: SIMPLE. The SIMPLE methodology is a plan devised to help those who are caring for depressed individuals, as well as for someone who may be depressed to take steps in self-care. It is as follows:

  • S - Self-Advocate

  • I - Increment

  • M - Meditation

  • P - Patience

  • L - Listen

  • E - Educate


  • Learn about mental health and psychology, and educate yourself on the way social-cultural, biological, and cognitive factors can all affect one’s mental state. The more informed you are, the more tools you’ll have on your side. With the stigma of mental illness, it can feel tough to bring up or acknowledge mental turmoil. But when you are more educated on the issue, you give yourself more power to control the narrative.

  • A great starting curriculum is CrashCourse’s free series on psychology:


  • Go one step at a time

  • Be accepting of change and don’t try to force it

  • Try to set small stepping stones or milestones

  • Slowly bring up the topic in small amounts, incrementally


  • Rather than imagine this as someone sitting in the lotus position humming “Ohm,” think of this more as a state of mind; a shift in perspective

  • This mindset asks for you or the individual you are talking with to reflect on life and emotions, but more importantly, specific moments as well:

  • How does this affect me?

  • Is this good for me and my well-being?

  • What do I feel?

  • Do I understand why I feel the way I do?

  • Try to slow down thoughts and really think about them

  • The more one can capture individual moments and make sense of them on a macro scale, the more control one can restore over mood and behaviors.


  • Be gentle and patient with others and yourself. If therapy or medication don't work out, for example, remember that you are not alone

  • Be non-judgmental with differing views and ideas, and understand that it may take time for both you and them to arrive at a point where mental health is prioritized the way you desire it to be.


  • Ask questions: use “what” rather than “why” (“why” can feel accusative); clarify moods so you can respond more appropriately (ex: “That sounds like it must be really frustrating, yeah?")

  • Echo the individual’s thoughts and opinions with affirmative phrases after each break in their narrative

  • Confirm the individual’s thoughts and opinions, oftentimes by repeating back bits of what they said to demonstrate rapt attention

  • Speak in the “I” - if you are going to suggest something, speak about it from your perspective and acknowledge that it is only your perspective. Rather than saying “Yoga will make all this go away,” say “I’ve found that yoga works for me, but I’m sure you’ve thought about it already?”


  • Do your research on mental health, be aware and knowledgeable of these issues, and then spread the knowledge

  • Embody your knowledge in your everyday life: know and avoid common assumptions and stereotypes, be gentle and not confrontational with the people around you, and offer unassuming resources to those who may not know where to seek help



Dealing with depression is one of the hardest things that one can ever go through. Seeing someone whom you love face depression is itself another struggle. But you are not alone. Millions of people throughout the US alone face minor to severe depression every single day. Many of them go untreated. Mental illnesses like depression aren’t things we can just sweep under the rug. The truth of the matter is that it is there, it is real, and it is raw and hinges on often volatile emotions. And it can happen to anyone. There is no specific ethnicity that is targeted by mental illnesses nor gender nor age. That is part of what can make it so crippling and so deadly. And most important of all, you are not weak if you seek help.

It takes strength and fortitude to seek treatment for mental health problems. And it is worth it. Those who get treatment usually have a better standard of life and generally, live happier lives. It is important to note that the perception of mental illnesses as diseases that can be cured or even immediately mitigated by medication can actually be dangerous because even though it can be the case, “curing” a mental illness is not a universal occurrence. When we perpetuate the idea that a mental illness is just a “phase” that can be cleanly wrapped up with the right medication, we can also unintentionally further the stigma against those whose mental illnesses persist and fluctuate. Mental illnesses need to be treated in the same ways that they affect those who are suffering through them: through emotions and behavior, through self-, peer-, professional-, and perhaps medical care, depending on the person and the disorder. By listening and learning about these illnesses, only then can we begin to be equipped to deal with them. It is equally important to continue active listening, however. The foundation of our mental health education relies on truly hearing someone and being there for them, as well as giving yourself that same permission for self-reflection and self-forgiveness.

Many organizations have come forth to treat various groups with mental illnesses, or at least provide support and destigmatization outreach. The Letters to Strangers community aims to create a more empathetic world where self-reflection and empathy empower everyone - not just those with mental illnesses - to appreciate the importance of mental health and the human connection. Throughout the past five years, we’ve learned the one letter can and has saved a life.

50% of all lifetime cases of mental illness begin by age 14. 75% by age 24. Now that you know more about depression, join us. Learn more, advocate, and fight for the cause.


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