Depression or Sadness: How Do You Know?

Good day, folks.

I'm back from a year's absence, during which time I had chemotherapy for a resurgence of my on-going non-hodgkins lymphoma.

Just when I thought I was done with that, I had pneumonia; spent Thanksgiving of 2007 in the hospital. Very pleasant visits from my daughters and my wife.

Then, just when that was over, my wife suddenly died - no illness, no good reason, just a heart electrical malfunction. We had been married 46 years.

The emotional ups and downs of this year, as you can imagine, were enormous. But what were they? Was I depressed, sad, angry, frightened...what?

Start with the cancer. It had been 15 years since I first was diagnosed. My initial reaction in 1992 was great fear. Then, as I learned that my particular lymphoma could be treated - though it would return from time to time - the terror lessened. But depression replaced it. Each time I would go to the hospital for treatment (or a C.T. scan) I would find myself diving into a mild depression one, two, even three months beforehand.

Just as I was learning not to be depressed before C.T. scans, my oncologist told me that the lymphoma had come back big time. Chemo was indicated. I was "brave," and set out on that course of action. But the debilitating drugs, including massive doses of steroids, left me feeling more and more depressed. I cried in my doctor's office. Though I upped my anti-depressants, it was clear to everyone around me that I was not a happy fellow.

After that, the pneumonia was almost a joke. Almost. But no depression, just anger that the chemo had reduced my resistance to infections.

My wife's death: a shock, a terrible blow, an inexplicable occurrence.

But I was not depressed. I was intensely sad; in mourning; grieving.

The difference was not only in the justification for my sadness - a spouse's death after years of happy marriage - but in the physical feelings. With depression, I could be lethargic, or my back would hurt, or I'd get stomach cramps.

With grief came a pain, a heaviness, in the area of my heart and chest. With grief came huge amounts of tears and shouting at fate.

Depression often is the result of an imagination or internal feelings that cannot find a realistic outlet. We believe something bad is going to happen or has happened - but it often has not. With my wife's death, there was no doubt.

One of my therapists previously had pointed out to me that I was okay when I had to deal with real problems, real crises. When they were fantasized or imagined was when I had depression.

This was a real problem. This was a real crisis. I was intensely sad, but not depressed.

Which is not to say depression won't follow.

As time passes, I may feel abandoned by my wife. This is not an accurate portrayal of what happened, of course. She did not abandon me. But my mind may twist things in that direction.