New Content Added: To update the content we have added Depression information found at the end of the Table of Contents.
you are aware, the title of this home study course is "Sad is How I Am! Treating
Dysthymia in Children and Adults." On this track, we will discuss the difference between sadness and depression, Thought Distortions, and Handcuffed Depression.
to the DSM, a dysthymic disorder is a type of depression that is not severe
enough to be called a Major Depressive Episode. A Dysthymic Disorder lasts much
longer than Major Depressive Disorder, and there are no high phases. For purposes
of brevity of terminology in this home study course, however, I will use the terms
dysthymia and depression interchangeably.
make sure we are on the same page, so to speak, a dysthymic disorder is characterized
by sadness, pessimism, dysomnia (dis-som-nee-a) or sleep disorder, poor appetite
or overeating, and so on. Symptoms occur most of each day, most days for an extended
period of time.
3 Differences Between Sadness and Depression
do you feel is the difference between sadness and depression? Here are
my ideas; see how they compare with yours.
I feel sadness is a normal emotion
created by perceptions of a situation. With sadness, your client describes an
event involving loss or disappointment in usually an undistorted way. Thus, I
feel, sadness oftentimes comes without distortion, for example it comes without
Second, sadness involves a flow of feeling, and therefore,
it is time limited.
Third, sadness does not involve a lessening of self-esteem.
Do you agree with these three ideas concerning the differences between sadness
versus depression? If not, turn the CD player off and derive criteria that is
more meaningful to you.
depression, just to make sure we're on the same page, I define depression as an
illness that results from thoughts that are distorted in some way. According to
the National Institute of Health, major depression is the leading cause of disability
in the United States. Depression affects almost 10% of the population, or 18 to
19 million Americans in a given year.
example of a thought distortion that differentiates depression from sadness
would be your client uses all or nothing thinking and states, "I'll never
be happy again." This concept of distorted thinking that accompanies depression
brings me to the title of this home study course, "Sad is How I Am."
Think about this phrase, "Sad is How I Am." Now think about a client
you are treating or have treated with a Dysthymic Disorder or perhaps a Major
Depressive Episode. Do you agree that to your client, their depression seems frozen?
By frozen I mean it tends to persist or reoccur indefinitely. Also, unlike sadness,
depression involves loss of self esteem.
One aspect of being frozen in depression is, as you
know, difficulty in making decisions. I like to think of this difficulty in making
decisions as Handcuffed Depression. Perhaps you have heard this term before. Think
of a depressed client you are treating who feels constantly faced with decisions
they cannot resolve. Do they feel confused? Overwhelmed? Do they repeatedly vacillate
Freud's 3 Kinds of Ambivalence:
-- One type of
ambivalence was emotional oscillation between love and hate.
The second type of
ambivalence was voluntary inability to decide on an action.
The third type of
ambivalence was an intellectual belief in contradictory propositions.
does all this mean to the depressed client you are currently treating? I
like to boil all of this down into the concept I mentioned earlier, the concept
of Handcuffed Depression. I like the term Handcuffed Depression, because
it creates a visualization which describes the depressed client's inability to
I describe three interventions on the next track regarding handcuffed depression,
think of a client you are treating who feels frozen or handcuffed into depression
because, as the title of this course states "Sad is How I Am" or rather
"sad is how they are." Sadness appears to your client as being a state
or condition that is beyond their control.
as you will see on track two with Alison her depression held her captive and frozen
Peer-Reviewed Journal Article References:
Ahern, E., & Semkovska, M. (2017). Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis. Neuropsychology, 31(1), 52–72.
Delgadillo, J., & Gonzalez Salas Duhne, P. (2020). Targeted prescription of cognitive–behavioral therapy versus person-centered counseling for depression using a machine learning approach. Journal of Consulting and Clinical Psychology, 88(1), 14–24.
Fernández-Theoduloz, G., Paz, V., Nicolaisen-Sobesky, E., Pérez, A., Buunk, A. P., Cabana, Á., & Gradin, V. B. (2019). Social avoidance in depression: A study using a social decision-making task. Journal of Abnormal Psychology, 128(3), 234–244.
Gómez Penedo, J. M., Coyne, A. E., Constantino, M. J., Krieger, T., Hayes, A. M., & grosse Holtforth, M. (2020). Theory-specific patient change processes and mechanisms in different cognitive therapies for depression. Journal of Consulting and Clinical Psychology, 88(8), 774–785.
Keen, E. (2011). Emotional narratives: Depression as sadness—Anxiety as fear. The Humanistic Psychologist, 39(1), 66–70.
Rutter, M. (1982). Review of Loss: Sadness and depression—Attachment and loss, Vol. 3 [Review of the book Loss: Sadness and depression—attachment and loss, vol. Iii, by J. Bowlby]. American Journal of Orthopsychiatry, 52(1), 176–177.
Online Continuing Education QUESTION 1
are Freud's three states of ambivalence? To select and enter your answer go to .