Recognize and Manage Sadness

Sadness

While it can be technically described, it's hard to describe the emptiness, the loneliness, and the unfathomable feeling of true sadness. It is a feeling that penetrates your gut and gives you heartache.

A Look at Sadness

Sadness is usually due to untoward circumstances. Everyone in this life has experienced some degree of sadness, grief, or distress after a loss (for example, death or a break-up), a disappointment (not getting that job you wanted; when a person is diagnosed with a long-term illness), or some kind of trauma (like an assault or accident). A sad response is a natural and normal neurological response that lasts for days, sometimes even weeks.

This response can be very difficult, involving both physical and mental symptoms. It can make a person cry sometimes; it can cause irritability, difficulty concentrating, isolation, emptiness, and can cause a change in eating or sleeping patterns (too much or too little). It can make a person feel downright sick with stomach aches and headaches. Sometimes it is pretty incapacitating, BUT it should not be disabling for more than several days. When it goes on for too long, it technically becomes an "adjustment disorder with [a] depressed mood," once known as situational depression (see below).

In sadness, unhappy feelings usually come in waves that ebb and flow, interspersed with an occasional good thought or memory (however rare as it may seem). People who experience sadness do tend to maintain some integrity and self-esteem (however tenuous), both of which can be lacking in major depression.

The “good” thing about this kind of “depression” is that it is caused by a sad situation - an actual event. It is not some kind of free-floating depression that comes out of nowhere and seems to have no cause. With sadness, people usually begin to feel a bit better within a matter of days to a couple of weeks. A person knows what is causing it and can understand and deal directly, often with a logical approach.

While sadness - or an adjustment disorder- can be very painful, the ability to recognize and manage sadness may be key to preventing it from evolving into depression. If you have sadness, there is often light at the end of the tunnel - and it may become an opportunity to grow. Do not despair; things should, and usually do, change.

From Sadness to Situational Depression (also known as an Adjustment Disorder with Depressed Mood"): Recognizing the Shift

If sadness is not going away, situational depression (adjustment disorder) typically develops. The terms “situational depression" and "adjustment disorder" describe this problem to a tee: A person is unable to mentally adjust to a situation over time, usually a sad or tragic event. It is usually a reaction to a significant loss: Loss of a significant other, a job, income, health, personal integrity, physical integrity, and others. However, unlike "sadness", a person's response has become out of control: The response is out of proportion to the occurrence itself and begins to demonstrate ongoing symptoms that are more overwhelming and pervasive, like those of major depression.

How do you know if it is sadness or an adjustment disorder? According to the DSM-5 (the American Psychiatric Association's "bible" of official diagnoses), the onset of an adjustment disorder or "situational depression" must have occurred within three months of the event. If it has been more than three months since the incident, it has likely morphed into major depression.

This is why it is important to manage sadness and situational depression early. You can start with treatment approaches to sadness. But, if those are not helping, if you are having too much trouble coping with your depression, if you are stuck in a rut, muster up your energy, be bold - if only for a minute: Call a counselor to talk (even online) - they can help point you in the right direction. If that is not for you, call a friend or relative. Look at and think about the approaches discussed for major depression. There are some very, very successful solutions. Attack it early.

Approaches, Remedies, and Treatments for Sadness and Adjustment Disorder

• Be aware of the cause.

• Go outside, walk, and indulge in nature.

• Meditation, yoga, mindfulness, tai chi, aromatherapy, Reiki

  (positive energy)

• Embrace your emotions - it's okay to be sad. Cry.

• Talk to someone about your sadness.

• Figure out what might make you happy and make yourself do it-like gardening or shopping.

• Visit with others (reach out if you need to).

• Take care of yourself: You might even indulge yourself a bit - spoil yourself.

• Write about your sadness in – journal. This often helps you sort out your emotions.

• If you can function, consider going to work. Depending on your situation at work, you might be able to share your problem with others who can help provide support and help you cope. Sometimes work can help take your mind off things for a few hours, too. Or…take a day off.

• Try to think of the problem differently: Maybe what is “bad” with the event has some “good” angle as well (for example, people experiencing divorce often find personal growth as they move on and "rebound" from sadness and disappointment).

• Try Reading – Especially read about the situation you are dealing with (i.e., the concept of loss) and how other people have dealt with it.

• Listen to music - it helps your mind process emotions

• Dig deep and try to find a little humor now and then.

• Explore online apps for dealing with grief and sadness.

• Make yourself smile once in a while - according to some studies, the act of smiling can sometimes increase our "happier" hormones: endorphins, serotonin, and dopamine.

Over-the-Counter Medications

​There are not a lot of over-the-counter medicines that will quickly lift your spirits, but there are other medications that will help treat any physical manifestations of depression. Things for your headaches, body aches and pains,  sleep,, and stomach problems.

Considered Herbal and Natural Remedies

​Personal response times and effects are variable, but the following might be worth a try.

• ​Multivitamins (also see vitamins below)

• ​St. John’s Wort helps increase serotonin, dopamine, and norepinephrine (see above). Like "anything antidepressant," it works for some people but not for others. It takes about four weeks to work optimally, so if you are sad (as in unhappiness because of an occurrence), you may already be improving before it even begins to work. 

  St John's Wort should not be taken with other antidepressant medications because it can cause too much of an increase in serotonin (serotonin syndrome). It also has some interactions with other medications, so be sure to check on these if you decide to try this.

• ​SAMe (S-adenosyl-L-methionine) is a naturally occurring substance made in the body that is also available as a supplement. This also helps increase serotonin, dopamine, and norepinephrine. This takes about a week to start working, if it is going to work, which is a bit faster than other antidepressant remedies. Besides depression, it might also help with arthritis. Like St. John's Wort, it should not be taken with other antidepressants and has interactions with quite a few medications.

• 5-HTP is a precursor to serotonin and helps increase serotonin levels in the brain, thereby helping to decrease depression. From patient reports, response time is very variable, with this (weeks to months. Since it can potentially take so long, a person's sadness may start going away before the effects of the supplement take effect. This should not be taken with other antidepressant medications because of the threat from the cumulative effects of serotonin.

• ​​​Lavender oil may help decrease feelings of depression to some degree. It reportedly acts on hormones (i.e., oxytocin) that enhance mood. I don't see this as the miracle drug for major depression, but it may be a good adjunct to other treatments.

Prescriptive Treatments

Antidepressants are not typically prescribed for sadness because it is usually short-lived. Antidepressants normally take around four weeks to optimally work (give or take a week or two on either end). So, by the time an antidepressant starts to work, a person has usually worked through much of their sadness. Antidepressants can be used, however, for adjustment disorder/situational depression. Commonly used antidepressants include SSRIs (which increase serotonin) and SNRIs (which increase serotonin and norepinephrine) - Also see depression. If anxiety is a component of the depression, some antianxiety medications and approaches may help as well - see anxiety.

It can be a very tough journey, but time and support, sometimes in conjunction with those self-help approaches above, can help with sadness. If the depression is severe, incapacitating or long-lasting, that is a different ballgame.

If you are thinking about suicide, you can call, text or chat at 988 lifeline on your phone or PC. It is confidential. Things can change. Just talk.