Self-Care With Dr. Shermaine: “'Low-Grade Depression'

Michelle Obama is getting attention after she got incredibly candid about her mental state in the second episode of her podcast, The Michelle Obama Podcast. The former first lady opened up to journalist Michele Norris about struggling with “low-grade depression” during the pandemic and resurgence of the fight for racial justice.

"These are not, they are not fulfilling times, spiritually," she said. "I know that I am dealing with some form of low-grade depression. Not just because of the quarantine, but because of the racial strife, and just seeing this administration, watching the hypocrisy of it, day in and day out, is dispiriting." "I'm waking up in the middle of the night because I'm worrying about something or there's a heaviness," she continued. Obama said she tries “to make sure I get a workout in,” but that there have been “periods throughout this quarantine, where I just have felt too low.”

Obama also said that it’s “exhausting" to hear stories about racial injustice in the US, noting that it’s hard to be “waking up to yet another story of a Black man or a Black person somehow being dehumanized, or hurt, or killed, or falsely accused of something." "It has led to a weight that I haven't felt in my life, in a while,” she said. "We talk about white women clutching their purses at the sight of us, or feeling uncomfortable when we walk in the store, but I wonder, do you know how afraid we are?"

Stepping away from social media and spending time with her family has helped Obama’s mental state, though. "You kinda have to sit in it for a minute, to know, 'Oh oh, I'm feeling off,'" she said. "I gotta feed myself with something better. And sometimes for me that means turning it off. It means turning off the phone, not taking in the news, because it is negative energy. I learned that in the days of the White House."

Here's what you need to know about low-grade depression, including the symptoms that may accompany it, and what to do if you think you may be experiencing it.

WHAT DOES IT MEAN TO HAVE LOW-GRADE DEPRESSION?

Low-grade depression isn’t exactly a medical diagnosis—but that doesn’t mean it’s not a real thing. “People describe their health symptoms using language that resonates with them and their experiences,” Monifa Seawell, MD, a board-certified psychiatrist in Atlanta, Georgia, tells Health. In the case of someone saying they have “low-grade depression,” like Obama (and which Dr. Seawell says she’s heard several times in her practice), a mental health professional then needs to ask questions to “translate the patient's health language into more specific medical language” to guide diagnoses and treatment, Dr. Seawell says.

Low-grade depression can be used to describe a range of different things, Gail Saltz, MD, clinical associate professor of psychiatry at the New York Presbyterian Hospital, Weill-Cornell Medical College, and author of The Power of Different, tells Health. “She may mean she has more feelings of sadness than usual that are pervading more of her day for multiple days, but that she does not feel overwhelmingly down, hopeless, helpless, worthless nor is she having a significant affect on her concentration, sleep nor appetite,” she says. “Or she might mean that she is having a clinical depression but that it is mild.”

Depression is a serious mood disorder that causes severe symptoms that impact how a patient feels, thinks, and deals with daily activities, according to the National Institute on Mental Health (NIMH). Major depressive disorder impacts 16.1 million American adults on any given year, per the Anxiety and Depression Association of America (ADAA).

Depression—even depression that feels like it’s on the minor end of the spectrum—is important to pay attention to. “If you feel like you have low-grade depression, you could actually have depression,” Thea Gallagher, PsyD, clinic director at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perlman School of Medicine, tells Health.

WHAT ARE THE SYMPTOMS OF LOW-GRADE DEPRESSION?

Since low-grade depression isn’t a formal medical diagnosis, the symptoms can vary in people. “I have had patients tell me they have low-grade depression and their symptoms ended up meeting the criteria for major depressive disorder,” Dr. Seawell says, adding that others have experienced some symptoms, but haven't met those same criteria for a diagnosis.

Basically, symptoms can vary from person to person. To be diagnosed with clinical depression, you need to have symptoms that persist for at least two weeks, according to NIMH. That can be a big differentiator between struggling with depressive symptoms and actually having clinically diagnosed depression, Dr. Saltz says.

If clinical depression is behind your low mood, NIMH says you may experience these symptoms:

A persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Irritability
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that don’t get better, even with treatment

Keep in mind that there are varying degrees of clinical depression, and the condition can generally be classified as mild, moderate, or severe. “In mild major depressive disorder, a person's symptoms are distressing but manageable and overall the symptoms don't significantly impair the person's personal and/or work life,” Dr. Seawell says. “In contrast, in severe major depressive disorder, the symptoms are intense, incredibly distressing to the person, and the symptoms cause a significant and severe disruption in the person's overall functioning.”

WHAT SHOULD YOU DO IF YOU FEEL LIKE YOU HAVE LOW-GRADE DEPRESSION?

Don’t let this slide or write off your feelings. “The problem is, left untreated, mild depression often worsens, and doesn’t get better on its own,” Dr. Saltz says.

She recommends trying things like getting regular exercise, talking to friends and family, forcing yourself to socialize (in a socially distant way, of course), and practicing daily gratitude to try to help. Dr. Gallagher says it’s also a good idea to think back to things you loved to do before you developed a low mood and try to replicate them. “It’s like muscle memory—the more you do these things, the better your chance of getting back to how you used to feel mentally,” Dr. Gallagher says.

But, if your feelings are persistent, Dr. Seawell says it’s a good idea to talk to a mental health professional. Also, keep this in mind, per Dr. Gallagher: If you think you think you might need to see a therapist, you probably need to see a therapist.

“Don't try to diagnose yourself,” Dr. Seawell says. “Even if you don’t meet the criteria for major depressive disorder, there are still other effective treatments that can be implemented such as therapy to help get you back to feeling like yourself.”

BY: Korin Miller, Health Magazine, On August 06, 2020

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