They say, “Write what you know,” but as a therapist, I also like to think, “Treat what you know.”
I deal with depression every day—both as a “regular person” existing in this world and as a therapist. I’m generally a pretty calm person, but there are a few ways to push me until my inner New Jerseyan comes out, and oversimplifying depression is one of them.
Sure, from the outside, depression doesn’t always make sense. It may look like an outsized reaction to a certain stressor or even reacting “over nothing.” When I’m well, even I have a hard time understanding how I could have felt so depressed over certain things.
It is my life’s mission to help others feel less alone in their pain, so whether I can help you think differently about a loved one’s depression or help you feel seen, here are six things people get wrong about depression and what I wish they knew instead.
There’s “No Reason” to Be Depressed
Can we please stop it with this one? I’ve heard people use this to describe someone else’s depression; I’ve used it to describe my own depression. For starters, blaming yourself—or someone else blaming you—isn’t going to help.
Looking at me from the outside, you could say that I “have no reason to be depressed.” (Can you see my big finger quotes here?) I am an incredibly privileged person in many ways, and I live a life I largely love—and my background of trauma and my genetic predisposition means that sometimes that squirrelly organ in my skull just doesn’t have the resources to fight off a stressor, much like our immune system might not always have the power to fight off a new flu strain.
You Can Just “Snap Out Of It”
Despite what Instagram or TikTok might have you believe, it’s not as easy as “one quick hack” to get rid of depression. Maybe that does work for a few lucky ones, but for most people, it’s not that easy—and that’s not your fault, either. Just as you wouldn’t blame yourself for having Stage IV cancer vs. Stage III (we hope!), the severity of your depression isn’t your fault either.
Depression, like most other mental health conditions, exists on a continuum. This can range from having a few symptoms commonly associated with depression (i.e., low mood, fatigue, loss of appetite) but not enough to meet diagnosis—all the way to severe major depressive disorder, which can severely limit how one is able to care for themselves and may include hospitalization.
Telling someone with severe, suicidal depression that all they need to do is think positively is like using a band-aid for a bullet hole.
While you may mean well, telling someone how this one little thing cured your depression can make someone feel unheard at best—and can increase feelings of shame and stigmatization at worst.
Unless you are in my body and my brain and have had my exact set of circumstances, what worked for you probably won’t work for me—and vice versa.
That There’s a Depressed “Look”
Depression looks like the sullen teenager in their room wearing all black; it also looks like the bubbly blonde writer of this piece who’s typically donning at least several bright colors at a time. Depression might also look like the person in your mirror or in your house.
In a 2023 poll,1 nearly 1 in 3 people said they had received a depression diagnosis in their lifetime, so you probably know someone very close to you who has faced depression.
While some people with melancholic temperaments may be more prone to depression, those who appear outgoing and extroverted also deal with depression. This depression can be categorized in a few ways: “smiling” depression, high-functioning depression, masked depression. Often, these are the people who you’d “least expect” to have depression.
When I first revealed on my blog nearly a decade ago that I faced depression, I was working full-time, training for marathons, volunteering, trying to maintain a busy social life. I was constantly laughing and cracking jokes. I rarely had a free night on my calendar.
“I’m an extrovert!” I would have told you at the time. But the truth was that my thoughts were too dark to be with alone, and my perfectionism ran far too deep to admit—to myself or anyone else—that I was depressed.
SSRIs and Talk Therapy Are the Only Treatments
It’s a “good” time to be depressed. There were embarrassingly few advances in depression treatment for a very long time. Most modern depression medications are based on theories from the 1950s and ’60s.
‘I’m an extrovert!’ I would have told you at the time. But the truth was that my thoughts were too dark to be with alone…
Selective serotonin reuptake inhibitors (SSRIs) and talk therapy, until recently, were the main accessible depression treatments for most people. SSRIs come with side effects, and talk therapy can be very costly. (With that said, both of them can also be very effective.)
These days, ketamine therapy, and transcranial magnetic stimulation are just some of the currently available treatments for depression, but there are more than 2,000 clinical trials that are either ongoing or currently registered but have not yet begun.
Additionally, the Food and Drug Administration recently released guidelines for clinical trials of psychedelic medications,2 a step widely thought to be paving the way for FDA approval of psychedelics within the next few years.
Depression Only Affects Your Brain
“I’m not depressed!”
I’ve heard this countless times. The person doesn’t feel sad, hopeless, or suicidal.
They’re “just” having trouble sleeping and eating, and have “randomly” lost weight. Or maybe they have a lot of aches and pains and are constantly exhausted during the day. News flash: Our brains are actually a part of our body! In fact, they control the whole thing!
Our mental health can affect our physical health and vice versa. While some of the “classic” (read: diagnostic criteria) symptoms of major depressive disorder may include sleep disturbances and changes in appetite, often stomach issues and headaches with no other known causes may be related to psychological distress.3
That You’re Alone
When depression sinks its claws in, it feels like you’re fighting a futile battle as an army of one. But the truth is that is often the depression making you feel that way; those with major depressive disorder are more likely to blame themselves than others and then seek to distance themselves to escape the shame-inducing environment.4
Unfortunately, with depression rates higher than ever, odds are good that you know someone who has dealt with depression. Even if you think nobody that you know has gone through a depressive episode, remember that you’re seeing their highlight reel.