Being depressed is really not enjoyable. Depression takes many forms for many different people – some people have highs and lows, some have major depression, some have functional days and others never do.
Depression can involve a huge array of treatments including therapy, medication and experimental modalities. It can be permanent and intrusive, transitive. In all cases, depression is a monster, and depressed people often feel isolated and frustrated by what they’re experiencing. That’s made worse by some of the ways people respond to depression, like it’s something easily understood, and sometimes their suggestions are wildly unhelpful. For those with depression, dealing with these responses in addition to their mental illness is a huge waste of energy – and for those wanting to support depressed people, these attitudes may seem well-meaning, but they’re actually harmful.
So depression is just being really sad, right?
Actually, no. Depression is a mental health condition. Lots of people get sad. Lots of people experience really intense sadness, sometimes, or a prolonged state of sadness. Distinguishing between being sad and being depressed can be complicated, as there’s not a handy definitive test. People who are worried about their mental health should definitely seek counselling and advice – but being sad and being depressed are two very different things. Depression includes components of sadness, but it’s tangled with – depending on the person – fatigue, suicidal ideation, the inability to function or complete tasks of daily living, low or increased appetite, and many other symptoms.
If you’re interacting with depressed people, take your cues from them
Have you tried …?
Yes, probably. People who have been diagnosed with depression have likely gone over numerous options for treatment with their doctors and counsellors. Those might include counselling, which is the recommended first line of treatment, along with medication for people who need to bring their baseline mood level up so they can function. If medication doesn’t work, they’ve probably tried different psychiatric drugs to see if those are more effective. Patients might also have pursued massage, acupuncture, yoga, crystals, whatever the fuck else. Trust me, people have tried. No, don’t tell me your aunt’s boyfriend’s sister went mud bathing and it cured her. Just don’t. It’s been tried.
Why not just cheer up?
Seriously? This is my blank-faced expression. I’m sure it has occurred to no depressed person in the history of ever to “just cheer up” because being depressed is so fun and awesome. This seems to come with an implication that depressed people are to blame for their own mental illness, that if they just tried harder, they wouldn’t be depressed any more. It’s shaming, and also frustrating for people who are struggling with a really low mental state. Imagine if someone cut off your foot and then suggested that you just try growing it back. Have fun with that.
It’s all in your mind
Well, er, sort of. Yes, depression is related to imbalances of brain chemistry, and in that sense it is literally in your mind. But depression is actually more complicated than that. Sure, it can involve neurotransmitters, hormones and other chemicals produced within the body, including those that are a bit difficult to quantify and measure – sometimes it also involves fundamental brain changes, such as depression that sets in after an injury.
Sometimes it’s even a response to other medications; anaesthesia, for example, can cause depression for days, weeks and even months after surgery. But it’s also physical for many patients. Depression can cause gastrointestinal problems, disordered eating and other things that manifest in the physical world, too. Aside from the fact that it’s insulting and nasty to act like being attacked by your own mind isn’t real, it’s also factually incorrect to say that “it’s all in your mind” to someone who is experiencing, say, recurrent headaches associated with depression.
I can’t imagine …
No, you probably can’t. This is kind of an obvious and unhelpful statement. The only thing worse is pretending that you can imagine (“I was sad once too”) because, no, you can’t. Depression is extremely complicated and even depressed people can’t really imagine what other depressed people are going through, because this is an individual journey. Often people who say this seem to mean it in a kind of dismissive way – it’s not just that they can’t imagine, but that they’re implying your mental illness is imaginary.
Can’t you just be cured?/I thought you were fine now that you were on meds?
Depression is a mental health condition that can endure for life. Sometimes that means going to therapy and remaining on meds for the rest of your life, and it requires constantly adjusting your treatment as needed. You may have breakthrough depression where even with treatment you still have setbacks. You may have treatment-resistant depression where nothing really works for you and you’re struggling to manage your mental illness. There’s no cure for depression, meds aren’t always reliable and mental health conditions are variable over time.
Do you really need a service animal/meds/that much therapy?
Yes. Stop asking. Responding to depression when you have no framework for comprehending it is difficult. It’s also sometimes hard for people with depression to be able to focus on the needs of others around them because they are busy trying to stay alive. It’s not their job to make people around them feel better – and it’s not their job to explain depression or painstakingly answer the same series of intrusive questions over and over again. If you’re interacting with depressed people, take your cues from them, but remember this: depression can sometimes feel really isolating.
Sometimes, support takes the form of friends just being around and not backing down. Maybe that means consistently inviting people to events even if they often refuse. Or offering to bring food and help around the house or to pick up meds/drive people to therapy appointments. The needs of individual people are hugely variable, so this isn’t a prescription for “how to support your depressed friends and family”. It’s a start.
If you really want to know how to respond to depression, try asking the person who’s experiencing it – and don’t be offended if you’re rebuffed or the response is “I honestly don’t know.”
• This article was originally published on This Ain’t Livin’, part of the Guardian Comment Network