Depression Demystified

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Recently my husband lost a friend to suicide.  She had been in the midst of a deep bout of depression the situation she found herself in after leaving an abusive boyfriend was over-whelming to her.  She was feeling lost since the death of her best friend several years ago in a tragic car accident and found herself in this relationship her best friend would have discouraged.  Did she want to kill herself? Yes and No.  Her emotions would overwhelm her so much that she would take too many pills to dull the pain, knowing the fact she would likely die.  On at least two different occasions after taking an extraordinary dose of pills she came to her senses and called every friend she knew to ask for help.  Despite being further away from her than most of her friends, on these two occasions my husband was the first to respond.  He would take the trip in the middle of the night from Hamilton to Toronto to make sure she is okay, calling 911 on the way.  He saved her life.  After her last attempt she moved back to Montreal to be with her family.  Sadly, the feelings became overwhelming and she again took too many pills.  This time she did not survive.

Seeing my husband go through the loss of a dear friend brings to my mind the times I have lost friends of my own to suicide.  Being the one left behind is not an easy place to be.  Not only are you left to contend with your own feelings about the loss of someone you love, but you have to deal with the misunderstandings on the situation surrounding their death by those who do not understand the nature of depression as a mental illness.  For the ones who watched their loved ones suffer, the pain they faced is far too real; but for those who have never experienced or faced depression in someone they love, it is senseless.  In memory of the friends my husband and I have lost to suicide, and for those who are facing depression in our lives I have decided to write this post to demystify depression and suicide.  I apologize if this post is long, but hopefully this will help those who have never faced it understand a bit better, and those who are either going through it themselves or know someone who is can perhaps find a way to make it a little easier to deal with, if not, understand.

Depression is a hidden mental illness.  What this means is that unless someone is sobbing on your shoulder, you can not tell that they are depressed just by looking at them.  I should note that someone sobbing on your shoulder does not necessarily mean that they are depressed they just might be going through a hard time.  I embellish for dramatic flare. Here are some of the myths surrounding this confusing mental illness that I would like to debunk.

Depression is a Disease

Depression is not a disease. People often call it one because of the impact that it has on a person’s life.  Those who refer to it as such are often survivors of depression or the loved ones of someone who is/was depressed.  They do this because it is the easiest way to convey the all-consuming nature of this mental illness.  The truth is that diseases can be transferred from person to person, but you can not catch depression by being around a depressed person. It is an illness that exists solely in the person suffering from it.

You Can Tell Someone is Depressed by Looking at Them

As I stated earlier, depression is a hidden illness you can not tell that someone is depressed just by looking at them.  There are a lot of people who respond to someone’s depression by saying “they/you don’t look depressed”.  Someone crying or holding their head low, or slumping their shoulders does not indicate depression.  People who don’t have depression, but may be sad, stressed or tired tend to have this type of body language too.  Symptoms of depression vary from person to person and also vary in intensity.  Some of the common symptoms of depression are lack of appetite, difficulty falling or staying asleep, sleeping too much, lethargy, lack of interest in regular daily activities (even ones like brushing your teeth), lack of interest in social activities, negative talk, and poor self-esteem.  There are many more symptoms than the ones listed here.  If you are concerned that you or a family member may suffer depression talk to a doctor about the symptoms.

Once You are Depressed, You are Always Depressed

This is in fact, not true.  There are many forms of depression ranging from acute, to chronic, to seasonal.  Many mood disorders are actually co-morbid (coincide) with depression.  For example, Bi-Polar Disorder is a chemical imbalance in the brain, but depression is a very common symptom.  Not all mental illnesses are a permanent condition, and this is particularly true of depression.  Someone may be in a depressed state for long periods of time, but they do eventually come out of it.  The important thing to remember is that it is a temporary state of mind.  The time it takes for someone to come out on the other side varies based on the degree of the depression and if it is co-morbid with another illness such as a mood disorder.  However, people who have experienced depression are more prone to re-experience it.

A Depressed Person Can Just Snap Out of Their Depression

Nobody can just snap out of depression, it is not like having one bad day and then deciding to not let it bug you; it is more like having multiple bad days in a row that can last for a few weeks or months.  True they can recover and resume their normal activities, but this takes time, patience, and compassion from the people around them.  You can not tell someone who is depressed to “Just snap out of it”.  There are a lot of physiological things happening in the body that causes the depression.  It takes time for the body to recover from it.  Taking medications for depression can help regulate these and improve some of the symptoms.

There is Something Wrong With Depressed People

“What’s wrong/the matter with you?” is about the worst question you can ask someone suffering from depression.  What this does is completely trivializes the feelings and experiences this person is going through.  It suggests to someone already suffering from low self-esteem that they are less-than someone else or who they were before being depressed.  The only thing “wrong” with someone who is depressed is that they are for the moment ill and are in need of help.  In fact this is a completely unnecessary question to ask at all, but one that is often thrown out there.

They are on Medications so They Will be Okay

Medications like anti-depressants help normalize the body and alleviate some of the symptoms of depression, but they are not a cure-all for depression.  In fact many people refuse to use medications because it makes them feel numb to all emotions including positive ones.  Medications are recommended for severe cases of depression because those people are more likely to harm themselves.  In truth mild forms of depression can be treated simply by counseling, seasonal depression can be treated by light therapy, but moderate to severe levels of depression should be treated with a combination of medications and counseling.  It is not a good idea to assume that medications are enough as most people do not adhere to recommendations for taking the medications.  Inconsistency in taking them such as not taking enough, not taking it at the right times, or over-dosing can lead to tragic results.  Click here for more info.

If I Remain Positive, or Re-phrase What a Depressed Person Experiences in Positive Way it Will Help Improve Their Mood

This idea is wrought with good intentions, but it is in fact not helpful and potentially more damaging.  For example, I was going through a bout of depression several years ago.  I was in a tough place, and trying to get my life back together.  I was exhausted from the effort it took and was sitting in the mall waiting for my husband to come back from a store he went into.  I was inexplicably on the verge of tears when a well-meaning teen told me to “cheer up because nothing in life is that bad” and then walked away.  In less than 3 seconds he made everything that I was going through seem like it shouldn’t matter, and my feelings seem like a gross over-reaction to it.  Instead of appreciating his sunny disposition on life, I resented him and felt worse.  A better way to help someone who is depressed is to empathize with their feelings which is different from sympathizing.  Empathy requires understanding the person’s feelings where as sympathy is feeling sorry for them.  It may seem counter-intuitive but Negative Validation is more helpful.  It requires acknowledging the feelings of the depressed person, and normalizing their reactions to their experiences.

They are Just Trying to Seek Attention

People who are depressed are not just trying to seek attention.  If they appear to be seeking attention it is because they know that there is something going on with them and they are asking for help.  It may seem a little melodramatic to you, but consider that they are so overwhelmed that they are incapable of finding another way to ask for help.  Perhaps they had tried more subtle ways but they were either unnoticed, ignored or trivialized.  What they are going through may not seem like the end of the world to you, but it does to them.  If they are asking for help or talking about it, take it seriously.

If You Can Find What Triggered the Depression, You Can Fix it

Although there may be one thing that might have triggered the depressive episode, it is not the only cause of the depression.  Therefore, fixing that one issue may help the person feel a little better, but it will not cure the depression.  Depression is most often a response to many things going wrong in a person’s life.  It could be a lot of things that has happened all at once, or a pile of little things building up over time.  If it is part of a mood disorder it is a result of a chemical imbalance, if it is seasonal, it is connected to vitamin levels.  There is no exact cause of depression, however the most common one is a loss of anything that was important to that person.  Since the cause of a person’s depression can be multifaceted, it requires a lot searching to find what can be at the root of it.

All Depressed People Harm Themselves

Not true.  Very few depressed people harm themselves, but the ones who do get the most attention and often get medical help faster.  Part of the symptoms of depression is to feel everything all at once and be overwhelmed by it all.  Some people react to this influx of emotion by self harming as a way to cope with the feelings, while others respond this influx of emotion by becoming numb to it through repressing it.  For those who continuously repress the flood of emotions, it becomes the body’s default mode for dealing with them because it has been trained to not deal with the emotions.  After a while feeling anything during depression becomes more and more difficult for these people.  While some people either suffer in silence or have their emotions wildly out of control, those who have trained their bodies to react with numbness begin to miss feeling anything.  This is when they will engage in self-destructive behaviours in attempt to feel again; substance abuse and self-mutilation being the most common.

Depression Always Leads to Suicide

Mild forms of depression will not lead to suicide.  With a little help people suffering from mild depression will recover fairly quickly.  Truthfully most people suffering mild to moderate depression will not attempt suicide.  If someone is suffering from severe depression they are at a higher risk of committing suicide.  That being said, there are other factors that need to be considered to see if someone is really at risk.  If someone is talking vaguely of not being here any more, or life with out them, and there is nothing more concrete that that it is low risk and considered suicide ideation.  They are not likely going to commit suicide.  However, if someone is harming themselves, talking concretely about suicide, has attempted before, are making final arrangements for their things/tying loose ends, and upon further questioning have a plan; they are extremely high risk and need professional help immediately.  There is a very small proportion of people suffering from depression that will commit suicide with out showing one or more of these indicators.  Most of these are accidental suicides, where it was not intended to kill themselves but they did by overdosing on medications or drugs for example.  In the case of accidental suicides notes are not usually left because it was not intentional.

A Person is at Highest Risk of Committing Suicide at Their Lowest Point of Depression

Not true.  Picture depression as a valley between two hills.  Before depression you are at the top of one of the hills, but when you start to enter depression you lose your footing and end up rolling out of control in a flood of emotions.  During this time you are just trying to get your bearings, but once you are at the bottom of that hill you are really too hurt, tired, and confused to do anything.  It is only when you start to recover and heal that you venture up the next hill, and this is when a person is most at risk.  In the depths of depression, you are unable to see anything clearly, but when you start to recover, clarity comes and you see how far you have fallen and how far you have to go to reach full recovery.  This is often scary and overwhelming for someone who has already gone through a lot, and without a strong support system, they can either fall back into depression or seriously injure or kill themselves.  When a depressed person starts to have a little more energy, and starts resuming some of their normal activities, and is beginning to talk about their experiences is when they need their supports the most and when they are in the most danger of becoming suicidal.  It is when they are at the half-way point of that second hill (recovery) that they are truly out of immediate danger.

Depressed People Just Need Some Space

No!  They may say they want to be alone, and could be very irritable and difficult to be around, but you should never just leave them alone.  I’m not saying that you should hover around them like a helicopter either.  Let’s be honest, it is very taxing to be the only person looking after someone experiencing depression and struggling to get them to do things in their daily routines.  This is why the support network of family and friends is so important.  It keeps you from burning out, and keeps them from becoming more isolated and withdrawn.  It is not good to let people with depression to become more withdrawn because they need their support network if they are going to recover.  They need to know that there are people who do care about them and won’t give up on them.  This being said, try to recognize when something has become too much for them and let them take the time they need for a break.  For example, it might be a little too overwhelming to have the entire family move into their home to care for them, or to have friends call them everyday to see how they are doing.  Trading off responsibilities and checking in once in a while would be better.

Depression Only Affects the Person Who is Depressed

Depression affects every aspect of that person’s life as they withdraw from family and friends, and may miss a lot of work.  Those who are directly involved or are a part of this person’s life are left to pick up the pieces as well as take care of the person struggling from depression because they simply don’t have the energy or drive to do it themselves.  Family and friends in the caregiver role will have to deal with the emotions of their loved one as well as their own.  They will experience burn-out, and would benefit from having a support network of their own or going for occasional counseling when things are really rough to know how to best deal with the situation and help their loved one.

I hope that this has helped my readers understand the nature of depression and the myths and attitudes those facing depression deal with.  If you or someone you love struggles with depression remember that there are things that will help with recovery.

1) Establish a routine, no matter how simple.  It could be just getting up and getting dressed and brushing your teeth, small everyday things will help a depressed person’s life gain some sense of normality.

2) Eat regular meals.  Depressed people have a decrease in appetite, but eating small regular meals will help them stay healthy and give them some energy

3) Establish a regular sleep cycle. It is better that you maintain going to bed and getting up at a regular time every day, even if it means sleeping in a little longer than you would otherwise.  This aids in giving life a sense of normality and forces the body to sleep when it needs to.  If a nap is necessary during the day, keep it short.

For more tips on helping someone recover from depression click this link. More