Depression 101

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Avatar for JonicaBradley
3 years ago

Although it really isn't up to the depressed person to educate the general public about depression, and although it is incredibly exhausting to try to explain depression to the uninformed, I'm going to try anyhow.

Some of us have a better grasp of and the wherewithal to articulate the ins and outs of depression. I hope to explain a bit more about what depression is and isn't and how it differentiates from some of the more commonly held beliefs and stereotypes.

I happen to not only have the vocabulary to help ease this lesson, I also studied psychology in College. I never got my degree. I have, however been involved in psychology as a patient for 47 years. I do have a firm grasp on my diagnosis.

A recent, well-meaning comment on one of my articles is the impetus for this piece.

The comment, paraphrased, was basically asking if I was sad again, and advising me to not let depression into my personality.

I know the comment was well intended. I also know the commenter obviously dies not suffer from or really understand depression.

I'll go over some commonly held misconceptions and stereotypes and explain how they miss the mark.

Misconception #1

Depression = Sadness

Sometimes, yes, a person suffering from depression will feel sad.

More often, however, sadness and crying aren't the first signals to psychiatrists and psychologists that a diagnosis of depression is appropriate.

A person suffering from depression may not seem sad at all, ever. When asked how the depressed person feels, the most common answer is, "I'm ok."

Other signs and symptoms include

  • lethargy

  • sleeping too much

  • sleeping too little

  • cessation of activities one normally enjoys

  • withdrawing from friends and loved ones

Misconception #2

Depression is a choice

This misconception is on fact incredibly damaging to people suffering from depression. Especially when it is followed up by advice such as

  • Think positive thoughts

  • Just smile

  • You just have to shake it off

  • Decide to be happy

These statements to a depressed person most often have the result of heaping shame on top of an already depressed state.

Shame is toxic under the best circumstances. Shaming a depressed person results in self-hatred, self-blame, and even self-harm.

See, the thing about depression is that it's not an emotion or an attitude. It's not a choice. It is an illness. A physical disease.

Science had determined that people with this disease either have brain chemical imbalances or do not have access to the chemicals a healthy brain produces naturally.

No amount of willpower, attitude, determination, or positive thinking can change brain chemistry.

People living with depression have no control over their bodies over-manufacture or under-manufacture of chemicals like serotonin, dopamine, endorphins. We have no control over whether or not we can access the serotonin our brains do produce.

This is why medical doctors will prescribe medications. Which will take 4 to 6 weeks to begin working. It can take years of adjusting dosage and medication before the right balance can be found.

Meanwhile, the depressed person is still depressed. Still can't get out of bed. Still can't go to work. Still can't care for their children. Still do not have the ability to fulfill tasks of daily living.

This is why it is so damaging to believe it is a personality trait, a decision, a controllable situation.

This is why it's so damaging to give advice such as just be happy or think positive thoughts.

There are, of course, some activities a person who is living with depression can do in order to mitigate and of the worst symptoms.

Exercise releases endorphins and dopamine. Waking, running, and cardio can be very beneficial and help prescribed medications with their efficacy.

But the person living with depression must first have the energy to even think about doing these things.

Self harm behaviors such as cutting, burning, or punching will also release dopamine. It takes far less energy to run a razorblade across your skin than to

a) get out of bed

b) get dressed

c) leave the house

d) go for a run

In my deepest depression, I can't even get out of bed. I can't even think about getting out of bed let alone doing it. And I feel ashamed. Which only makes things worse.

Research has relatively recently drawn a connection between gut bacteria and brain chemistry. Research is ongoing in this area.

My medical team insists I take probiotics for this very reason. I do. I also take a host of other medications for depression and anxiety. I've found a good balance of drugs that enable me to get out of bed, get dressed, do chores, write, paint, exercise, cook health food, bathe, and brush my teeth. (I still dislike brushing my hair, but I have the energy to do it when I need to).

Misconception #3

It is easy to get treatment

All over the world there's a stigma attached to mental illness. So even if a person suspects they have problems, they are too often reluctant to seek help. And when help is offered they are reluctant to accept it until in desperate, dire straights.

I am not familiar with healthcare systems around the world, but in the U.S. you can buy an assault rifle faster than you can get mental health treatment.

Unless a person attempts suicide, in which case they are put on a 72 hour hospital hold and given medication and referrals to psychiatric services, the quest for a diagnosis is a long one.

First the person must recognize there is a medical issue. Many people believe (because they are told) they are just lazy or unmotivated.

Once the person decides there's more going on than meets the eye, they have to find a psychiatrist. People with healthcare insurance can do this fairly quickly.

But people without health insurance or boatloads of money will have to find county services.

In 2020 it is estimated that 31 million Americans were without health insurance.

Once a depressed person acknowledges they have a mental illness, and they find county services, they'll have to go through a battery of tests to get an appointment to see a psychiatrist. Who will then make their best guess at a diagnosis.

For most of psychiatry, the diagnosis is based on what medication works.

Talk about backward.

Each of these steps is incredibly overwhelming. Either for the patient or the patient's caregivers.

At each step there's the very strong temptation to just give up. And many depressed people do just that. Treatment is neither easy to come by nor necessarily precise. It's never immediate.

Mental health is not like appendicitis or a broken bone. You don't take an x-ray and say ah-hah! and go fix whatever is wrong by splinting the bone and throwing on a cast or doing surgery to remove the infected organ.

Depression, especially, is diagnosed based on the patient's self-reported behaviors, thoughts, and feelings.

Treatment is NOT easy to come by, not is it cheap, not is it desired much of the time. Because seeking treatment and accepting help means admitting there's something wrong. Which is hard because social stigma.

I'm going to close now because this article is turning into a book.

I hope I have helped someone to understand a bit better what depression is and isn't.

  • Depression IS a disease.

  • Depression IS a physical ailment

  • Depression IS a chemical imbalances.

  • Depression IS debilitating.

  • Depression IS NOT just feeling sad.

  • Depression IS NOT a choice.

  • Depression IS NOT a personality trait.

  • Depression IS NOT a moral failing.

As always, I'm open to comment and question.

I do want to stress how very grateful I am to my read.cash family. I feel supported at every turn. I appreciate each and every one of you.

Til next time!

Lead and first image license free from Unsplash

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3 years ago

Comments

I have always grappled with the "idea" of depression. But you are right. My confusion is probably due to my not fully understanding it. This article does help me to understand it better. I guess when most of us think of depression, that's what we tend to think of. Sadness or despair or just being down in the doldrums—due to whatever reason.

But of course, that is depression of a different sort I suppose. CLINICAL depression seems quite different, and so while I can sit here without a clinical case and say, "Just pull yourself up and suck it up buttercup," it is probably said without fully understanding what I am asking you to do and why it is much more difficult for you to do that than it is for me.

I also can relate to having a situation or circumstance that is beyond your control, and having people around me constantly wanting to diagnose me or offer suggestions as to what I need to do to make things better. As the old saying goes, "When you are sick, everyone around you suddenly becomes a doctor."

It can be frustrating to say the least.

$ 0.05
3 years ago

It's so sad to me, with all of the advancement in medicine, we still seem to be in the dark ages when it comes to mental conditions.

Some areas of the world are darker than others when it comes to it.

Even here in the west, people don't want to take the time to understand it. People also don't want to take the time to understand diabetes, T1 or T2!

People here are very quick to pass judgement, less quick to have empathy, and rarely take the time to learn what it is they are judging.

I'm glad you aren't one of those people!

Thank you for taking the time, my friend.

$ 0.05
3 years ago

Really, depression is bad for both physical and mental health.Sometimes I also become depressed but always say my heart and mind that everything is ok,think positive don't scared.I can feel this bad situation but can't overcome from this problem. Even I saw lots of people who lost their life just for this depression.

$ 0.03
3 years ago

Yes depression is a serious disease. But it is different to sadness or anxiety.

$ 0.00
3 years ago

Thanks for explaining it a bit farther than what I've usually heard at school. One thing is for sure, depression is real and is happening to people. We may not be aware of what a person is experiencing. Also others keep denying the fact that a person is experiencing depression and literally expecting them to change the way that person should think. Rather than widening their perception to that of that person with depression. That may have help a lot of people. And maybe, just maybe, we could decrease the suicide rates. Especially during these tough and lonely times in the pandemic and in quarantine.

$ 0.02
3 years ago

I agree, empathy and compassion are necessary. Not just for depression, but for humanity itself.

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3 years ago

Yeah, I just hope that by time. We actually get to empathise with each other's feelings. And not just making them think that it's just all in their heads.

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3 years ago

Agree!

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3 years ago

Depression is worse than death. In misconception #1 those are the most common symptoms where 70% of the people go through. Mostly if we are around positive thinking people, to a certain extent we can control depression.

$ 0.05
3 years ago

I understand what you are saying. I believe we can control the behaviors that accompany depression more easily around other people, but just being around "positive" people doesn't change the fact of the chemical imbalances or the traumas that caused the depression. "Controlling depression" sounds more like controlling sadness or, something I am extremely guilty of, shoving the emotions so far from down inside that I can pretend they aren't there and the trauma never happened. As I've learned, that's not a healthy or permanent way of coping. My recent flashbacks and the anxiety accompanying them are proof. But I do get what you are saying. I don't much fancy being alone these days.

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3 years ago

When I turned 15, I always felt this void in my heart and it kept on growing daily maybe because of my age but for a year I have really been feeling void of emotion even when people die I don't feel anything!

$ 0.05
3 years ago

I'm sorry you have been going through that. How are you now?

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3 years ago

With the help of my Mother and Older Brother I came out of it, the only thing you have in this world is Family that's why I will cherish them always!! thank you for asking dear!

$ 0.02
3 years ago

In my case, my found family has been much more helpful to me than my birth family. Still, family rocks!

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3 years ago

Just a few question, what if somebody is just always staring into something and sometimes walking back and forth and not talking and saying that somebody is dictating him/her to do this and that, is that someone having a depression too?

Thanks for your article, and I got curious with this topic too.

$ 0.02
3 years ago

Hearing voices and having delusions *can be because of Bi-polar (manic depression). It can also indicate psychosis due to any number of factors. Drugs, dehydration, brain injury, schizophrenia, Bi-polar disorder, PTSD, and many more. There important thing is to get a proper medical diagnosis. If this is happening to a friend or family member, I STRONGLY encourage you to guide then toward a doctor. A general practitioner will recognize if the condition warrants a psychiatrist and would make the referral. If the person is endangering themselves or others following the directives, it is very important to get them into a safe and secure environment such as a hospital.

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3 years ago

He was bring to a psychiatrist before and give some medicines but he did not drink it, and telling them he is not crazy, why need to drink that medicine

$ 0.02
3 years ago

That's too bad. Unfortunately one symptom common to many mental illness is the resistance to taking medication. Either because the person convinced themselves medication means they really are "crazy" (this was me) or because the medication makes them feel worse than the illness. I hope your person find the help they need and accepts it.

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3 years ago

He didnot accept the medicines, and there are times that he act differently and only looking in a direction and walking back and forth.

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3 years ago

His loved ones must feel very frustrated and hopeless. It takes a lot of patience to get people the help they need. Do you know the saying, "You can lead a horse to water but you can't make it drink?" This would apply perfectly to your person. You can lead him to help but you can't force him to accept it.

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3 years ago

Yes, patience and understanding, like last night her nieces talking to him and he said he is ok, and fine nothing to worry, but when it comes to his actions he is not sometimes

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3 years ago

In the Philippines, few can only afford to pay for consultation and treatments because most of us are not insured. The majority has also misconceptions about insurance. There was a trending post about a mom who committed suicide due to postpartum depression. She was misunderstood and I do feel for her. You're right, we cannot force depressed people to just "think positively" because it is beyond that. And I wish there will be more awareness and support about mental health in the future.

$ 0.02
3 years ago

I'm so sorry for that mother and her family. In some places in the world, people still view depression as posession by the devil and evil spirits. It really is very misunderstood.

$ 0.00
3 years ago

Yes, especially in poorer countries. My partner and I used to fight a lot, I just didn't get it why he cannot understand me. I had to tell him I am fighting postpartum depression.

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3 years ago

I got divorced because of postpartum depression. I smashed his heart in a million little pieces. He didn't speak to me for 15 years.

Now, we are back together.

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3 years ago

Wow, now that's true love. I admire your relationship.

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3 years ago

Thank you this has a lot of information to take.

If only many people could have the chance to read your very enlightening article, there could be a lot of chances for people suffering from depression to be saved. If only everybody understood what depression is and how should it be taken, there should have been no one suffering alone, crying in the dark, and wishing to die at the very moment.

Depression is not something to laugh at or something to think about that someone is just overly dramatic over things. I believe people who haven't experienced great trauma will never understand the battles that you only have in mind.

If you will allow me to post this on my news feed on Facebook, of course, will include the courtesy of you as the author, I will appreciate it. It's something I read today that is what people needed to learn. I wanted to share with all my friends the lesson I learned from your article. Thank you very much.

$ 0.02
3 years ago

Please feel free to share. Also feel free to read any of my other articles and share those as well. https://read.cash/r/JonicaBradley

$ 0.00
3 years ago

Thank you so much! I really believe this could spread awareness to many people.

Yes been reading a quite few of your articles. You're such an inspiration. With your ability to touch the hearts of others from writing, you could be something in the future 😊

$ 0.02
3 years ago

I appreciate the encouragement!

$ 0.00
3 years ago

Thank you 💓

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3 years ago

I have to admit, I used to think depression was something the victim had control over. So when I heard someone was depressed my thoughts were: "why choose to be depressed when you can shake off your worries and be cheerful?" But as I gained more experience I realized that it is far from what I thought. People don't choose to be in that state, it's beyond their power. That is why it is nearly impossible to get out of depression by yourself, one needs consistent and effective assistance. Thanks for the educating article

$ 0.02
3 years ago

Your welcome. There are things we can do as a depressed person. We can choose to accept help. We can choose to take our medications. We can choose to go to therapy. We can choose to keep physically healthy once we are able. But just getting to the point where we have the energy to think about these things let alone choose then is incredibly difficult. Especially when we feel so alone.

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3 years ago

One reason why depression is not taken seriously mostly is because of other people who claims they have it even they do not consult or let themselves be diagnosed first. This is why when other people who REALLY have depression opens up, the society thinks that he/she is just bluffing. This generation has become so toxic that depression has become a trend, that if they have it, they are "IN". That is stupid, because depression is NOT a joke, and being sad does not automatically means depression. Others think that when they post sad thoughts of social media, they are depressed. The real depressed people don't even have the energy to engage in social interactions. Real depressed people don't even seem like they are! I have heard about many people suddenly committing suicide and their loved ones did not expect it at all, because "That person looks so happy!" and all.

In short, it sucks that there is a big stigma surrounding depression. Until people try to dig deeper and try to sincerely understand, it will be an ongoing problem that kills silently.

Thank you for enlightening us about depression. And being an example of the right thing to do, ask for medical help. Open up. Keeep going even it's hard. You are amazing. You are strong. Remember that. :)

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3 years ago

Thank you.

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3 years ago

Always my pleasure.

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3 years ago

Depression is not what other people think about it,only the person who is passing through it can explain the real situation.They need our attention and care because sometimes few words can be serve as a great relief for depressed person.

$ 0.02
3 years ago

Yes. And sometimes words don't help at all, but the attempt of the other person does help.

$ 0.00
3 years ago

This is so scary as other disease but people fail to understand this. It will kill you from inside like slow poison but people will not understand. Nicely narrated dear. Thanks for the awesome post to aware people.

$ 0.02
3 years ago

Thank you for reading it.

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3 years ago

Welcome dear

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3 years ago

Thank you for letting this out here Jonica. It is a great help for us who are lost about depression. I know someone who is suffering from this and I just don't know what to do and am afraid to say a thing 'coz I may say something that worsens her feelings.

$ 0.05
3 years ago

Sometimes, not saying anything is the right move. Maybe, just go to get house and do some chores. Don't ask permission. Just barber the dirty clothes or the dirty dishes and wash them. Or if that is taken care of by someone else, just go sit with your friend. Ask her if you can brush her hair. Physical contact is something so small to do, but so big to receive. Sometimes just a few moments of distraction helps a lot. I used to call a friend and ask them to just tell me about their day. Like what they did from the time they woke up. Sometimes just listening to boring life stories really helps keep the panic at bay.

The scariest part of depression for me, is the fear I will spend the rest of my life in the darkest deepest depression.

I never do, but I'm always a tiny bit panicked about it.

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3 years ago

Ah, so it's okay not to ask permission... I was afraid to touch her things as she might be mad. She locks herself inside of her room all day and wouldn't talk. It's like she withdraws herself from anyone. Sometimes I feel frustrated not being able to do anything for her.

It is good to know that you are surrounded by people who know how to make you feel safe.

$ 0.02
3 years ago

They don't do my laundry, though... Lol. Does she get mad when she's not withdrawn when you touch her things? If you try it once, and she gets annoyed, don't do it again, I guess. Everyone is different. Sometimes it takes experimenting. If you feel more comfortable asking, then ask. One thing to keep in mind is another person can't fix the depressed person, can't force them to come out of their shell. But for some, just the act of you trying of appreciated even if that appreciation is not expressed

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3 years ago

Haha, perhaps they know you can do it yourself so they don't touch your laundry :D

Yes, there was a time I organized her things on the table and she wasn't happy. It just pains me to see her so alone but I guess I can't do much, only try my best to understand. I sometimes ask her, but she wouldn't say a word.

$ 0.03
3 years ago

you're doing what you can. and that is a lot more than many ever even try to do.

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3 years ago

Depression is the deadliest silent killer of all.

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3 years ago

It really can be.

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3 years ago

We can't exactly, determine who is under depression just by looking at their faces. Sometimes those who's smiling and has a jolly behavior was more depressed than those whos crybaby. We don't know which is which, when I found out my friend is sad, I just making them feel I am always on their side no matter what. That I am one call away. I don't know if they're under depression or what I just want to help them out when they call me . Depression is no joke, I know someone who commit suicide because of it. And he's a lively person before. What little thing but has big impact we can do is to smile every time, to everyone we see. Show a genuine smile and make them feel they're notice by their sourrounding

$ 0.05
3 years ago

Oh. That's a good one! Many depressed people feel invisible. Nobody really sees them. Nobody understands. Nobody hears their cries for help.

Letting people know you see then is very important. Even if you don't really know or understand what they are going through, your willingness to stand by their side is huge!

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3 years ago

I knew it because, I know what it feels being alone when there's a lot of people on your sourrounding. And that very sad, so I told myself to smile as I could for them not to feel what I had before

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3 years ago

Depression kills and not as most people think, you can die of starvation or even any infection by relieving yourself lying in bed. I say this with propriety since I lived it with an aunt who fell into a deep depression that urinated and defecated on herself.

She got out of it! Yes, fortunately and thanks to psychiatric treatment. She only took one year of treatment and left it on her own responsibility or irresponsibility from my point of view since the doctor recommended 2 years of treatment.

She feels good, she is active and back to her old life, but not everyone makes it.

Brain chemistry is so important and delicate that life depends on it.

I feel sad when I get my period and sometimes I cry for no reason, that is hormonal it is not even sadness due to external causes, it is something physical it does not need a reason to justify it, because people always want a reason for everything and to have it.

However, I may not brush my hair either, I socialize less and less every day, I need a lot of energy even to get out of bed, and I sleep more. Is it laziness or depression? The experts are the ones who know, if my life loses meaning I will seek help, as you say the first thing to do is to recognize and evaluate yourself.

Thank you for using your life experience as an example and to help others.

$ 0.05
3 years ago

Ugh. The hair... There is absolutely no way I would be able to pull myself out of a deep depression. Literally someone else has to pull me. Fortunately, I have had people in my life that have helped with this.

Others are not so fortunate.

I'm really one of the lucky ones.

$ 0.00
3 years ago