What You Should Know About Depression

Depression is common: Almost 16 million Americans deal with it every year. But for those who have it, explaining their feelings can be hard.

It can affect different people in different ways. “It doesn’t always look like what you hear about or see on TV,” says Crystal Clancy, a licensed marriage and family therapist in Burnsville, MN. Clancy had postpartum depression (PPD) after having her second child in 2005, and now she counsels people with PPD and other forms of depression.

People with depression may not want to share what they feel. But learning more about depression can help you help someone who has it. Here are seven things that people with depression wish you knew.

1. Depression isn’t the same as being sad.

“We’ve all been sad. But feeling sad is usually a temporary state. Depression is long-lasting,” says Tina Walch, MD, a psychiatrist and chief medical director of South Oaks Hospital in Amityville, NY.

In fact, you may not even feel sad when you’re depressed. “When I’m having a rise in my depression, I’m not always sad. Sometimes I can be disengaged or disinterested. Other times, my depression causes anger and frustration,” says Mark Black, a 38-year-old speaker and life strategy coach in New Brunswick, Canada. “That can be especially hard at work, where I have a lot of demands and am expected to be upbeat.”

“With depression, you might have trouble concentrating. You might be angry or irritable. You may not want to care for yourself or spend time with other people,” Walch says. “It’s about being unable to enjoy or be engaged in your life.”

2. You can’t just wish or pray it away.

“People think that you can just control depression,” says Ashley Valencia, a 30-year-old printing professional in Dallas. “But trying to help someone with depression by saying ‘pray,’ ‘try to get over it,’ or ‘just try this or that’ isn’t actually helpful.”

What does help? “Be loving and kind and understanding,” Valencia says. “Instead of trying [to ‘fix’ me], let me work with my doctor to find real solutions.”

3. It’s a real disease.

“When I had depression, it was a chronic, physical thing I could actually feel inside my head,” says William Seavey, a 69-year-old living in Cambria, Canada.

“Too many people still believe it’s not a real medical disease. But research shows that it is,” Walch says. Experts believe it’s caused by a combination of things. “If you are experiencing symptoms of depression, you should see a medical or mental health professional,” Walch says.

4. You can be strong and still be depressed.

Depression can sap your energy and make you blue. But many people with the disease may not seem like they’re struggling. “Just because you are a strong person, and you don’t ‘look’ or ‘act’ depressed, does not mean that you aren’t depressed,” says Holly Rodriguez, a professional in the mid-Atlantic area. “The ‘strong black woman’ stereotype is very damaging to African-American women like me, because it keeps many of us in the darkness about this illness and [leads us to] try to handle it on our own.”

5. Depression medication doesn’t turn you into a zombie.

“I hear this from people all the time,” Valencia says. But depression medication helped Valencia enjoy life again: “I still have depression, but I feel more evened out now.”

Not all people with depression need to take medication. But for those who do, there are many good medication options available that can help them feel better. (Talk therapy, lifestyle changes, and brain stimulation therapy are also good ways to treat depression.)

6. Depression isn’t a sign you’re ungrateful.

Especially with postpartum depression, new parents hear comments like, “I don’t understand why you’re not happy since you just had a new baby,” or “You should be grateful, especially with so many people struggling to have children.” “Depression is an illness; it’s not a choice. Counting your blessings can’t mask it or make it go away,” Clancy says. “In fact, if you tell someone with depression that they should feel grateful for what they have, it can make their depression even worse.”

7. Feeling better doesn’t mean it’s over.

Some people will have depression only for a short time. But for many, depression is a long-term illness. You might feel good for months or years, and then suffer from a depressive period again.

“It’s [often] a chronic condition, just like diabetes,” Walch says. “You don’t just stop taking insulin because your blood sugar numbers are good. In the same way, you don’t abruptly stop taking medication or seeing your therapist because your mood has improved.” Instead, staying on top of depression involves working with your mental health team and taking care of yourself, even during “good times.”