I’ve been clinically depressed over thirty years. There are times when I am in what I’ve termed remission but the depression never ever leaves. It’s become my companion for better or worst. Over the years my depression takes on different faces to the point where sometimes I didn’t even recognize it until much later. What that means is that the methods I use to manage my depression have had to shift and morph to fit. And that’s something to keep in mind when a loved one is dealing with depression. Depression not only looks different in individual people it can also look different in the same person.
Here’s my handy list of ten things not to say to your loved one (or even yourself) about managing depression.
“Why don’t you just go on meds?” or “Why don’t you go off meds.”
The choice to take meds is a personal decision that should exist between a person and their health care provider. I have over various depressive episodes made choices in both directions. Currently, I am medicated and I’m okay with that decision. But I’m open that at some point it may not be the path I wish to take and when that happens I’ll be okay about not being on meds. But it’s not up to those in my life to decide if I should or should not take medications.
The stigma around both positions makes it hard for people to feel comfortable with this aspect of depression. I remember at one point feeling that medication was a sign of weakness and that it would erase some central aspect of personality. The first time I made a choice to take medication I remember feeling that I’d somehow lost a battle. But over time I realized that this attitude came more from others than from my own experience. If I don’t want to take meds I don’t want it to be a decision rooted in other’s judgment.
“If you just exercised you’d feel better.”
I love to exercise. I workout every day of the week. I run. I do trapeze. And yes it absolutely helps my mood swings. Endorphins are amazing things. But when I am in the depths there are times when I literally cannot leave my house to move my body. The gym can be a high anxiety place for me as a fat woman and anxiety feeds my depression like tinder to a fire. Telling me to go exercise to get out of depression is futile if the situation actually making my depression worst.
“Eat only organic, paleo, whole food,” etc.
Every day I get on Facebook to face yet another meme about how if I just eat some veggies I’ll be a whole new person. Or if I take an herbal supplement. Or if I just follow the cave woman diet. For some of us, depression does weird things to our relationship with food. Some of us struggle with using food as a drug to get us through the dark times while others turn away from food. Limiting what we can eat or should eat just complicates an already stressful minefield.
“You’re too fat, too thin, too fit, etc to be depressed.”
As a fat person, I’ve encountered plenty of people who think I should be thin because of my depression. Apparently a lot of people in my life believe depressed people don’t eat. Other friends have commented that people tell them they look “too healthy” to be depressed aka thin and fit looking. Because we as depressed people have a variety of relationships with food and exercise it only makes sense that our bodies are going to manifest depression in different ways. And really how our bodies look should not play any role in judging the validity of what’s happening in our minds.
“You just want attention. Your self-harm is just an attempt to get attention.”
When I had my first break down at sixteen, most of the people around me dismissed me as seeking attention as if this was a horrible shameful thing. When I began cutting in my early twenties, again my actions were dismissed as “attention seeking.” I remember feeling horribly ashamed by these comments and also struggling to figure out if my depression was “real.”
What I’ve come to realize is that seeking attention is not a bad thing. The desire to want help and support does not make depression or self-harm any less real. Loving support is a positive thing and the desire for it does not make one weak or fake.
And sometimes these actions have nothing to do with wanting attention and that’s okay as well. Self-harm for me was a way to release the inner pain and torment I felt during depressive episodes. It was something I did in secret not just because of shame but because it was an intensely private experience. When someone noticed it was usually because they were seeking it out.
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“You can’t be that bad you’re not suicidal.”
Being suicidal is not the only sign of depression. The majority of my worst depressive episodes did not involve suicidal thoughts at all. Often I wondered if being dead might be preferable but it never progressed to actually contemplating ways to kill myself. And frankly when suicide became the most dominating expression I knew things had reached critical level. Depression is NOT going from sad to suicidal in 30 seconds. Depression has stages of progression like any other condition. And suicide is not the only symptom. Nor is it usually an early symptom.
“You don’t act like you’re depressed.”
Robin Williams once said “I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless.” While humor is not normally my go-to when I’m depressed I’ve meet many people who while depressed made people laugh the hardest. For me depression makes me irritable. I don’t act sad. I don’t always cry. I’m usually incredibly snappy and grumpy.
People have commented to me often that depression means sadness which is a fundamental misunderstanding of depression. Depression does contain sadness but it also contains other emotions including total ennui. Depression is boring. Dreadfully boring. I am not always sad when I’m depressed. I’m listless, tired, angry, frustrated. So many other emotions. The similarity is that the emotions drain me and over-whelm me. But I’m not always going to be sad or crying or showing signs that have become the stereotype of depression.
“You’re lazy, bored, etc so why don’t you get a job? Or “How can you be depressed when you work regularly?”
Another no win for those of us managing depression. For those of us who can work, people can’t imagine we’re depressed because we’re functioning in what they consider a normal world. And for those of us who function at a job, we’re informed that if we just kept busy we’d not be depressed. Keeping busy is good for me when I’m depressed. But there are days when I wake up and literally can’t get out of bed. The thought of having to go out and interact is painful and unbearable. Yet often during my life I had no choice but to work. And l lost a lot of jobs because I called in too much or because when I did manage to get to work, the irritability drove away customers.
“Why don’t you just get therapy?”
Therapy can be a wonderful tool but it’s not a cure, it’s not available to everyone, nor is it always effective. Therapy at its best provides tools that one can use to manage depression. At its worst it can heap on more shame. And that is if you’re fortunate enough to have access to therapy. For all too many people, therapy is a prohibitively expensive venture. In addition, getting therapy involves steps that for those in the middle of depression might not be capable of even accomplishing. It took me months to find a therapist who would let me email with them as my phone anxiety had reached the point where I literally could not a make phone call without panicking. For many of us managing our depression, has been a long road. Sometimes I literally feel talked out. I know what factors lead to my depression. I know how my past contributes. Therapy helped me to get to those places but at this point it’s covering old ground. My therapist and I have an “as needed” relationship but not all therapists are willing to engage in that kind of relationship.
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“Your life is great. Why can’t you just be happy?”
When I was pregnant with my last child, I lay curled on the bed sobbing, in a pit of darkness that I wasn’t sure I’d ever pull myself from. The darkness smothered me with my own recriminations “Why are you depressed when your life is amazing?” I thought for so long that if I could just get my life in order things would be okay. I did too. I went to college. I partnered with a wonderful person who treated me well with whom I shared so much. I had children. Amazing children. But still the depression came.
Depression is not the polar opposite of happiness.
Because again depression is not simply sadness.
I wake up some days feeling nothing. I know that my life is happy. That I love. But inside the depression sits and dulls everything. I am not sure if I even think it lies as others say. It warps perhaps. It shifts perceptions, it smothers intensity. I don’t forget that I have a good life. The depression whispers sometimes that I don’t deserve this life. I don’t need anyone else to remind me of what I have. I already know.
Essentially don’t shame us. All of these comments have one purpose. They shame. They suggest that if we just did certain things we’d be cured, freed, better. Sometimes we do all these things and when we weren’t cured, the world made us feel we failed. Now I can finally stand and say that managing my depression is victory no matter how I choose to manage it.
I really enjoyed your article & I thank you for taking the time to express your thoughts & feelings with such clarity & compassion.
I do have one question though – all of the ten things you have mentioned (as statements not to make to those suffering depression) are quite natural & normal things to say. For a person who does not suffer depression, they may even be considered clear & compassionate ways to help. Forgive me for saying so but there isn’t much else people can tap into.
My sister suffers ongoing, chronic depression & it hurts me to concede that she cannot self-care. However, if everyone is too afraid to question her choice not to medicate/leave the house/eat better food/engage a professional then what chance does she possibly have of managing her illness? where is the boundary & what is our responsibility as those who love her? to say nothing? to stand idly by?
I feel that by gently asking the question at least we stand a chance of penetrating her habitual cycle of depressive episodes, at least we are holding a hand out….
What is the alternative? say nothing? pat her on the back & say “hey, you’re doing a great job?” She isn’t.