“The hardest part of depression is finding a way to tell people. It is like you are hiding a terrible secret. I think I felt ashamed of myself for getting depression, like somehow I had failed. That’s what depression does to you: it makes you feel like a terrible failure…it feels as if you are not you anymore, you’re just a hollow shell. You can’t be bothered with yourself anymore so why should other people? How can you possibly tell someone that you feel like you want to die? How can you describe the arctic winter wipe out blizzard that has become your headspace?”  

David at Time to Change


Have you ever said this to or about someone with depression, even just in your own mind?

What do you have to be depressed about? Just snap out of it. Cheer up. Suck it up. Fake it till you make it. This too shall pass. I know how you feel. Everyone’s got problems. It’s all about me-me-me, isn’t it? Stop wallowing in self-pity. Ever think other people have feelings too? You’re being selfish/ungrateful. Stop letting your mood ruin it for everyone else. Be thankful. Focus on the positive. Happiness is a choice. Just think of all the people in ____ who had to deal with [insert tragedy/natural disaster/catastrophe]. I hear exercise really helps. You should get some. You are what you think. Could you stop [nail-biting / hair-pulling / skin-picking / leg-shaking / insert other behavior or habit]. Go get a [manicure / hot bath / massage / hot fudge sundae / new outfit / beer / hobby / other shallow consolation]. Stop being so negative. If you don’t like it, change it. You’ll be stronger for it. You have to carry on. Think of the people who love you. Why can’t you just deal like any other normal person? You just have to be tougher. Just let go of whatever’s bothering you and move on.


Chances are, most people who live in the presence of depression have wrestled at one time or another with thoughts and feelings like these. Many of these phrases or similar ones can be found on internet lists entitled “worst things to say/what not to say to someone with depression.” Arguably one of the hardest aspects of the disease, for both patients and their loved ones, is its incomprehensibility. People who have not suffered with depression cannot know fully the experience of those who do suffer or have suffered with it and cannot understand why it has the power to do what it does. This can be terribly isolating for both sides, exacerbating the insidious effects of an already taxing illness.

For people who haven’t been through it, learning about depression and trying to develop empathy are important and can be difficult, but writers like William Styron, through their attentive and vivid descriptions of deep depression based on true life experience, can increase understanding of this “storm of murk.” From his book Darkness Visible:

I was feeling in my mind a sensation close to, but indescribably different from, actual pain…[others’] incomprehension has usually been due not to a failure of sympathy but to the basic inability of healthy people to imagine a form of torment so alien to everyday experience. For myself, the pain is most closely connected to drowning or suffocation—but even these images are off the mark…

…with their minds turned agonizingly inward, people with depression are usually only dangerous to themselves. The madness of depression is, generally speaking, the antithesis of violence. It is a storm indeed, but a storm of murk. Soon evident are the slowed-down responses, near paralysis, psychic energy throttled back close to zero. Ultimately, the body is affected and feels sapped, drained.

That fall, as the disorder gradually took full possession of my system, I began to conceive that my mind itself was like one of those out-moded small-town telephone exchanges, being gradually inundated by floodwaters: one by one, the normal circuits began to drown, causing some of the functions of the body and nearly all those of the instinct and intellect to slowly disconnect.

…What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain., like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze sites this caldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.

…One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes, And this results in a striking experience—one which I have called, borrowing military terminology, the situation of the walking wounded. For in virtually any other serious sickness, a patient who felt similar devastation would be lying flat in bed, possibly sedated and hooked up to the tubes and wires of life-support systems, but at the very least in a posture of repose and in an isolated setting. His invalidism would be necessary, unquestioned and honorably attained. However, the sufferer from depression has no such option and therefore finds himself, like a walking casualty of war, thrust into the most intolerable social and family situations. There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words.

From these paragraphs any reader can understand that the phrases mentioned in the very beginning of this post are failures, albeit understandable ones. They are failures of empathy, of understanding that depression is NOT a choice or a bad habit or a moral failing but a disease that affects a vital organ. Because that organ is not the pancreas or the heart, and the manifestations aren’t elevated blood sugars or pulmonary edema but rather lie in behavior and cognition, which usually involve human will, there is wishful thinking that human will should be able to fix what’s wrong, and frustration when it alone is insufficient. It’s hard to know what to say, and even harder sometimes to know how to help. Very often, well-meaning platitudes are all we feel we have.

Recognizing the gap between our understanding of depression and the reality of it is an important step; a commitment not to give up on closing that gap is a step that has to be re-taken daily, and sometimes moment to moment.

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