When people don't understand depression

I have a chronic depressive illness, and sometimes it irritates me to no end, feeling like I have to justify myself for others. But, we do live in a populated world, and simply by interacting with our loved ones, we are going to come head-on with situations where we have to explain what depression is.

People who don't have the illness, just don't get it. My beloved husband is one of those. We've been married just over a year, and we are still adjusting to each other. He understands that depression is an illness, not a chosen way of life, and although that's about all he *can* grasp at this point, it's a big concept. He freely states that since he doesn't have the illness himself, he's never going to understand completely.

Still, sometimes when my depressive illness is acting up and I need medical attention, he'll drag his feet in a way he wouldn't do if I were, for example, having an insulin reaction or something. To him, a physical symptom is somehow more "real" than a mental one. He doesn't consider anything psychiatric to be an emergency. But I guess I can understand that. He knows my life is not in *immediate* danger--I'm still breathing, I'm not bleeding, and my vital signs are stable--and he will get me to the doctor as soon as is practical.

There are several helpful ways we can explain to the average Joe or Jenny on the street that we have an illness, not merely a bad attitude. Here are a few of my favorite ways to handle unenlightened questions and statements.

"What are you depressed about?" Oh, how I despise that question! You might as well ask me what I'm diabetic about. It's an illness, and there doesn't have to be a reason for it.

When asked that question, I simply explain that nothing has to happen to cause a depressive episode. Recently I had a brainstorm and explained to my husband that I have two friends inside my head, who are in charge of balancing my brain chemistry: Sara Tonin and Nora Penephrine. If one of or the other of them isn't doing her job properly, I'm not going to feel well, even in the best of situations.

I think most unenlightened remarks are simply variations on "What are you depressed about?" Examples:

• Find some joy in life.
• Look at the silver lining.
• Think good thoughts.
• See the glass half full.
• Choose to be happy.
• You're blessed, you've got this and that going for you.
• You're too young to be so gloomy.
• Cheer up.

Yes, I'll grant you that these things are *ultimately possible* and *sound good.* But they are far easier said than done. Like diabetes, depression can be managed and kept under control--but not by a simple act of the will. Both illnesses are a matter of some part of the body not putting out the right chemicals in the right amounts. Both illnesses require medical supervision and daily self-monitoring. I cannot "snap out of" depression any more than I can "snap out of" diabetes. But I can make lifestyle choices that will accomodate both illnesses, and live in a healthy way despite having these hurdles to jump.

I expect many here can relate to your frustration.

Very well said to say the least. I agree that the question "what are you depressed about" is horrible. I actually had a friend ask me "what CAN you be depressed about" earlier today. I was pretty upset about it, but I kept my mouth shut. Then he goes on about how he wants to go bowling tomorrow. Seriously--I can't just sit at home by myself without pestering the crap out of me? I usually don't give an answer when someone asks whats wrong, and just say that I'm fine. As you stated, unless you suffer from it, no one knows.

I hope that things get better for you and your husband makes an effort to try a bit harder to help you out. Again, great post and welcome to PC!

Absolutely brilliant! May I use it?

We all relate...
There are brain examinations that demonstate differences between disturbed people and sane persons: neurotransmitters quantity, electric activity, brain parts involvement, and so on. Probably these tests should be advertised more. A disease is more respectable if it can be viewed and printed in colors.

I too loved the story about Sara and Nora... LOL.

Great post.
At least your husband is trying to understand and is truthful about why he doesn't fully understand your depression. My wife of 28 years picked the day i finally gave in to the urges to end it all, to throw me out of the house. Now I have been diagnosed with Bipolar Depression and am getting treatment, both medication and therapy. As yet nothing is working well, but we keep on trying. The soon-to-be ex-wife is going ahead with the divorce. And people still ask me "what have you got to be depressed about?" I just agree with them as I don't believe they will ever understand.

Welcome LovebirdsFlying. Thank you for sharing your points of view and insights. Many will relate.

I will say this though, yes depression is an illness and what that means is that you have to work that much harder at it. If you could do nothing about it then psychotherapy would never work would it?

Asking the question, 'What are you depressed about?' is actually a very good question to ask. You will find in your healing journey that there is usually a reason for the depression even if you are hiding it from yourself at this point, there will be a good reason.

Your list of unenlightened remarks are also good things to think about, maybe not the 'cheer up' remark as it is not as simple as that. It takes a lot of work on your part.

Learning to understand depression is hard and coping with it too is a challenge but it is possible to make changes.

I respectfully disagree, Pegasus for me, anyway.

One of my illnesses is biochemical--bipolar disorder. The question for me is not--"what are you depressed about?" or “What are so manic about?”--it is "what triggered your depressive episode?" or "what triggered your manic episode?"
There is a big difference, in my opinion.

My other illness is OCD and in my case it was triggered by emotional trauma but it still a neurological disorder. It is a glitch in my brain.

"talk" Psychotherapy helps me cope with the bipolar episodes by identifying triggers, and to keep me from self harm. It is not to cure me. That will never happen.

And my OCD is not helped with "talk" psychotherapy. It is only helped by CBT, specifically ERT (exposure response therapy)

I can be helped, not cured. I have lots and lots of stuff going for me. But I still have an illness.
I've been in therapy for 25 years and I am still not cured.

(this is my experience, don't know about anyone else)

I didn't say anything about curing depression.

Umm... CBT and ERT IS psychotherapy.

I said, ' Learning to understand depression is hard and coping with it too is a challenge but it is possible to make changes.'

Sorry, I realize I went a bit too far. Just got lost in trying to convince myself of a few things. And no you didn’t say cure.
I just meant that there is a difference between “talk” therapy and “ERP” therapy. You are right they are both psychotherapy
And just trying to say that I personally have nothing to be depressed about, nonetheless I am. But I think I know what triggered it this time.
Again, sorry. Just got lost in the moment.

No need for sorry (((((((((( Berries ))))))))))) I know you have been working really hard in therapy. I do know how hard it can be.

I think we're all looking at the same picture, from different angles.

I must disagree with the *implied* (although not stated and probably not intended) notion that a "positive attitude" is all that is needed to treat depression. If a simple change in outlook were all it took, psychotherapy wouldn't be a huge billion-dollar industry and this forum probably wouldn't exist. Yes, I realize that Pegasus did *not* say it was that easy. But, neither did I say that since it is an illness then it follows that we can do "nothing" about it.

I must note too that I may be new to this forum, but I'm not in any way new to depression. I've been battling it since I was six years old--almost four decades--and I'm experienced enough to know it doesn't always take an external event to trigger it. I can win the lottery today, and be in a huge depression tomorrow. If my meds are off, all the positive thinking *and* psychotherapy in the world won't help. It takes all elements. Similarly, I can have something terrible happen--a death in the family, for example, and be sad but not "depressed."

Again I use my other illness, diabetes, as a parallel. To keep it under control, I need diet, exercise, and insulin. Any one of those by themselves won't do the whole job, although insulin would probably come the closest. Even if I eat exactly right and exercise like a world-class athlete, but don't take insulin, I'm going to have blood sugar problems, and sometimes my sugar can spike for no reason within my control (a virus, for example.)

So too with depression. I need meds, therapy, and self-monitoring. Yes, that means a positive attitude, but the conflict comes when people think that's *all* you need. The positive self-talk is only one tool in the box, and it takes all of them.

I forgot to add--those who complimented me on Nora and Sara are perfectly welcome to use that analogy.

Great discussion, even if I don't ave anything to add right now Welcome, Lovebirdsflying!!!!!!

Answers in green.

Well, Peg, we each have our own experiences, and we only know about ourselves. I don't think we're disagreeing at all, and I hope there are no hard feelings. I did not intend to imply that I know more about depression than you do, and I made every attempt to use I-messages in order to make clear that I am talking about myself. I, for one, am NOT the "wisest elder ever."

And I quite agree about not defining ourselves by our diagnoses. I have depression. It doesn't have me.

But I do mildly disagree about a depression being merely psychological. Not when there is brain chemistry involved. I think there is much about depression that is physical. This is not to say that it cannot be helped, and I really don't want to get into a debate about it.

I can deeply identify with the lack of understanding for depression by family members. I have a family member currently visiting me for a month, who somehow manages to find TV shows that demonstrate his belief that depression is a "sin" caused by demon possession. These shows blare forth whenever I enter the living room and make my illness all the worse for the guilt that these beliefs cause. If your family member is at least willing to acknowledge your illness, that is something to be happy about. Well, maybe not happy, but grateful to them for the effort. billieJ

Depression is a sin caused by demon possession? Oh boy.

Then medication can battle a demon?

Depression is not a sin. It is not a moral weakness. It is not a bad attitude. It is not feeling sad because your puppy ran away. It is not a sign of poor upbringing. It is not anybody's fault.

It is an illness, with symptoms and treatment.

If this relative is in *your* house, can you ask for some respect? You shouldn't have to be dehumanized in your own home.

Let me finally add this thought: There are times when family or friends don't understand, because I am doing *well.* "If you're doing so well, when are you going to get off those medications and quit going to see a shrink?" Of course you realize what would happen if I did just that. I'd fall so hard you could hear the splat from the other side of the world.

I'm doing well *because* I'm doing what I need to do in order to take care of myself. And I'm not going to stop doing it just because some family member is embarrassed by the fact that I am a psychiatric patient.

Yes I think we are.

I agree in that a really grave and scary thing might be going on and I still can be in a state of pure euphoric mania. Or things might be coming together and going great in my life and at the same time I might be deeply depressed.

I totally agree. I need meds, therapy, and monitoring of my levels of stress. That is why I am on disabiliy and only do part-time work and/or volunteer work, or no work at all depending on my psychological state.

And by triggers, not only did I mean certain events, I also meant things like not getting enough sleep, too much caffiene, stress, med noncompliance...

I am not diagreeing with you. Just like you said--looking at in a slightly different angle.

Thank you for reminding me of this. This is something that I forget. When I am doing well the first thing I think of is--I am not sick.
That can get me into lots of trouble as well as trigger my intrusive thoughts. So, thank you very much for saying that.

My DH gets very worried about me and part of his way of coping is to ask me every few min. (literally) about my mood. It does get annoying when he asks over and over, but I try to be patient with it. Last night when he had asked again why I was sad I asked him why not? He didn't have a reply.

I Really Like This Thread and Completely agree with the opinions and insights about depression that have been provided here....I would describe depression as a clone of Satan... It comes back with venom each time you punch a hole in it's chest...It is a Severe and nerve racking disease which has sadly been neglected quite often by people who have not suffered from it...I love the Nora and Sara part and interestingly I too have got imaginary friends in my head from amercian soap operas! They talk to me inside my head and give me advice when I am feeling blue (which is usually the case)...Maybe I am delusional as well as depressed

I also believe that "just snap out of it" and is more gentle cousin "get a positive attitude", are more or less acceptable and useful depending upon who they come from. It may shift from caring suggestion to a scornful remark. This type of suggestions should be issued with care, and rarely.

I agree with Stefano.... In my experience most people that say get a positive attitude and snap out of it or change your thinking (An annoying tip my parents always come up with) are NOT being supportive...It's not the words it's the manner in which the words are said... If every nice word was warm then 90% of depression would have been eliminated... the delivery of most nice words is given with sarcasm and uncaringness... :P