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Depression

4 Ways to Better Understand Depression

Critically thinking about depression at Christmas.

Key points

  • ‘Living with depression’ isn’t just a label, it’s like having housemate.
  • People with depression don’t need a reason for it.
  • Depression isn’t necessarily an increase in ‘sadness,’ it’s often experienced as the ‘absence of happiness’.
  • Helping someone with depression is mostly passive, not active.

Though Christmas is often referred to as, "the most wonderful time of the year," it’s also one of the toughest times for people living with depression. The end of the calendar year is often associated with retrospective consideration of all the good and bad that we’ve faced, being thankful for the blessings we have, and placing hope in the new year. Unfortunately, for the person living with depression, the focus is more likely placed on the ‘bad’ that happened and a positive view for the year is less likely. If they happen to be alone, a holiday like Christmas only puts a spotlight on their isolation and may enhance any feelings of guilt or low self-worth.

Though society is becoming more and more aware of depression and its prevalence, that doesn’t necessarily increase understanding. At Christmas, we must be conscious of loved ones who may be experiencing depression and try to lend support where we can. People sometimes wind up doing or saying the wrong things and a better understanding is fundamental to both helping support someone living with depression and to helping the individual living with depression better acknowledge what they’re experiencing.

I’m neither a clinical nor counseling psychologist, but as a researcher and academic in psychology who has taught on the subject, alongside experiences with people close to me living with depression (considered from that psychological perspective), I present four critically considered understandings of depression that may better facilitate one’s ability to provide support.

1. ‘Living with depression' isn’t just a label, it’s like having a housemate.

A friend of mine whom we’ll call Adam is a fun-loving guy. He enjoys a few drinks on a night out. Over the years, his behavior became unpredictable when he drank. Some nights, he’d be fine—quick with a joke, charismatic, and fun to be around. Other nights, he’d isolate himself, become anti-social and, sometimes, recklessly pose a danger to himself or others. More and more, the latter version is what would present. On occasion, Adam would drink to excess during the day, by himself. We spoke once about it, and he went for counseling. Some of his other friends were convinced that he was an alcoholic. Adam didn’t believe so, and, truth be told, neither did I. But he did periodically use alcohol as a coping strategy for his depression. He told me that he was once confronted about how he could be such an intelligent, humorous, good-natured person when sober yet, such a selfish, irresponsible liability when drunk. It was like he was two people: Sober Adam and Drunk Adam. He was then asked what goes through his head when Sober Adam decides to pick up that first can or a bottle. He replied that there was a third Adam that people never knew about, Sad Adam.

Drunk Adam was misunderstood, as in some ways, he was a victim. It was really Sad Adam who was the one to watch out for, the weight on Adam’s shoulders telling him he was worthless, filling his head with guilt and despair. It was Sad Adam always handing him those first few drinks.

The phrase "living with depression" is more accurate and more appropriate than "depressed person," as the latter implies that depression is the only facet of their lives. "Living with depression" is also particularly accurate and appropriate in the context of Adam’s story, where it’s like depression is another person—living with the sad version of oneself, who winds up taking the wheel.

2. People with depression don’t need a reason for it.

Depression takes a number of forms (e.g., major depressive disorder, persistent depressive disorder, or as part of another disorder) and manifests itself in a variety of manners. For example, in cases of situational depression (i.e., adjustment disorder with depressed mood), it can be argued that there is a foundation or reason for the depression, such as the death of a husband, or having to put your wife into a nursing home. However, it’s important to acknowledge that depression doesn’t need any one reason or any reason at all.

Another friend whom we'll call Brendan lived with depression that would just "hit him out of nowhere." He told me a story about a day he woke up feeling particularly good. He went for a walk around town and went out for a meal with his family. Then, around 5:30 p.m., as he sat down to watch TV, Brendan’s depression hit him for no reason. Nothing was wrong. There was nothing to be sad about. This was one of the worst aspects of it, he said, because it comes out of nowhere and makes him feel guilty. Life had been basically good to him: physical health, good family, friends, and no problems with money. So, to him, this depression meant he took all the things he had for granted. He fixated on those feelings for hours, before finally looking at his watch. It was 2:00 a.m.

People living with depression don’t need a 'reason' to be depressed and this is, sometimes, one of the toughest things for the person to reconcile. The truth is that, in cases like this, the depression will essentially create a reason, either through exaggerating the negative aspects of a real experience or simply through imagining one. We need to be cognizant of this if and when we're in the position of supporting a loved one with depression.

3. Depression isn’t necessarily an increase in ‘sadness.’ It’s often experienced as the ‘absence of happiness.’

Depictions of depression earlier in this post describe an aura of sadness, be it through an alternative version of Adam or this overwhelming wave that hits Brendan. One way of thinking about sadness is as something that is added to one’s mood, one that steals the show, hanging a grey cloud over everything else. Oftentimes, however, depression does not manifest like this; rather, it often presents as a subtraction of happiness.

One last friend we’ll discuss here, whom we'll call Cal, described his depression as a constant feeling of numbness. Of course, he’d have episodes of sadness hit, but these were infrequent. As he would relay, he had simply lost his joie de vivre. He acknowledged that he had stresses in his life—he’s got a wife, son, job, and a mortgage—but no more than the "average person." Cal first identified something was wrong when he found himself simply going through the motions. He'd stopped having interest in leisure activities and engaging his wife for intimacy. He was tired all the time, even when he had not been doing anything physically or cognitively demanding. What really hit him was playing with his son. He’d see his wife overjoyed by their child’s reactions to play, the smiling and laughing. Though Cal enjoyed it himself, it was clear it was not to the extent his wife was—or even Cal's own parents and siblings were. It seemed everyone else was enjoying his own son more than Cal. Much like in Brendan’s case above, there was no core reason for Cal’s depression—a vast majority of the time there wasn’t sadness at all—just this numbness. Cal also referred to it as diminished positive emotion, like someone put a cap on how much he could feel.

4. Helping someone with depression is mostly passive, not active.

This fourth ‘understanding’ serves as both an additional, final consideration and a conclusion to this piece. Though the previous anecdotes all present different aspects of how depression can manifest, the same rule for support applies for all: don’t feel the need to be active—be passive in your support. When people seek help and support, there is a tendency for the person they approach to address this as a problem that requires solving and, so, they offer solutions that may ‘help’ the person in need. Unfortunately, without understanding depression, the solutions offered through ‘active’ helping, such as exhortations to "Cheer up!" or insisting, "You have to choose to be happy!" may not only fail to help, but may also make the person feel worse. Tough love and reality checks are also frequently not helpful.

Understanding what depression is and how it can present itself is vital for providing support. Don’t assume that you know what depression is. Just listen to the person (passive support), and let them explain if they’re willing to. This might provide the therapeutic effect they need (and possibly inspire them to seek out further support). Don’t ask why they’re depressed or express feeling sorry for them. People living with depression have good days and bad days, so don’t assume everything is alright if a bad day hasn’t reared its head in a while. Remember, it’s likely that you are most needed when you are pushed away, so make a point of being there for them. Passive listening is the most helpful support you can provide, but soft encouragement towards treatment is important, too.

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