Depression is one of the most common conditions in the world. It affects all segments of society and virtually all cultures, said Constance Hammen, Ph.D, a Distinguished Professor in the Department of Psychology and the Department of Psychiatry and Biobehavioral Sciences at the University of California.
And yet many people don’t know much about depression or tend to misunderstand it. Some misconceptions “persist because depression has tended to be stigmatizing and people don’t learn about it, discuss it, or recognize it.”
But it’s key to become well informed. Depression may affect you or your family. It may affect your friends or colleagues. Even if it doesn’t touch you personally in any way, learning about the reality of depression helps you be compassionate to the people who are struggling, because depression is a debilitating illness (which is, thankfully, very treatable). Below are five revealing facts.
1. Depression isn’t weakness.
We often believe that people can control their moods, said Hammen, also co-editor of the third edition of the Handbook of Depression. So when someone can’t seem to manage their mood, they may be seen as somehow inadequate or flawed.
“It is very common for people to believe that feeling down and bad is a weakness of will or lack of effort to just get over it, or even a willful resistance to fighting it,” Hammen said.
A stressful event or stressful conditions trigger most depression, which makes it seem like people should promptly bounce back. If they don’t, they may be viewed as “weak-willed.” Even people with depression might see themselves as weak if they don’t recover right away.
Some people don’t even realize they (or someone else) are struggling with depression. “They may think of it as ‘just stressed out’ and expect them to get over it more quickly.” (These people also “are unlikely to seek professional help for being ‘stressed.’”)
Clinical depression is an illness. It can’t be willed away. The symptoms of depression — such as hopelessness, helplessness, fatigue, and difficulty concentrating — make it harder for people to take the steps to get better, she said.
Others’ perceptions (e.g., “get over it”) only make them feel worse about themselves and more alone, she added.
2. Irritability may be a prominent factor.
People are well aware that persistent sadness is a symptom of depression. But irritability is a key sign as well. In fact, irritability may even indicate a more severe depression, said clinical psychologist Shannon Kolakowski, PsyD. Irritability also is associated with a greater chance of having other mental illness, such as anxiety, she said. (Learn more about the research here.)
Other emotions tend to underlie irritability, such as sadness, shame and overwhelm, she said. But irritability shows up on the surface. “This happens when people are less aware of their internal states, where there’s trouble recognizing, labeling and processing their emotions.” (Therapy helps with this, she added.)
3. Depression affects the entire family.
“People tend to think of depression as an individual condition,” said Kolakowski, also author of the book When Depression Hurts Your Relationship. However, it’s a systemic condition that affects couples and families, she explained.
For instance, depression can affect everything from a couple’s communication and connection to their sex life to how they handle conflict to their ability to empathize with each other and enjoy time together, she said.
When someone is struggling with depression, it’s hard to foster warm, supportive relationships, Hammen said. This isn’t “because one is a ‘bad’ parent or spouse, but because they cannot will away the irritability, withdrawal, oversensitivity, lack of interest [and] low energy that are needed to sustain healthy relationships.”
Consequently, when someone has recurrent or chronic depression, their partner and kids may need treatment, as well, she said. (Learn more about how depression damages relationships and tips for rebuilding your bond here.)
4. Adolescents and young adults are particularly at risk.
A complex combination of factors causes depression. These factors include the environment, genetics, biology and personality traits. Many risk factors may predispose teens and young adults, who are “particularly at risk for first onset of clinically significant depression,” to the illness, Hammen said. She shared these examples:
- A mother who has depression or is impaired in another way.
- Difficult childhood, which, for example, led to attachment insecurities.
- Anxiety and fearfulness.
- Unrealistic expectations (for yourself or others).
- Poor role models for resolving relationship conflict or disappointments.
- “Brain circuits that reflect dysfunctions in processing and resolving negative emotions.”
- Poverty, which exposes individuals to stressors from an early age.
These factors increase the likelihood of recurrent depression, so it’s important to identify and treat teens and young adults who are at risk, she said.
5. Cultural views perpetuate depression.
“There are many self-perpetuating aspects of depression, within the person and within families and within cultures [and] communities,” Hammen said.
For instance, some cultures believe that because life is hard, it’s normal to be miserable, while other cultures regard happiness as a life goal (“the antidote to feeling low is to pursue the things the culture think should make one happy [such as] intimacy, fame, fortune”).
Some societies also believe that if you have certain things, you shouldn’t be depressed, she said. “If you are [it’s considered] a flaw of character.” (Again, it is not.)
Depression is a serious illness. “The more people are aware of depression and how debilitating it is, the hope is that they will demand more resources to be devoted to the problem,” Hammen said.