Almost 15 million Americans suffer from clinical depression, according to the National Institute of Mental Health. Depression is also the leading cause of disability among 15- to 44-year-olds. Still, even though depression is so common, there are many misconceptions about its symptoms, causes and treatment. The problem is that misinformation gives rise to stigma and isolation. Individuals with clinical depression often feel alone because others expect them to simply snap out of it or stop being lazy. These kinds of myths can make people not want to seek treatment. Untreated depression also can have devastating consequences like health complications, drug or alcohol abuse and suicide. Here’s a selection of myths you might not know about.
- Depression is deep sadness. Depression goes beyond the blues or profound sadness. A depressed mood is just one symptom of depression. While depression varies from person to person, many feel irritable, guilty, worthless and hopeless. Many lose interest in activities they used to enjoy. They become indifferent. They can isolate themselves from others. They also experience difficulty concentrating or remembering things.
In addition, physiological symptoms are pervasive. Individuals with depression experience fatigue and physical pain, such as headaches, back pain, general aches and digestive problems. There’s also the trouble with sleeping and eating too much or too little. Some may turn to drugs and alcohol to soothe the pain, which leads to other problems. Suicidal thoughts can lead to suicidal attempts. In fact, according to a White House Conference on Mental Health in 1999, depression is the cause of more than two thirds of suicides reported each year in the U.S.
- Depression is a natural part of aging. According to Rosalind S. Dorlen, Psy.D, a New Jersey clinical psychologist, there’s a multitude of studies that show depression isn’t a normal part of the aging process. Other factors can play a role. “Many older people can become quite depressed as a result of a side effect of a medication for a medical condition not associated with depression,” she said. Other factors include the “loss of a loved one, loss of meaningful work or health-related issues.”
- Difficult circumstances or stressful events cause depression. Depression is caused by a complex interplay of factors. The situation itself doesn’t necessarily play a pervasive role. The “inability to cope or solve problems effectively may be a factor associated with depression,” Dorlen said. She added, “It is hard to find suicidal patients with good emotional problem-solving skills.”
Even more important, genetics and biology increase someone’s susceptibility to the disorder. Depression runs in families and some research has pointed to certain chromosomes that may boost risk. Also, chemicals in the brain that control appetite, sleep, mood and cognition may function abnormally in depression. However, thinking of depression as a chemical imbalance is overly simplistic and misses the intricate and elaborate role of the brain.
Environmental factors like stress, the loss of a loved one or abuse can contribute. Stress may even change the brain in people predisposed to depression, writes Peter D. Kramer, M.D., author of Against Depression in a 2003 New York Times piece.
- Depression is due to underlying issues that haven’t been addressed. According to Therese Borchard, Beyond Blue blogger and author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes, it’s a common myth that “Once [people with depression] get to the core of their anxiety and depression, once they get to the unconscious issues, they will be free.” However, since so many factors are involved in leading to depression, focusing on underlying issues doesn’t get at the disorder. Various forms of psychotherapy, including cognitive-behavioral therapy and interpersonal therapy, are tremendously helpful, as is medication. Again, depression is different for everyone, so the specifics of treatment can differ, too. But typically a combination approach — with psychotherapy and medication — is effective.
- You can only get better with medication. Mild to moderate depression may not require medication. According to Dorlen, “Psychotherapy can be extremely useful in reducing mild to moderate depression in adults, adolescents and older people particularly if the focus is on learning coping skills, assertiveness techniques, problem-solving skills, correcting faulty assumptions, and increasing communication skills.” For severe depression, however, medication is often necessary.
- Depression is an identity or character flaw. As mentioned above, depression is a disorder with its own symptoms. It is separate from the person and his or her attributes. Unfortunately, to the outside world, a person with depression is lazy. In reality, though, the disorder causes apathy and usually extreme exhaustion, so what may look like slothful behavior is really the devastating symptoms of depression. Borchard writes in Beyond Blue, “…the person underneath the illness never goes away; she only waits for proper treatment in order to surface again.”
- The key to depression recovery is mastering your thoughts. According to Borchard, a pervasive myth is that “when you learn how to master your thoughts and control your emotions, you won’t need medication…you can train your mind to believe it’s possible to reprogram your thinking because it is.” While identifying and changing maladaptive thoughts — for instance, as part of cognitive-behavioral therapy, with a professional therapist — helps with depression, it is just one part of treatment. For some people, especially those with severe depression, medication is vital. Also, this kind of thinking presumes that depression is something an individual has control over. While individuals do have control over seeking treatment and following a treatment plan, they don’t have control over getting the disorder. This kind of thinking can further fuel one’s depression, and it’s simply not true.