Many people assume depression presents with obvious symptoms, such as always appearing sad or withdrawn from loved ones. While these can be signs of depression, the condition can manifest in many different ways, and often holds hands with other mental health disorders, particularly anxiety.
“Someone with depression may seem more overtly irritable or anxious than sad, even if they are internally experiencing sadness as well,” says Cory Newman, Ph.D., director of the Center for Cognitive Therapy at the University of Pennsylvania. “This is something clinicians often will mention to parents who are worried about a child’s behavior, cueing them in that excessive, ongoing surliness in their youngster or teen may be a sign of depression. In adults, those who are less comfortable expressing the sorts of emotions they associate with weakness or vulnerability may be more prone to display irritability as a sign of their depression.”
But symptoms aren’t the only type of misconception around depression. Ahead, five myths to know—because getting the real deal can help you or a loved one get help.
Myth: You’d know if someone was depressed.
Many sufferers go to school or work and seem more irritable or anxious than sad, says Newman. It’s also possible that they might have trouble concentrating and/or speak or move slowly, says Jocelyn Smith Carter, Ph.D., director of clinical training in DePaul University’s Department of Psychology, because depression’s effect on the brain also affects some motor functions.
The key is to look for significant changes—the person may become more argumentative or hopeless or markedly less social, Newman says; they might start drinking more, start stress-eating, or stop wanting to eat. If you notice such changes, “be a good listener and recommend that they see a professional,” he says.
Myth: Everyone gets depressed sometimes.
Most of us have said, “Ugh, I’m so depressed!” at some point, but true depression is a specific diagnosis that about one in six adults will experience in their lifetime. Sadness is an emotion that tends to come and go, but clinical depression is more constant and lasts a long time, often a month or much more, says Newman.
“Clinical depression comprises a number of symptoms that you experience most of the day, nearly every day, for at least two weeks,” he says, and you may not know why. Other signs: feelings of extreme guilt or worthlessness, loss of interest in activities you once liked, and/or suicidal thoughts. There’s also dysthymia, a treatable and less extreme form of persistent depression that can ebb and flow—symptoms can include hopelessness, low self-esteem, and fatigue. If you feel unusually down for two weeks or more and/or have suicidal thoughts, talk to a mental health professional.
Myth: Depression only affects mood.
Mood is part of the picture, but depression can sap people’s energy and appetite and disrupt sleep. It’s also connected to a host of physical symptoms, from hives and migraines to respiratory, cardiac, and gastrointestinal issues, Newman says. “Your mental and emotional state can trigger specific physical reactions, and vice versa,” he says.
There seems to be a strong connection between inflammation, autoimmune disease, and depression: A large Danish study found that patients with an autoimmune disease were 45% more likely than those without one to have a mood disorder. If you may have a health condition, mind your mental health too, advises Newman.
Myth: You just have to power through depression.
It’s not about willpower. The condition is partly caused by, and also causes, physical changes in the body and brain, says Carter. That includes disruption of mood-regulating chemicals, and the sufferer cannot just “snap out of it.”
With the help of a therapist, someone with depression can learn skills to keep symptoms at bay or cope better if they do arise, says Newman. For example, patients learn to reframe the way they see things, resist defeatist all-or-nothing thinking, and celebrate small accomplishments, which makes them feel better and avoid giving up on themselves, he adds.
Therapy can also teach people to “complete tasks in small bursts and build their way back up to doing things they enjoy,” Carter says, which further lifts mood. Some may need medication to help balance mood and assist with sleep. “Depression is a disorder,” Newman says, but a treatable one from which recovery is often possible.
Myth: Depression is really hard to treat.
It’s actually one of the simplest mental illnesses to treat. That’s because “it’s one of our most well-researched disorders in terms of how people respond,” Carter says. The tricky part is landing on the right treatment, Newman says, as well as addressing conditions such as anxiety, PTSD, and substance abuse that often come along with depression. With therapy and medication (which research shows is most effective for folks with moderate or severe depression), up to 70% of people with major depression show improvement.
The FDA has recently approved a version of ketamine as a treatment for some sufferers, and in several small studies the use of psychedelic drugs for treatment-resistant depression and PTSD has shown promise. The important thing is not to wait to get help: The sooner treatment starts, the more effective it is, according to the National Institute of Mental Health.
If you or someone you know is at risk, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text HOME to 741741 to message with a trained crisis counselor from the Crisis Text Line for free.
This article originally appeared in the September 2021 issue of Prevention.
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