Depression is often viewed as the “common cold” of mental disorders, because it is so prevalent in our lives. The lifetime prevalence of depression suggests that more than 1 in 9 people could be diagnosed with the disorder at one point in their lives. And unlike some other mental disorders, depression affects virtually every aspect of what you do and how you interact with others. Every year, it wreaks havoc in millions of Americans’ lives, especially amongst those who believe it is something you should just “get over” on your own.
Here are seven common myths about depression, and the facts that answer them.
1. Depression means I’m really “crazy” or just weak.
While depression is indeed a serious mental disorder, it is no more serious than most other mental disorders. Having a mental disorder doesn’t mean you’re “crazy,” it just means you have a concern that is negatively impacting how you live your life. Left unaddressed, this concern can cause a person significant distress and problems in their relationships and life. Depression can strike anyone, at any time — whether you’re “weak” or strong, it knows no bounds. Some of the strongest people I’ve met are people who’ve coped with depression in their lives.
2. Depression is a medical disease, just like diabetes.
While some pharmaceutical-influenced marketing propaganda might simplify depression into a medical disease, depression is not — according to our knowledge and science at this time — simply a pure medical disease. It is a complex disorder (called a mental disorder or mental illness ) that reflects its basis in psychological, social, and biological roots. While it has neurobiological components, it is no more of a pure medical disease than ADHD or any other mental disorder. Treatment of depression that focuses solely on its medical or physical components — e.g., through medications alone — often results in failure. Get to know the risk factors for depression.
3. Depression is just an extreme form of sadness or grief.
In most cases, depression is not just ordinary sadness or grief over a loss. If it were ordinary sadness or grief, most people would feel better just over time. In depression, time alone doesn’t help, nor does willpower (“Pull yourself up and stop feeling so sorry for yourself!”). Depression is overwhelming feelings of sadness and hopelessness, every day, for no reason whatsoever. Most people with depression have little or no motivation, nor energy and have serious problems sleeping. And it’s just not for one day — it’s for weeks or months on end, with no end in sight.
4. Depression just affects old people, losers and women.
Depression — like all mental disorders — does not discriminate based upon age, gender, or personality. While generally more women than men are diagnosed with depression, men suffer for it all the more since many people in society believe that men shouldn’t show signs of weakness (even a man’s own upbringing may reinforce such messages). And while aging brings many changes in our life, depression is not a normal part of the aging process. In fact, teenagers and young adults grapple with depression just as much as seniors do. Some of the world’s most successful people have also had to deal with depression, people such as Abraham Lincoln, Theodore Roosevelt, Winston Churchill, George Patton, Sir Isaac Newton, Stephen Hawking, Charles Darwin, J.P. Morgan and Michelangelo. So being a loser is not a prerequisite to being depressed.
5. I’ll have to be on medications or in treatment for the rest of my life.
While some doctors and even some mental health professionals believe that medications may be a long-term solution for people with depression, the truth is that most people with depression receive treatment for it for a specific period of time in their lives, and then end that treatment. While the exact amount of time will vary from person to person based upon the severity of the disorder and how well the various treatments may work for each individual, most people who have depression do not need to be on medications for the rest of their lives (or be in treatment for the rest of their lives). In fact, a lot of research suggests that most people can be treated for depression successfully in as little as 24 weeks with a combination of psychotherapy, and if needed, medications.
6. All I need is an antidepressant to treat depression effectively.
Sorry, no, it’s not as easy as popping a pill. While certainly you can have an antidepressant medication quickly prescribed to you by your primary care physician, you’re unlikely to feel any beneficial effects from that medication for 6 or more weeks in most cases. In two-thirds of patients, that first medication won’t even work! Combined psychotherapy treatment with medication is the recommended gold standard for the treatment of depression. Anything else is going to be significantly less effective, meaning most people will suffer with their depressive symptoms longer than they need to.
7. I’m doomed! My parents (or grandparents or great uncle) had depression, and isn’t it inherited?
While in the past there’s been research to suggest the heritability of depression, more recent studies have called into question how much of depression really is genetic. The upshot? While researchers continue to explore the neurobiology of mental disorders like depression, having a relative with depression only marginally increases your risk for getting depression (10 to 15%). Remember, too, that relatives impart a lot of their own coping strategies upon us in our childhood development — strategies that may not always be the most effective when dealing with things like depression (making one more vulnerable to it).
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I really enjoyed this article. I came across a post today actually of a young woman that feels she may be suffering post natal depression in which she has found great difficulty in actually admitting the possibility to herself let alone mention it to someone else.
A well meaning but in accurate reply that could have had disasterous effects on someone stated that “it is a mind problem & if you can’t get you thinking right you are simply weak willed”
I saw many colours all REDDISH LOOKING!!!!
I had to reply to that – don’t know the consequenses of it yet!
I suffered an extremely devasting depressive episode at one point in my life. I think I am one of the strongest willed stubborn, determined, independent people I know!!! Those qualities have a place in live if they are used correctly & in appropriate ways.
But I never knew enough about the illness – I didn’t view it as an illness. I would be dead a thousand times over If I had continued listening to well meaning individuals that had probably only ever experienced the blues with a menstrual period.
If any reader ever comes across someone that finally dares to mention what they may be going through – praise them for their honesty, their trust and advise them to discuss it with a professionally trained person. (if someone had diabetes you would certainly not advise them to take two jelly beans – go to bed & it will all be fine in the morning)
Thanks for educating or alerting people to the facts surrounding this totally self destroying illness.
Sorry for the big grouchy response.
I am dismayed at your item #2. How exactly is depression NOT a legitimate medical illness? Because it has psychological and social components along with the neurobiological?
Would we not counsel someone with high blood pressure to exercise as well as take their medication? Would we not counsel people with any number of chronic illnesses to manage the stress in their life? Just because we use psychotherapy as one of the treatment options does not make depression less of a medical condition.
You cannot separate out psychiatric illnesses as being somehow different or less “real” than other medical conditions. We have the brain scans that show differences between depressed and non-depressed persons. You yourself acknowledge the neurobiological underpinnings. We are treated by psychiatrists, who are medical doctors. Our symptoms are physical as well as “mental”. We know there is a genetic component. We have effective medications as well as other treatment modalities. Just because we do not know absolutely everything there is to know about psychiatric illnesses yet, that does not mean that we don’t know enough to recognize them for the serious medical conditions that they are.
We have had to fight long and hard to inch closer towards something even vaguely resembling parity for treatment. We still fight stigma. I believe that what you have written above in “Myth 2” is very damaging and IMO, wrong.
Medical diseases have known biological signs; mental disorders do not. That is the primary difference. Brain scans do not tell a doctor a person has depression, contrary to what you might believe from the hype you read in news articles about such scans. Nobody uses brain scans for diagnosis of mental disorders today.
If all medical diseases have a psychological component (and they do), then of course all mental disorders have a biological component. But diabetes isn’t a psychological disorder (you can’t just go into psychotherapy to learn how to deal with your stress and expect it to help cure your diabetes), any more than depression is a pure medical disease.
All of this could certainly change with our increased understanding of the brain. But as far as we know right now, mental disorders remain just that — mental disorders that involve complex psychological, social and biological factors. To call them simply a “medical illness” is to minimize that complexity and suggest it can be treated and cured by only a medical intervention (e.g., medications).
How can it not be a physical disorder?? Everything is physical. The mind is physical. There is no mystical spiritual attributes to humans, its simply mythology. We have no free will, it is a complex illusion. Everything is physical.
That’s reductionist. I agree with the author. While mind and body cannot be separated, the mind is not exactly physical, rather it is the process of a physical entity. It’s like saying running is as much a physical entity as legs are a physical entity – the running itself is an action that you have SOME control over. If you are born with short legs, you can’t change that, but you can learn better techniques for running and you can train. You can improve the process even if you can’t do much for the physical entity.
I agree that it is not the same as a medical illness (and I’ve had mental disorders for 16 years – largely recovered now). I don’t think there’s anything shameful about that, we are all nothing but conditioned beings. Some people have been conditioned very well, others less well, and if you haven’t been conditioned quite right you have to recondition yourself.
Hm. I thought the very real physical fatigue, headaches, joint and other bodily aches, weight gain or loss, and difficulty sleeping were all biological signs used in diagnosing depression. If they are, then indeed depression is as valid medical disease as it is a mental illness.
What exactly do you call a â€œknown biological sign?â€ That can mean almost anything. What about the fatigue, appetite disturbances, sleep disturbances, and cognitive problems that accompany depression? I would certainly call those biological signs. Of course we are not using brain scans to diagnose depression yet. We have not progressed that far at this time. But I do not think it is valid to disregard the evidence they provide for biological underpinnings and use the lack of current diagnostic capability to dismiss the medical nature of depression.
We have not always had specific diagnostic tests for many illnesses. Was, say, TB less of a medical illness before we identified and could test for the microbe that causes it? For â€œknown biological signsâ€, letâ€™s take the example of Lyme disease. Many sufferers do not test positive, leaving physicians to diagnose based on symptoms, history, and response to medication (antibiotics). This is similar in some ways to depression. Does someoneâ€™s lack of a positive Lyme test make their condition any less medical?
I am quite aware that diabetes is not a psychological disorder. However, exercise and diet can bring Type II diabetes under control for some. And I have had a psychologist who works with diabetes patients tell me she has seen many diabetes patientsâ€™ blood sugar worsen due to stress and that she works with them on stress management. So where exactly is the dividing line between mental and physical? You are making an arbitrary distinction between illnesses rooted in the brain and those rooted in other parts of the body.
I donâ€™t believe for one minute that recognizing that psychiatric illnesses are truly medical conditions minimizes their complexity. Since when are medical conditions by definition simple??? Besides, I consider both medication and psychotherapy to be medical intervention.
I have noticed for quite some time that you seem to be rather anti-medication. I can tell you that the biological component of my illness is so pronounced that all the psychotherapy in the world will not bring me into remission, nor will it keep me there (and Iâ€™ve tried). Iâ€™ve benefitted from very fine counseling, as I think most people can. But at the end of the day, what keeps me well is medication and careful oversight from a good psychopharmacologist. It gave me my life back, and you canâ€™t mess with success.
Those are symptoms, not signs. Signs – in medicine – mean physically quantifiable signifiers. For instance, if you had rheumatoid arthritis, severe fatigue and pain would be symptoms; but biomarkers in your blood would be signs. The doctor would never diagnose you with RA because you had severe fatigue and pain, he would base his decision on biomarkers.
Sometimes depression has some outwardly observable signs – generally in a noticeable slowing psychomotor activity and disorientation/detachment (for severe depression) – just as psychosis has ‘signs’ (patient’s speech has stopped making logical sense…), but most of the time depression has symptoms.
Well, Martina, Depression can also be a symptom of another illness, just like insomnia is a symptom of Depression. High blood sugars cause Depression as well as does Hypothyroidism, and/ or can Beta Blockers that are used for the treatment of High Blood Pressure, and/or Cardiac Disease and/or hormonal treatment with estrogen antagonists.
Not everyone has the same experience as you do, and for some people medicine does not help their Depression.
I would also argue that Depression is not more or less either a psychological or medical issue but
instead a ‘sickness of the soul’.
The soul is mythology. The mind is 100% physical. If your going to pick and choose how you want to replace science with your religion than leave.
I never said everyone has the same experience I do, and yes, of course other illnesses can have depression as a symptom. However, I think it’s important to recognize that there’s going to be a certain subset of the depressed population who respond well and do best with long term medication. There will also be a certain subset of the population who will do well with just psychotherapy. But I still believe it is an illness.
I’m just curious. Where do you believe the ‘sickness of the soul’ comes from for those for whom depression is not a by-product of another illness?
I think it comes from when we are in some way prevebted from, as in not allowed to, or not able to speak our own truth, and it is not heard.
For myself, injury to the soul causes pain unlike no other can, that severe. For me Depression always comes from the soul, or it has been in connection with hormonal stuff.
But for me, also, Martina, meds work great and I have been on the same prozac for some 25 years with only one dose increase after the first 15.
I would be honoured if you could help the Answer. I became depressed in part to help my brother and others who no longer had the will to live. I thought that I could think himself and others out of depression. It was only with his death that I again saw the world in a normal light. 12 months after this the Answer to depression and the like became apparant. I would be honoured if you could help this cause.
Until recently, it was thought that there was no universal way that people could think and behave that was deemed as “normal” to a society or culture. This however has been proven wrong with the discovery of a “universal belief system” which is thought to help prevent and cure psychological disorders.
Thanks for a well-balanced, factual article.
Our society has a tendency lately to offer up easy excuses to repudiate personal responsibility, and the pharmaceutical industry spends millions of dollars every year to encourage that.
If you have diabetes, it is your responsibility to manage it, and to adopt coping strategies that serve you well. And if you don’t, you suffer the consequences.
If you have depression, it is your responsibility to manage it, and to adopt coping strategies that serve you well. And if you don’t, you suffer the consequences.
Both conditions absolutely require behavioral changes (unless you’re intent on slow suicide). Both conditions absolutely require mental, emotional, attitudinal, and maybe even spiritual accommodation.
Only some with either of these conditions require and/or are helped by medication.
What we do know, from broad and extensive study, is that talk therapy is *in the aggregate* more effective than medication alone. And talk therapy plus medication is only slightly more effective than talk therapy alone. Talk therapy helps more people and helps them to a greater degree than medication. And medication has side effects, some of them very unwelcome.
No doubt that lives are saved through medication treatment of mental conditions. Just not that many, compared to the number of positive outcomes from talk therapy.
You, Dear Reader, are not an aggregate. You are an individual. Your Mileage May Vary. Please respect the “mileage” of those you share a planet with.
No Rebecca, I am not an aggregate. I am an individual, and a grateful one. I am grateful that after years of effort with a top-notch psychopharmacologist and the support of fine therapists, I have finally achieved a large degree of remission.
I am grateful for the scientists that formulated the medications that make it possible for me to work at a challenging job and enjoy my friends. I am immensely grateful that there is a variety of treatment options out there for those of us (and there are LOTS of us) for whom psychotherapy alone (or exercise or yoga or vitamins or whatever good things we try – and they are good things to do) doesn’t get the job done.
It was long, hard work to get as well as I am. I hope my outcome offers encouragement to others who are experiencing treatment resistant depression. Taking medication is far, far from an easy way out. It requires diligence and responsibility to work with one’s doctor, as does talk therapy.
I am not sure why you think I do not respect the experiences of others. I have never disparaged psychotherapy, and if that enables one to get well, then that is excellent. If talk therapy is not sufficient, but medication helps, that is excellent too. The important thing is to get someone well so they can participate fully in life. I do think it’s critically important that depression be recognized for the serious and sometimes life-threatening illness that it is.
This is a very interesting article regarding depression, and some very good comments have been placed on this site. My own personal knowledge of this illness is of myself and what i went through some years ago, i am 62 years old now. mine was caused by a miscarriage in the 1970’s and also moving to new area and it was during the recession of the 1970’s and i was unable to find work in my new area of Sutton Surrey and i became very lonely at home all day. I came from the East-end of London and always had a job to go to be it only part time. I was put onto anti-depressants by my doctor and was sent to a doctor at a local hospital who dealt with this type of illness. I did get better in time but it took two years in all, i have had a touch the illness again but nothing like the previous bout years before. I think that depression can happen to anyone circumstances can bring it on and this myth only certain types of people get it i don’t agree with. But i think that more women seem to suffer it as my doctor told me at the time could be true as woman have more hormonal problems than men, and perhaps also the pressures that women have running homes etc and looking after children if they have any if also a factor in my opinion. And the theory that more intelligent people seem to get depression is most likely true in some cases Vivien Leigh the actress had bi-polar (know as manic depression by many people, and she was a very intelligent woman who was well read and spoke about seven different languages. To try and avoid depression if you can you must try to relax and unwind and try not to let things get to you if you can it isn’t easy the fast pace of life today. I go swimming every week and go for a long walk with my dog and i feel much calmer when i return. It is also said another factor is the winter months that does get some people down i know. Depression is a horrible illness sufferers have my sympathy i know what your going through.
im goin thru serious “depression”. what makes u think its real. i feel like i can pull thru and make sumn out my life if im lucky. but what if i stay a loser. is depression fake and who in the world is so sure of them selves to make that definite? are we all just a show for the doctors. i feel like any pys. doctors get payed to manipulate people having a hard time. pretty easy to take advantage of. no matter how a paitient questions a “psy” doctor, the paitient is wrong. who knows the patient?
I am a counselor who has struggled with depression and fibromyalgia in the past. I loved your “7 Myths…”. Would it be possible to include them on my web site? I think they would be very helpful for people who are trying to decide whether to get help and what kind of help to get. Certainly, I would identify you as the author. Thank you for your insight!Lori Capri, L.P.C.
I’m of the opinion that we need to stop using the term depression at all, as it seems to have become a very vague and woolly term that seems to mean a dozen or more things.
I’m pretty sure that medication has done very little to aid me over the many years, but I’m far from keen on CBT which is the only thing currently available on the NHS in my area. What I’d really like is something akin to Logotherapy, something or someone ( a soul-friend) to help me explore the darker aspects of my psyche which seem to be at the root of my own distress.
It’s good to see you addressing some of the myths of depression. However, I strongly disagree with point 5 in particular. What concerns me is your comment that “the truth is that most people with depression receive treatment for it for a specific period of time in their lives, and then end that treatment.” I have had depression on and off for the past 10 years and I’m still young. I go to regular psychological therapy and take antidepressants. I was recently diagnosed as bipolar but mostly I get depression. The problem doesn’t go away but needs to be managed. I’m working very hard at it. What concerns me is that people could conclude that because most get over depression relatively quickly, someone who has it long-term is weak or not doing anything about it. There is already enough stigma.
I’m also not sure I agree with your second point (medical disease). Depression is a complex disorder, and I don’t think it’s appropriate to label it as either a ‘medical disease’ or ‘not a medical disease’. Sometimes it is psychological but it can be biological, and usually a combination of both. Saying that it’s not a medical disease is not strictly true, as it can have a medical element in it. I do agree with the rest of your comments though.