The Depression Problem No One Talks About

About two years ago, my near-engagement fell apart. I wasn’t just sad; I was vehemently angry. I not only cried, but I lashed out. I spent large portions of my days in a cloud of my own dark thoughts — dazed and confused. I managed to hold down a full-time managerial job, and for a while, I was able to keep up with social obligations. I sought professional therapy, but it wasn’t enough. So, I leaned on my closest friends, probably too much. Eventually, one by one, they dropped off. Here’s what I learned the hard way: Mental illness is one of the last true societal taboos. Although we’ve made progress in talking about mental health issues, which include everything from depression and anxiety to addiction, bipolar disorder, and schizophrenia, the stigma of mental illness remains. But fighting that stigma starts with simply caring for the people around us. While people tend to rally around one another in times of tangible need — say, the loss of a loved one or a major physical illness — mental illness scares some people. It angers them. You can’t see depression the way you can see the symptoms of cancer or kidney disease. It affects the brain, which affects behavior, so it often gets dismissed as "drama." But “depression is a mental and a physical disease," says Deborah Serani, PhD, a psychologist in Smithtown, NY. “It is not a result of laziness, attention-seeking, or weakness. Research points to specific neurobiological origins. To tell a depressed person to just 'snap out of it' or 'shake it off' is just like saying this to someone who lives with diabetes or muscular dystrophy.”

Even if someone wants to help in general, it’s not uncommon for them to back away when the real, damaging symptoms appear. Depression is depressing. Who wants to be depressed? “I can’t have this conversation anymore. It just cycles,” one of my best friends said. And she was right; cycling thoughts — the inability to roll an idea around in your head until you come to a logical conclusion — is a hallmark of depression (as well as many anxiety disorders). “I need to surround myself with positive people,” proclaimed another close, intimate friend, who had recently become pregnant. When I tried win her back, she told me to stop being “so emo.” But I’m not talking about just “feeling sad.” Sadness is spending a weekend in your pajamas watching Netflix amidst a sea of your own junk food wrappers, or a couple of weeks of tear-soaked blues after a bad breakup. “Everyone gets the blues,” Dr. Serani says. “But if you’re feeling sad, irritable, or depressed for more than two weeks, that’s the defining line for a clinical disorder.” The exact symptoms of clinical depression may be different for different people. But for me, true depression means I can’t get out of bed, literally, for days. And when I do, it’s because I’ve mustered all the energy inside me just to relocate to the couch. I can’t remember the last time I showered or brushed my teeth, because my mind is consumed with doomsday scenarios: No one understands me. There’s no hope for me. Nothing means anything, and my life is over. I’m fighting against a "reality" that isn't real — and depression usually wins. In a moment I’m not proud of, I reacted to a third friend’s engagement with snark, instead of joy — which was unusual for me. This friend had worked hard for her happiness. She's a warrior who battled cancer six years ago at age 24. Though she was understandably absent from my life during this period, I did everything I could to support her, including raising money for the Leukemia & Lymphoma Foundation and running the New York City Half Marathon in support of her fight (she finished the race before me — a testament to her strength). But after I crapped on her happy news — and quickly apologized profusely, reminding her I was not in a healthy state of mind — she wrote me off completely. I even tried to educate her about depression’s stranglehold on a person’s emotions and actions, to no avail. “Many [people suffering bouts of clinical depression] say things they normally would not say,” says Melinda Gallagher, PhD, a psychologist in New York City. "It’s important that loved ones understand this as a symptom of the disorder and that with treatment and time, she will feel better and more like herself.” So, if it’s the sufferer’s job to seek help during a serious case of clinical depression, what’s the role of friends, family, and other loved ones who feel helpless, drained, or overwhelmed? It's simple. Dr. Gallagher says the simple gesture of acting with compassion can go a long way toward healing. That means doing your best to understand the emotional state of this person you love and what they’re going through, even — especially — if doesn’t make sense to you. You don’t have to fix someone with depression. That's not your job. You don’t even have to interact with that person if it’s too much for you. But if you truly do love the person and you want to maintain a relationship in the long run, listen with compassion, that desire to understand, and help in the ways you actually can. Communicate your boundaries with compassion. Don’t take the illness as a personal affront and certainly don't abandon them; that's probably the worst way to react.

The best you can do is have empathy and trust that they'll come through the other side. Eventually, you'll recognize them again, and you'll remember that they're a person — not an illness. As for me, I’ve taken a fair amount of time to reflect on what my friends may have been feeling as I indulged my impulses to heal through oversharing (something I was unable to do in a heightened emotional state). And I get it. No matter how much someone loves me, they also needs to love themselves — and that can involve drawing boundaries when they feel my depression is overwhelming. As their friend, I’m required to love enough to understand and accept that. But there have also been the friends who have stuck it out with me all along: Incredible women who not only stood by me during the worst of times, but also took time out of their busy days to check in on me daily, visit me, listen to me, and even try to distract me. At first, I called them my “true friends.” But I no longer think that distinction is fair. In fact, it’s a bit obnoxious. The truth is, everyone does what they need to do to get by, whether that means backing off or stepping up to the plate. I don’t think any of the friends who abandoned me during my low points love me any less. I certainly don’t love them any less. But now, I realize we all do the best we can. The best I can do right now is to help spread awareness about an affliction that affects an estimated 14.8 million American adults at some point in their lives. And you know what? Doing my part to fight the stigma about it makes me happy. RELATED:
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