While there is a lot of talk on depression, there are still a lot of myths and misconceptions about it. Psychiatrist Dr. Sweta Sheth from Bengaluru sheds light on some of the common myths.
As a psychiatrist, depression is one of the most common illnesses I see and treat. I call it an illness, because it is one. A serious, sometimes debilitating illness, which often remains hidden and undiagnosed. It’s not just a state of being sad or low when things aren’t going right for you. We see it everywhere, we hear about it all the time, and most likely, we all know somebody who has suffered from depression and may have taken treatment for it. But what exactly is depression? How does it occur? Who does it affect? Could you be next? These are some of the common questions that patients or relatives ask me, and it often surprises me how little they know about an illness that is so prevalent. Oftentimes, even when they say they know about depression, some of the knowledge they have is misleading, or false. Even with the wealth of information on the internet, there still exists a large void as far as actual knowledge about depression is concerned, and there is often an attempt to fill that void with half-true myths and half-false facts which ultimately end up causing more harm than good.
Here, I will attempt to dispel some of the common myths surrounding depression, and present facts that are medically true, and represent some of the common questions and misconceptions that I have come across in my experience as a psychiatrist.
1. Depression is not a real illness
Depression is very real. It’s a disease in the sense that it results from chemical imbalances in your brain and misfiring of some of the neural circuits. The happy chemicals (most commonly Serotonin, Norepinephrine and Dopamine) are affected in depression. There’s either too little of them, or they don’t act the way they’re supposed to. The brain then becomes incapable of processing emotions normally, leading to a state of sadness and all the associated negative emotions and thoughts that accompany it. This happens whether the depression is endogenous, i.e of the type that happens without any apparent cause, or exogenous, where there is an identifiable stressor leading to depression. When the depression is very severe, it is more likely that the changes in the brain are also more pronounced
Some of the most common symptoms of depression are:
- Feeling sad most of the day
- Feeling tired and unenergetic
- Lack of interest and enjoyment in day to day activities
These are the most common and characteristic symptoms that a psychiatrist would look for in order to establish a diagnosis of depression. The other common symptoms include
- Inability to concentrate
- Ideas of guilt, worthlessness, helplessness, self-loathing
- Reduced self-esteem and confidence
- A bleak view of the future, inability to see the bright side in anything
- Ideas or plans to take one’s life
- Disturbed sleep and appetite
- Reduced libido
- Slowness of movements
- In some cases, the person may become irritable and agitated
- Frequent crying spells, often over very trivial matters
- Inability to feel pleasure from previously pleasurable activities (anhedonia)
- Weight loss
Also Read: Symptoms of Depression In Men
The more the number of symptoms, the more severe is the depression. Each individual manifests depression differently, hence it is important to know all the symptoms so that depression becomes easier to recognise
2. He can’t be depressed, he’s the toughest person I know!
This is a myth that is extremely harmful and damaging. It’s unfair to categorise people as ‘tough’ or ‘weak’. No disease chooses its victim based on some special characteristic or ‘flaw’ they have, and depression is no different. I say this because people who are depressed often tend to blame themselves for no reason, and to imply that they have become ‘weak’ or lost their ‘toughness’ may simply end up making things worse for them. It would be more helpful to be empathetic and non-judgmental and assure them that they are not to blame; that what they are going through is in no way a sign of weakness
Anybody can suffer from depression, at any stage in life. A lot of times, a depressive episode can manifest out of the blue, in a completely healthy individual. Resilience to stress is a protective factor against depression, but it is not sufficient to ensure that a person will never suffer from a depressive episode. Similarly, someone who can’t handle stress or adversity very well may go their whole lives without ever being depressed.
3. I failed my exam. Will I suffer from depression?
It is normal to feel low during a stressful phase or after a loss, such as the death of a loved one. It may take weeks or even months to recover. But is this the same as being depressed? No. The hallmark of a depressive episode is that the sadness experienced by a person is pervasive, relentless, present throughout the day. There is no change in mood from day to day, an inability to feel cheerful or happy even when the situation calls for it. The other symptoms of depression may also be absent.
4. How long will it last? You’ve been depressed forever!
A typical depressive episode lasts for 6-9 months, but can go on for longer, especially if left untreated or if the person continues to live under stressful circumstances. It’s very hurtful to tell a person that they should simply ‘snap out’ of a depressive episode because it’s gone on long enough. People take time to recover and heal, with or without treatment, and each one has their own journey to recovery. Treatment by any means generally makes for faster recovery.
5. He doesn’t look sad and I’ve never seen him cry- he can’t be depressed
Not all depressed people look depressed. I’ve known patients, who by dint of will power alone have simply carried on like nothing was wrong and have successfully fooled everyone around them. Not just that, depression may have atypical manifestations in some people. For example- irritability, anxiety, oversleeping and overeating. If someone tells you they feel depressed, they should be taken seriously and offered help, whether they appear depressed or not.
Related Read: Overlooked Signs of Depression
6. Does everyone with depression really need treatment? Isn’t it enough to just talk to someone who understands my problems?
Yes, everyone who suffers from depression requires treatment in some form or the other. While it helps to give pep talks and positive vibes to depressed individuals, it may not be enough to treat the depression. There are various treatments available, and a doctor might recommend any of them, or a combination of these treatments based on the severity of depression. The options available include
- Psychotherapy, most commonly cognitive behavior therapy
- Medications.
- Brain stimulation methods, including Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT)
7. Do yoga! Go exercise! Meditate peacefully! You’ll get better automatically
Yes, try all of these, but always in addition to the treatment recommended by your doctor. These techniques are extremely helpful and hasten the process of recovery, but not as stand-alone treatments. Even a mildest form of depression may require intervention by a psychiatrist or psychologist. Don’t try to treat depression by yourself, you’ll only make things worse.
8. Don’t take medicines- you will get addicted
This is an extremely common misconception that patients have. Anti-depressant medications are not addictive. Some individuals require medications for longer - that doesn’t make them in any way addicted or dependent on medications. Sometimes, your doctor may prescribe a low dose of a sleeping pill to help you sleep better, but this is temporary, not longer than 2-3 weeks. The duration for which medicines are required depends on factors like the severity of the current episode, number of past episodes amongst other, and your doctor will take these into consideration when formulating your treatment plan. I’d recommend strongly that you don’t discontinue medicines till your doctor thinks it’s okay to do so- a half treated episode carries a higher risk of relapse. If you experience side effects, discuss with your doctor, there are several classes of medications out there and it may take a bit of trial and error to see which suits you the best.
9. Whose fault is it that you got depressed anyway?
NOBODY’S. Not yours, not anybody else’s. Playing blame games will only serve to embitter you and hamper recovery.
10. It’s just in your mind, why can’t you just act normal and live your life?
No it isn’t. Depression is very very real. It alters your brain chemicals and neural circuits, it messes your circadian rhythm, it leads to several hormonal changes. It’s far more than just a reaction to stress and should not be taken lightly. It’s not just a negative state of mind that results from ‘overthinking’ or having ‘negative thoughts’. It’s a serious disease that though invisible, may have lasting consequences
11. Let’s not talk about the S word.
This is probably the most important and serious aspect of depression. Suicide. Several people who are depressed may experience suicidal thoughts. These may range in severity from ‘life isn’t worth living’, to detailed plans to take their life. Always ask an individual with depression whether they feel suicidal. Encourage them to talk about it. Reassure them. Give them hope. If they’ve made detailed plans or have a history of suicide attempts, it may be wise to discuss this with their doctor. Keep a close eye on them. Never think “he/she won’t do it, I know them very well”. There is no foolproof way of knowing who will go on to carry out their plans and who will not. Paradoxically, sometimes people who appear to be on the road to recovery may also attempt to take their lives. This is because they regain energy and motivation as they get better and may be in better shape to carry out their plans. Bottomline, always ask and never take suicide lightly.
In conclusion, don’t ignore depression, not in yourself and not in your friends or loved ones. Talk. Share. Seek help. Don’t get tangled in a toxic cycle of hate and blame. Surround yourself with positive, happy people. Make changes to your diet and lifestyles. Depression doesn’t have to ruin your life. Remember, you can have had depression, but still be happy!
Dr. Sweta Sheth (M.B.BS, D.P.M, M.D) is a psychiatrist based in Bangalore
