No. Depression can't simply be willed away.

'Think positive', 'tough it out', 'count your blessings', 'it's all just in your head', 'snap out of it'...

Imagine saying any of these to someone suffering from cancer, or even diabetes. Ridiculous and cruel, you say? Yet, time and time again, the same ludicrous and insensitive advice is handed out to people suffering from depression.

Depression. A word we've all used to describe sadness; a normal human response to negative experiences. “Major Depression”, the mental disorder, is not mere sadness. Approximately 350 million people worldwide suffer from it, and nearly 1 million people lose their lives to it every year. Isn't it a tragedy that a debilitating and life-altering disorder is synonymous with a natural and benign state of the human mind? Major depression is not a sign of weakness, or the result of moral failings, or a melodramatic attempt at seeking attention.

Depression is a disease, and no, you can’t just 'snap out of it'.

"Everybody gets depressed sometime or the other."

Imagine being in a state of paralyzing numbness — an apathy that makes mere existence feel like a chore. Imagine an absence of feeling, of desire, of joy, of hope, where every single waking moment seems like an onerous burden to be endured, so much so that you don't see the point in getting out of bed. Imagine an unbearable heaviness pressing down upon you, until even the simplest tasks begin to seem insurmountable. Depression often manifests physically as incapacitating exhaustion leaving you drained and burnt out. Even in the rare moments of lightness, the sense of foreboding and dread lingers. Waiting. Imagine feeling like this constantly, for weeks, months, even years.

People who don't understand depression can't imagine feeling low without a proximate cause. Sadness always has context. I am sad because____, I lost a loved one, I was diagnosed with a serious illness, or I lost my job. Major depression is sadness without context.

"But you can choose to be happy".

Depression is not a choice. Asking a depressed person to 'think positively' is like standing on the shore and telling a drowning man to 'just get out the water'. Depression robs people of the ability to motivate themselves to do anything, especially to take care of themselves. Intelligent, active people find themselves incapable of mundane tasks like cleaning the dishes or taking a shower. Even as they spiral downwards, they acutely feel their failure to deal with life like a normal person. The self-loathing only worsens the symptoms. Depression makes you think you're unworthy of help. People convince themselves that they're simply making a fuss about nothing. But putting on a facade of happiness when you're down does not make the depression go away.

“It’s just a phase. It will pass.”

Clinical depression doesn't simply appear from nowhere. While we still don't understand the complete pathophysiology of the disease, we conclusively know that there are significant structural differences between the brains of depressed and normal people. The hippocampus, the seat of emotion and memory in our brains, is significantly smaller in volume in depressed individuals. This impairment contributes to memory dysfunction, self-hatred, and suicidal thoughts. fMRIs have shown hippocampal atrophy, and reduction in the number and density of neurons in the cerebral cortex. Depression may not manifest like a physical disease but it lights up the same neural pathways as those activated by physical pain. Willing depression to go away is about as effective as willing yourself sober after drinking too much.

“Weak and selfish people kill themselves. I don't support suicide. It is stupid.”

The callous cruelty of this statement aside, to me it betrays a smug ignorance. Especially when people hold themselves up as paragons of strength in the face of adversity, while denying the struggles of others. It is okay to not understand why someone would be driven to take their own life. But to ascribe weakness, or cowardice to suicide is a shallow and simplistic view of a very complex issue.

One of the best analogies I've read explaining suicide is that of the burning room. Imagine yourself in a room that's on fire, and the only exit is a little window looking down upon a 10-story drop to the ground. Hot smoke fills the room, choking you, singeing your eyes, scorching your lungs, as the flames lick your ankles. You look at the window, and imagine how it would feel to be out there, away from the fire. You are scared to jump, you don't want to die. But the scorching heat, the excruciating pain, the breathlessness is unbearable. You keep waiting until every square inch of your body begins to scream in pain. Then you jump. That is suicide. Depression is that burning room. Suicide may not be a wise decision, definitely not a rational one, but to the person suffering, it becomes the only way to end the pain.

Suicide is the final symptom of chronic, uncontrolled and untreated depression. It is the terminal stage of the disease, not unlike stage IV cancer. Survival against all odds is an instinct programmed into our DNA. The rejection of life can only be the result of an impaired thought process, where ending the immediate pain seems more desirable than life itself. How can suicide be a choice, when the very organ humans use to make decisions is rendered unfit and broken by depression?

If everyone could experience clinical depression for just one day in their lives, it would put an immediate end to the ignorance and inconsideration surrounding this topic. Many depressed people live successful lives. They get educated, build careers and raise families. But none of these are made possible by 'thinking positive' and 'sucking it up'. It takes a combination of medication, therapy, exercise and support, through which most cases of depression can be controlled and even treated.

Next time you are tempted to tell someone with clinical depression to get over it, remember this — No one who has experienced it would choose depression over the trials of a normal life. Unless you've lived it, you cannot imagine what it takes to feign normalcy when all your capacity is being exerted on trying to keep hanging on. If there is a force bigger than depression, it is compassion. Even a little of it can give someone the reason to give life a second chance.

 

Thank you for talking about how you feel. If you are experiencing periodic episodes characterized by unexplained sadness, then I highly recommend seeing a doctor. You may feel that a doctor can't help you, but you won't know until you try. Depression doesn't always need to be treated with medicines, just talking to someone, and letting them know how you feel can be helpful. Talk-therapies and exercise are both very effective in combating mild depression. Please tell someone, and see a doctor.