Confessions of a positively depressed person

Photo by Fernando @dearferdo on Unsplash

Have you ever felt broken? So broken, that no matter what you did or said, nothing would ever fix that brokenness? A lot of people do. An estimated 17.3 million adults in the United States had at least one major depressive episode. This number represented 7.1% of all U.S. adults. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others.


Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else — but it can also occur spontaneously. If you have survived trauma, this might be a regular narrative that is running in the background of your mind. It is an intrusive message that has been etched into your personality, which is reinforced by what other people say to you or about you. This message can be amplified in situations where you perceive that you have not lived up to your own personal potential. As a result, internally, this is seen as validation or reinforcement that what people say is true.

  • Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
  • Genetics. Mood disorders, such as depression, tend to run in families.
  • Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
  • Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
  • Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
  • Drug and alcohol misuse. 21% of adults with a substance use disorder also experienced a major depressive episode in 2018. Co-occurring disorders require coordinated treatment for both conditions, as alcohol can worsen depressive symptoms.

People living with depression wear many masks as a way to cope and feel safe. On the outside, a person might see someone as outgoing, jovial, and over the top. On the inside, however, people living with depression are anything but those things. They can be reclusive, private, and isolate. This only serves to make them feel worse.

Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy, and healthy lifestyle choices, many people can and do get better.


Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

  • Changes in sleep
  • Changes in appetite
  • Lack of concentration
  • Loss of energy
  • Lack of interest in activities
  • Hopelessness or guilty thoughts
  • Changes in movement (less activity or agitation)
  • Physical aches and pains
  • Suicidal thoughts

10 things people living with depression need you to know

1. People living with depression feel miserable a majority of the time; however, most of the time, they can put a smile on their faces and act like it is not so bad this can deceive friends, family, and coworkers who think that everything is ‘alright’.

2. How they are feeling is not logical however it is their current reality. Don’t scold or blame people with depression or urge them to “try harder” to “just be happy.” Instead, make specific offers of help and follow through with those offers. Tell the person you care about them. Ask them how they feel and truly listen.

3. Odds are you do not understand how they feel, and that’s okay, you do not have to understand every aspect of it. People living with depression do not wish it on anyone else.

4. How people living with depression think, is exhausting. They go to sleep thinking, they wake up thinking, their entire day is spent thinking. This can be a truly miserable feeling. They are stuck in a groundhogs day of misery.

5. People living with depression judge every aspect of their thoughts and behaviors. It is not uncommon for people to judge stuff that is not even done yet. Yeah, if that sounds tiring, it’s because it is tiring.

6. People living with depression do not want to be around people, but they often have a deep desire to be around people. Their tolerance for other humans is extremely low, which causes them to feel miserable. But the entire time, they wish that they could actually be like everyone else.

7. People living with depression live in their head doing the ‘mental Olympics’. Odds are they have thought of the scenario and

8. People living with depression have perfected the art of not letting anyone know how they feel because generally, people do not know what to say or how to act. You listening to their concerns helps them to feel understood which allows them to take the next step toward getting help.

9. People living with depression do not feel like they are good people. They think the opposite. They simply want to be like other people.

10. People living with depression act as if nothing bothers them when, in fact, everything bothers them. Although they might not seem fragile, they are and if you ask the right questions, they will share the truth with you.


Although a depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After assessment rules out medical and other possible causes, a patient-centered treatment plan can include any or a combination of the following:

  • Psychotherapy including cognitive behavioral therapy, family-focused therapy, and interpersonal therapy.
  • Medications including antidepressants, mood stabilizers, and antipsychotic medications.
  • Exercise can help with prevention and mild-to-moderate symptoms.
  • Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
  • Light therapy, which uses a lightbox to expose a person to full-spectrum light in an effort to regulate the hormone melatonin.
  • Alternative approaches including acupuncture, meditation, faith, and nutrition can be part of a comprehensive treatment plan.

Coping with depression isn’t easy, but if you, a family member or a friend is struggling, there is help. NAMI is there to provide support and resources for you and your family.

I am a psychotherapist who writes about mental health, addiction, recovery and the impact of substance use from personal experience. Views are my own.

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