It’s Monday. I wake up at 4:30 a.m. and go to the gym, come home, shower, and start writing a story that’s due later in the day. I hear my husband start to stir, so I walk upstairs to chat with him while he gets ready for the day.
In the meantime, our daughter wakes up and I hear her singing happily in the crib: “Mama!” I scoop Claire from her bed and we walk downstairs to make breakfast. We snuggle up on the couch and I breathe in the sweet smell of her hair while she eats.
By 7:30 a.m., I’ve squeezed in a workout, gotten dressed, done a bit of work, kissed my husband goodbye and started my day with my toddler.
And then my depression sinks in.
Depression has many faces
“Depression affects all personalities and can look very different in various people,” says Jodi Aman, psychotherapist and author of “You 1, Anxiety 0: Win Your Life Back from Fear and Panic.”
“A highly functioning person can be suffering invisibly too,” she says.
According to a 2015 report by the Substance Abuse and Mental Health Services Administration, an estimated 6.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. This number represented 6.7 percent of all U.S. adults. What’s more, anxiety disorders are the most common mental illness in the United States, affecting 40 million adults in the aged 18 and older, or 18 percent of the population.
But many mental health experts are quick to point out that, while these numbers show the commonality of depression and other conditions, the way in which people experience symptoms is varied. Depression may not always be obvious to those around you, and we need to talk about the implications of this.
“Depression may inhibit the desire for activity and action, but high functioning individuals tend to forge ahead in an effort to succeed with goals,” says Mayra Mendez, PhD, psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California. “The drive to accomplish often sustains action and moves high-functioning individuals towards getting things done.”
This means that some people who have depression may also still maintain everyday — and sometimes exceptional — tasks. Mendez points to notable figures who’ve claimed to have had depression, including Winston Churchill, Emily Dickinson, Charles M. Schultz, and Owen Wilson as prime examples.
No, I can’t “just get over it”
I’ve lived with depression and anxiety for most of my adult life. When people learn of my struggles, I’m often met with “I never would have guessed that about you!”
While these people often have good intentions and just might not know much about mental health disorders, what I hear in those moments is: “But what could you be depressed about?” or “What could possibly be so bad about your life?”
What people don’t realize is that battling a mental health condition is often done internally — and that those of us dealing with them spend plenty of time asking ourselves those same questions.
“A misconception of depression is that you can just snap out of it or that something happened to cause you to feel depressed,” says Kathryn Moore, PhD, a psychologist at Providence Saint John's Child and Family Development Center in Santa Monica, California.
“When you are clinically depressed, you feel very sad or hopeless for no external reason. Depression can be more of a low-grade chronic unhappiness with life, or it can be intense feelings of hopelessness and negative thoughts about yourself and your life,” she adds.
Mendez agrees, adding that a mistaken belief about depression is that it’s a state of mind that you can control by thinking positively. Not so, she says.
“Depression is a medical condition informed by a chemical, biological, and structural imbalance that impacts mood regulation,” Mendez explains. “There are many contributing factors to depression, and no one factor accounts for the symptoms of depression. Depression cannot be willed away by positive thoughts.”
Mendez lists other damaging misconceptions about depression, including “depression is the same thing as sadness” and “depression will go away on its own.”
“Sadness is a typical emotion and expected in situations of loss, change, or difficult life experiences,” she says. “Depression is a condition that exists without triggers and lingers to the point of needing treatment. Depression is more than occasional sadness. Depression involves periods of hopelessness, lethargy, emptiness, helplessness, irritability, and problems focusing and concentrating.”
For me, depression often feels like I’m observing someone else’s life, almost as if I’m hovering above my body. I know I’m doing all of the things I’m “supposed to do” and often genuinely smiling at things I enjoy, but I’m left routinely feeling like an impostor. It’s similar to the feeling one might experience when they laugh for the first time after losing a loved one. The joy of a moment is there, but the punch in the gut not far behind.
High-functioning people need treatment for depression too
Moore says therapy is the best place a person can start treatment if they’re experiencing symptoms of depression.
“Therapists can help a person identify the negative thoughts, beliefs, and habits that may be contributing to feeling depressed. It could also include things like medication, learning mindfulness skills, and doing activities linked to improving mood, such as exercise,” she says.
John Huber, PsyD, of Mainstream Mental Health also suggests getting “out of your comfort box,” especially if the person is an overachiever.
“Although successful and oftentimes leaders in their fields, these individuals are [conducting their lives] much like running a race with a weight belt carrying 100 extra pounds,” he said. To decrease the load, Huber says, consider unplugging from devices, going outside for some fresh air, or taking up a new activity. Research has found that crafting may even have promising benefits for those dealing with depression.
As for my nonmedical opinion: Talk about your depression as much as possible. At first, it won’t be easy and you might worry about what people will think. But choose a trusted family member, friend, or professional and you’ll learn that many people share similar experiences. Talking about it eases the isolation that results from internalizing your mental health condition.
Because no matter the face of your depression, it’s always easier to look into the mirror when there’s a shoulder to lean on standing next to you.
The road ahead
In the field of mental health, there’s still so much we don’t know. But what we do know is that depression and anxiety disorders affect far too many people for our society to remain ignorant about them.
Being depressed doesn’t make me lazy, antisocial, or a bad friend and mom. And while I can do a great deal of things, I’m not invincible. I recognize that I need help and a support system.
And that’s OK.
Caroline Shannon-Karasik's writing has been featured in several publications, including: Good Housekeeping, Redbook, Prevention, VegNews, and Kiwi magazines, as well as SheKnows.com and EatClean.com. She’s currently writing a collection of essays. More can be found at carolineshannon.com. Caroline can also be reached on Instagram @carolineshannoncarasik.