When we consider depression in our society, a lot of people seem to overlook that it is is really and truly an illness that is a lot more complicated than just a temporary bad feeling, it’s really an illness or disease that often requires proper and ongoing medical or psychological treatment.
If you’re someone who’s depressed, it can be incredibly disheartening and frustrating to continuously hear things like:
“Why can’t you just get over it?”
“Just cheer up already”
“Can’t you just smile more?”
“Maybe you just need to be stronger and tougher?”
“It’s just life. Learn to deal with it”
“You can choose to be happy if you really want to”
Here’s a great article on some better things to say:
Sometimes people really seem to have the view that being depressed is really just about making a bad personal choice — that people suffering from the illness, really just choose to be sad and “down”. You might feel and think things to yourself like:
“Why me?”
“Why am I the only one?”
“What’s wrong with me?”
“Why does only my life suck?”
“Why can’t I… just get over it?”
Why is everyone else so happy?
But for many people, when it comes to the illness of depression, it’s just very, very difficult, if not impossible, to just stop being depressed; to just paste on a happy smile and feel better.
But why can’t people with depression just “get over it?” Interesting enough, some people actually do — some people can take the bull by the horns and tackle their depression, often with the help of medication, therapy, or physical exercise. But for many people, and especially those with more severe depression, it’s really just not that easy.
So let’s look at a number of important reasons why people just don’t “get over” depression:
It’s a tangible & substantial physical illness
Depression isn’t just in the sufferers head! Make no mistake, depression is an illness, one that a person often has very little control over, just like any other illness. Nobody tells people with diabetes or cancer or broken bones to just get over it and get better already! So why should people with depression feel pressured by confused helpers to ‘just get over’ their illness? Unfortunately, misguided friends and families often do not realize that the illness is a real, substantial physical “thing”. Really, one of the best ways to help someone suffering is to first really and truly educate themselves about the disease! If people with depression feel understood and supported by their loved ones, it can often truly help their healing.
Here are some great links to educate yourself and family members about depression:
1. CMHA Depression 2. NIMH: Depression 3. themighty.com/depression/
In fact, people uneducated about mental health often think that depression is just about feeling sad or bad or about having a few negative thoughts — but for many people, depression presents as having many distinct symptoms that actually affect their physical bodies.
In fact, physical symptoms are thought to occur in about 50 to 90% of depressed patients!
The physical symptoms of depression can include:
- chronic joint and limb pain
- headaches and neck pain
- back pain
- gastrointestinal problems (diarrhoea, upset, nausea, cramps, etc.)
- tiredness, exhaustion/severe fatigue
- significant sleep disturbances (either too much or too little)
- psychomotor activity changes (slowed speech, thinking, responding and body movements)
- degrees of physical agitation and restlessness
- significant appetite and weight changes
Many people ask, how can there be physical symptoms if depression is something that supposedly takes place in our brains?
The best answer is that depression is a disease that takes place in our brains, of course, with distorted thinking and strong negative emotional feelings — but it is also located in other body systems as well. Depression is really a very complicated disorder that involves physical (genetic/biological), environmental, social and psychological components. Without a doubt, it’s really much more complicated than just feeling the blues!
The reality is that it is a disease that is both mental AND physical in nature, a real and substantial medical disorder — it’s not just about feeling sad — and the existence and prevalence of the physical symptoms really prove this to be true.
Here’s a link to more information about the physical symptoms of depression: https://roberthammel.com/physical-depression/
Depression really and truly feels like it’s out of the sufferer’s control
People experiencing depression often describe it as struggling with an “unconscious” emotional process that is happening “to them” and feels largely outside of their control. Remember that depression is an especially complex disease involving a combination of biological/genetic, psychological and social factors. People with depression really feel like their symptoms are out of their control and there is very little they can do about it. Feeling desperately hopeless and helpless are truly two of the most difficult symptoms of having depression. Is it truly out of their control though? The answer is possibly and maybe. Often the hardest part of helping yourself with depression is making and attending that first therapy appointment or starting an exercise program or starting that self-help book. Although many may feel their depression is totally out of their control, many people also feel they do have some degree of control and by doing things like proper self-care and going to therapy they can actually gain some purchase over their disease. Going to therapy may not always cure the disease, but it can almost always help lessen the suffering.
For some sufferers, the symptoms can be truly debilitating
As mentioned earlier people with depression display both physical and mental/emotional symptoms. For some people with more severe depression, their particular combination of symptoms can really pack a punch! 
Imagine a scenario where:
- you feel extremely hopeless and helpless
- you feel sad and lonely most of the day
- you don’t feel that you’re good enough
- you can’t sleep more than 4 or 5 hours a night
- you have strong out of control feelings of worry and anxiety
- you have regular nausea or even diarrhoea
- you have frequent headaches and lower back pain
How easy would it be to get through your workday with that long list of symptoms tormenting you? For some people, depression can be legitimately debilitating. This is the reason that insurance companies follow the medical science, recognize depression as a legitimate disorder and will allow a medical leave from work. The reality is that for many people depression is a significant life-changing experience.
You can’t just choose to make it stop
Nobody likes feeling depressed for weeks or months on end. But just because you want to feel better doesn’t mean you can just flip a switch in your brain and feel better. Depression is really an insidious and enduring illness. You can want to feel better all you want, but until the illness has run its course, or you have the energy to make an effort to explore appropriate self-help strategies; improve your self-care; or even start to work with a therapist — there is no really any fast or magical route to getting better. Maybe the most important thing, though, is to start doing the small things to take care of yourself which are then often the first steps to start feeling better. In my many years of private practice with people with depression is that those who manage their depression better are the people who can start to be even a little proactive. The people who can “dig deep” and try, even a little, are often the ones who can lessen their symptoms or even conquer their depression sooner. In fact, every time we work on managing our depression, we can help ourselves build a sense of resiliency that will help us the next time depression rears its ugly head.
You can only “pretend to be okay” so much
People always seem to expect depressed people to just paste a huge, happy smile on their face and pretend like everything is perfectly okay and peachy. They’re told you should just fake it to make it!
A great idea in theory, but when it comes to being depressed, you just can’t pretend that your strong negative emotions and feelings don’t exist. Unfortunately, the depressed mind often just keeps replaying the same negative thoughts and emotions like a repeating film reel being viewed over and over again.
In a way, the depressed brain can be seen as being “miswired” and because of this miswiring, it can get stuck in a loop of bringing up our sad and negative emotions, reminding us of our past errors/mistakes and constantly thinking about and worrying about our future. Because of this miswiring problem, you can get stuck in repeating cycles of self-loathing, fearfulness, worry and despair that can really interfere with your ability to experience your life in meaningful and fulfilling ways.
In fact, there is actually some research that has found that if a person who is depressed actively suppresses the negative thoughts, they may paradoxically make those negative thoughts even stronger and more likely to reoccur! Sometimes sufferers experience whats called rumination, where they have negative and obsessive thoughts that repeat over and over again in a loop and they can’t just push those thoughts and feelings away. If they try to push them away it can actually make them feel worse! Depression of this kind pushes out any feelings of contentment and joy in life. It’s really hard to pretend everything is fine when your miswired brain is telling you over and over and over again, in no uncertain terms, that things are the diametric opposite of okay! So really, a depressed person can’t just push away those negative thoughts, as their brain deeply believes that is their current reality!
Like any other illness, it can vary by person
Like we’ve discussed above, because the illness is just so very complicated, people often experience it in different ways and exhibit different combinations of the symptoms. Just because one certain person can go about most of their daily activities with depression, does not mean that everyone with depression can. We simply can’t judge all people as the being the same! Some people are mildly affected, while some are affected a great deal and are debilitated to the point of not being able to leave their home or even their bed!
Some people feel that depression is only just a bout with the blues — but the reality is that depression is a substantial, tangible, physical illness that can be very severe and even incapacitating for some people. Regardless of how you’re affected though, accessing therapy can probably be a great start to help you or a family member deal with whatever form your depression takes.
This blog is not intended as medical advice, treatment or diagnosis and should in no way replace consultation with a mental health or medical professional.
References
Wenzlaff, R.M. & Luxton, D.D. The Role of Thought Suppression in Depressive Rumination Cognitive Therapy and Research (2003) 27: 293. https://doi.org/10.1023/A:1023966400540
I really don’t understand how to fix myself.