Misconceptions About Depression

A few years ago I posted an Instagram photo with me crying and a caption that said, “This is the face of depression. Be kind to others because you don’t know what they’re going through.” That photo upset some of my friends because I hadn’t really discussed my depression before in such an open way. To them I was happy and a goof ball. What most didn’t see was I was moody, miserable and even suicidal at times.

Though I was diagnosed with depression 17 years ago, it was after my babies were born that it really got bad — and scary. I had dealt with postpartum and post-weaning depression but had inadequate psychiatric care.

On the outside I was posting pics of my kids in cute outfits and everything online told a completely different story.

Many people mask their pain for different reasons. I had the idea that depression wasn’t talked about, that having depression makes you weak. That it was a matter of willpower. I didn’t want to be the depressed mom, I wanted to be the mom that does it all, which is a dangerous and unrealistic expectation for anyone. That stigma that I was buying into keeps a lot of people silent about their struggle. It can be especially hard in certain cultures, such as Asian cultures (read more about that here.)

There are definitely common misconceptions about what depression looks like. In my case, I’m not sad every minute of everyday. There are good and bad days, just like anyone else. Sometimes my depression manifests in other ways, such as overeating or binge eating; sleeping too much; having a short fuse; or partaking in other unhealthy behavior.

I was freed of the heavy weight depression holds when I admitted to all my friends and family that I went to a psychiatric hospital in 2019. I even wrote a forum piece about my experience for the local paper. It was not easy, in fact it was a little terrifying knowing that essentially the whole city knew my secret, but like I said, it set me free. I just didn’t care about anyone’s opinion anymore. I know it can be annoying when I plug my blogs or pieces in the paper but I’m hoping they will reach someone who needs to hear what I’m saying — that it’s OK having depression and there is no shame in it. Those who I’ve met who struggle with depression are the strongest people I know. We are fighters. We are survivors.

Ideally, everyone should be able to talk about their mental illness but I understand why people don’t. It’s terrifying being vulnerable, especially when there’s a chance someone will react negatively. But I urge everyone to reach out, even if it’s to one person. You’d be surprised how free it makes you feel, and by telling a friend or family member, you’re lightening your load. Your support system can help you carry that load, and you should take help where you can get it.

If you can’t reach out to someone, please know there are several online resources that can help. To learn more about depression or find resources visit the Substance Abuse and Mental Health Services Administration. They have a 24-hour helpline.

Other Misconceptions About Depression:

  1. “It’s all in your head.” – Depression is a psychological and biological disease. You have no control over it, so if someone tells you to “buck up” just know that the problem is not with you — it’s with them and their lack of understanding. You don’t have to pretend or fake it, just do you.
  2. Depression = being really sad. – Sure, you get sad when you’re depressed but someone equating it to “just being sad” is trivializing your feelings and your disease.
  3. Depression means you’re weak – I already touched on this but it’s worth repeating — I think people with depression are so strong. Depression can wreak havoc in all areas of your life. Some people deal with suicidal ideation daily and others have to tap into a reserve of strength and energy just to take a shower (me!) or go to work. Often that reserve is depleted.
  4. Depression is not treatable – There are a variety of medications that are safe and effective in treating depression. There might be side effects and it might take a while before finding the right combination, but (most of) patients feel better. There are also therapies you can try, such as talk therapy, TMS (Transcranial Magnetic Stimulation), ketamine infusion therapy, and my favorite, ECT (electroconvulsive therapy). Please consult your doctor before trying any medication or other treatments.

These myths are damaging, but again, please reach out if you are struggling. It gets better.

If you are suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit their site for chat support.

Treatment Resistant Depression

As I’ve mentioned in 389,432 of my other blogs, I have treatment resistant depression (TRD). It may sound like its not curable, but by definition it means one is non responsive to at least two antidepressants for a period of time. It also is characterized by extreme sadness, sleep disturbances, low energy, suicidal ideation and suicidal attempts.

TRD is experienced by 45 percent of patients with a major depressive disorder. That’s just crazy to me. It contributes to nearly one-third of patients attempting suicide in their lifetime, a rate more than double that of their treatment responsive peers, according to this article by Psychiatry Advisors.

While psychiatrists cannot pinpoint why some are treatment resistant, researchers have seen correlations in certain populations who are more vulnerable than others. For instance, women and senior citizens. Individuals who have had severe or recurring bouts of depression also appear to be more susceptible, according to Johnson and Johnson’s website on health.

What I found most interesting is other medical illnesses can play a part in TRD. The article states that thyroid disease and chronic pain (I have both thyroid disease and chronic migraines) makes you a greater risk for treatment resistant depression. Mind blown.

Other factors include substance abuse and eating and sleep disorders. I also suffer from compulsive eating and insomnia. I should donate my body to science when I die.

So, what happens with you’re treatment resistance and your meds don’t work? We do have options. We can go on the highest dosages of our meds – IF YOU’RE DOCTOR THINKS THAT IS RIGHT FOR YOU – or there are non-drug therapies which I’ve mentioned in the past, such as transcranial magnetic stimulation, ketamine infusions and ECT, which helps reverse symptoms of TRD.

I think the only non-drug therapy I haven’t mentioned in detail is ECT (electro-convulsant therapy), which is effective to 70-80 percent of patients. This is not to be confused of electroshock therapy, poorly portrayed in movies and TV. ECT uses general anesthesia intentionally triggering a quick seizure. It’s meant to reverse symptoms of mental health problems and as of now is the best treatment for depression.

So, as of now I’ve definitely more than two antidepressants/antipychotics: Doxepin, Zoloft, Prozac, Lexapro, Wellbutrin, Abilify, Rexulti, Saphris and Seroquel. For me, that’s a lot. I’m also tried Lamictal as a mood stabilizer.

I’ve also tried TMS (transcranial magnetic stimulation), ketamine infusions and I’m about to try the Spravato nasal spray which is based on ketamine.

Here’s to my people who are treatment resistant. You’re not alone and hopefully there will be better alternatives in the future.

One thing I forgot, there’s also a genetic test you can take that can tell you which antidepressants will work better for you. It’s called the cytochrome P450 (CYP450) test. Ask your doctor if this is an option for you.

Stay well. Stay in the light.