Explaining why depression is hard to understand to those who don’t experience it is like explaining childbirth to fathers. Its all-consuming nature is grossly misunderstood, and its clinical roots are overlooked by a judging public.

Small wonder, then, that the stigma toward mental illness is so widespread and perpetuated. And how unfortunate for those who suffer that the social stigma becomes internalized, creating a self-stigma that only exacerbates the suffering.

Depression affects over 300 million people worldwide. Perhaps one reason why depression is hard to understand is that it has many different forms. The most common types of depression experienced in America are:

major depressive disorder
persistent depressive disorder (dysthymia)
bipolar disorder
seasonal depression
postpartum disorder
psychotic depression

The best way to answer why depression is hard to understand is to describe it from the standpoint of those who live with it. If they could tell you what it’s like, these are some of the things they would want you to know. Some will surprise you.

Here are 9 reasons why depression is hard to understand.

1. Depression isn’t the same thing as sadness.

The misconception that depression and sadness are the same, and the loose interchanging of the terms, only serve to perpetuate stereotypes.

Sadness is a normal emotion in response to a circumstance or memory, and lifts within a few days.

Depression is persistent sadness, and can last weeks, months, even years. When you are depressed, you don’t see the light through the darkness, and life’s heaviness can be suffocating.

2. Depression is a medical disorder, not a choice or a weakness.

It affects the neurons, cells and chemicals inside the brain. It can wipe out how you think and your ability to feel. And it can break your spirit, causing you to forget your reason for living.

In a very real sense, it changes who you are. And if left untreated, depression, like any medical illness, can get worse.

3. You don’t just “snap out of it.”

Depression feels like a constant battle. In the same way that someone having an asthma attack struggles for every breath, depression makes you struggle for every moment. It’s not an expression of willful resistance or anti-social behavior.

You can’t force yourself to be happy when you’re clinically depressed because your brain chemistry actually changes. Anyone who suffers with depression will tell you that it’s exhausting.

4. You don’t always have a ‘reason’ for feeling depressed.

Again, depression and sadness are not the same. Sadness has a reason and a limit — you didn’t get the raise you were expecting, a friend let you down, someone special passed away.

Depression doesn’t justify itself. It shows up when the sun is shining and your bank account is overflowing as easily as it does when things are bleak.

Not being able to give a reason for feeling depressed is a major reason why depression is hard to understand. Because it’s an illness, it can affect anyone.

5. You’re not ‘you’ when you’re depressed.

Depression robs you of your identity. Your innate personality disappears. The gregarious, outgoing person who is known for lighting up a room no longer sees any light or feels any joy to share.

Those who don’t understand depression are prone to giving reasons for being happy…and expecting reasons for being depressed.

If you are the depressed person, you know that no mountain of cognitive reasons can fill the emptiness inside.

6. Everything is hard.

People with depression aren’t lazy or weak. If those who don’t understand depression could crawl inside the depressed person’s head, they would see an ongoing battle.

They would also see utter exhaustion. Everything from getting out of bed — “Why bother?” — to getting dressed to functioning at work feels impossible. And that run-of-the-mill midday slump pales in comparison to the complete lack of energy that drags along with depression.

There’s simply no energy for laughing, focusing, working, socializing. And in the worst cases, there’s no energy left for living.

7. It’s difficult to communicate emotions.

Emotions can be like whirling dervishes in the depressed mind, and can be difficult, if not painful, to express.

If you are depressed, you know what it’s like to weigh the vulnerability of sharing your feelings against the stigmas and stereotypes surrounding mental illness.

8. Depression is physical, too.

It’s all-encompassing, and can show up as symptoms like restlessness, nausea, headaches, and joint and muscle fatigue.

9. Depression can be lonely and isolating.

You have to choose recovery over and over. Sometimes finding the right kind of help is a long process. There are so many modalities — talk therapy, neurofeedback, support groups, etc. And taking on the responsibility alone, especially when energy is such a sparse commodity, can be daunting.

Answering why depression is hard to understand, in many ways, comes back to the lingering stigmas that surround it.

Consider a public attitude survey conducted by the University of North Texas to determine the community’s view of mental illness. Think about the above list as you read the results below.

Over 50% believe that major depression is caused by how a person is raised, or is simply God’s will.
Over 50% believe that major depression might result from people expecting too much out of life.
Over 40% believe depression is due to lack of willpower.
Over 60% said an effective treatment is to “pull oneself together.”

There is an obvious cognitive block, a ‘disconnect’ that makes people unable to comprehend things beyond their own experience.

It’s easier to expect the will to step in and do its job — take control, “get it together” — than to wrap oneself around something so elusive.

Sometimes, however, the first step to bridging the gap between the depressed and those who “don’t get it” is as simple as compassion. Even a desire to understand and a willingness to learn can diffuse the darkness with the light of hope.

If you or a loved one is in pain and you think I can help, please feel free to reach out to me on my confidential voice mail 310-314-6933 or email me at mfoxmft@yahoo.com.