Coming to Terms With Depression

Medically Reviewed by Michael W. Smith, MD on April 09, 2021
4 min read

Depression is one of the most common mental disorders in the U.S. More than 17 million Americans deal with the persistent emptiness, helplessness, and hopelessness of a depressive episode each year.

The nature of depression often makes it hard to go through the steps to get a diagnosis in the first place. But once you’ve identified your depression, you can move toward finding treatment and relief.

It can be hard to explain to someone who’s never dealt with depression exactly what it feels like. People often use the word “depressed” to mean “sad,” but most people have a much broader range of symptoms than sadness.

During a depressive episode, you may feel:

  • Cranky
  • Anxious
  • Restless
  • Aches
  • Pain

You might have a hard time concentrating. Trouble sleeping is also possible.

For many people, depression can feel like the absence of feeling, like life is on mute. Some describe it as if someone threw a blanket over their body and mind.

This makes it much harder to interact with the world the way you normally do.

When Rhiannon Giles, 39, was at the height of her depression symptoms, she says day-to-day life felt “excruciating.”

“I would be walking down the hallway at work and be overwhelmed with the desire just to lie down and curl up in a ball,” she says.

On top of that struggle, Giles says she also felt like no one wanted to be around her -- which is another common symptom of depression.

“With mental health issues, we often want to take blame for the problem because it’s ‘in our head,’” says Diana Samuel, MD, an assistant professor of clinical psychiatry at Columbia University Medical Center.

But your depression is not your fault. You didn’t cause it. It happens as a result of your body’s chemistry mixed with biological and emotional triggers.

There isn't one single cause for depression. Doctors think your genes may play a part. But even if you have a family history, depression rarely comes on for no reason.

“Depression can be triggered by a life crisis, a physical illness, a change in relationship, financial struggles, or even a trauma that happened at a young age and changes how your brain is able to respond to fear and stress,” Samuel says.

You can also have depression as a side effect of other medical conditions, like:

  • Diabetes
  • Cancer
  • Heart disease
  • Parkinson’s disease

Depression can also be a side effect of medications.

Other mental health issues, such as anxiety, also make you more likely to have depression.

Typical treatment includes psychotherapy and medication. Just like depression is different for everyone, so is treatment -- it’s not one-size-fits-all. For some people, therapy works well. Others need medication. But for many people, using both is the answer.

“The evidence is strongly correlated that the combination of medications and therapy combined is more effective than either one alone,” says Greg Sazima, MD, a psychiatrist and senior behavioral faculty at the Stanford/O'Connor Family Medicine Residency program in San Jose, CA.

Giles says therapy has been a “life-changing experience” for her, but it wasn’t enough treatment by itself.

“Adding medication on top of therapy gave me the breathing room to work on myself,” she says. “When you’re in the lowest depths of depression, sometimes you cannot help yourself. Exercise, sleep, nature -- those are all great, but until I got medication on board, I didn’t have the energy to get started on any of that.”

It’s important to know that it can take time to see a difference in your symptoms after you start treatment.

“The unfortunate reality is that medications take a while to work, and even then it’s a gradual change,” Sazima says. But you will feel the weight of depression lift once you find the right treatments and your body and mind begin to adjust.

Practice getting out of your head. Meditation, yoga, tai chi, qi gong, and other mindful movement practices can help ground you into your body and the present moment.

“Depression can be a cycle of catastrophic thinking,” Sazima says. “Over time, mindfulness practices can help you acknowledge your depression while also disrupting the fear state it can cause, so you’re able to put treatment tools in place earlier.”

Move whenever and however you can. Sometimes, just getting out of bed is more than you can manage, and that’s OK. But when you notice a little energy come back, latch on to it.

“Just use sneakers and gravity,” says Sazima. “Put on your shoes, go outside, and simply walk in one direction for 10 minutes and then walk home. There. You've moved. Now repeat every day, and you’ve created a healthy mental habit.”

Create. A depressive episode isn’t the time to pick up a new hobby, but if there’s a creative practice that brings you joy, inject some of it into your life.

“If you've drawn before, draw a little bit,” Sazima says. “If you know some music, listen to it. If you play some music, get back to it. Deploy some action that takes your brain out of the loop of ‘I’m at the mercy of this depression.’"

Remember: This too shall pass. “Depression hurts a lot,” Sazima says. “It’s important to validate that. But also, it comes and goes, like everything else. It can feel like things won’t ever change, but that’s depression telling you that.

"You won’t always feel this way. Hold on.”