Commonly referred to as ‘the black dog’, depression is a condition that has long been under siege by misperception.
Popularised by Winston Churchill, the phrase ‘the black dog’ has been instrumental in perpetuating notions of depression as a dark, ever-looming threat that can come out of the shadows to bite us at any moment it chooses.
Charities like MIND, MQ and Rethink Mental Illness are doing a great job of encouraging us to open up about our emotional well-being, to ask for help when we need it and to reformulate our existing (mis)perceptions of depression.
But there is still a lot more to be done in raising awareness about mental health, and this article is aimed at helping us all take a step into the newly emerging territory of stigma-free depression.
By unravelling 16 of the most common myths surrounding depression, I’m hoping to reach out to people with the condition and to people who want to learn more about it, so that we can all get involved in smashing through the stereotypes that prevent too many of us from speaking openly about the condition that affects as many as one in five of us.
So let’s get dispelling some myths. Right here. Right now.
1) Depression is just about being sad
Anyone living with depression knows that it produces a spectrum of emotions, and this spectrum is not built on sadness alone.
Clinical depression produces a range of different emotions in each individual it affects, and some of the most common feelings include fear, guilt, apprehension, hopelessness and helplessness.
Despite being largely defined as a ‘mood disorder’, the emotional impact of depression can often manifest in physical symptoms, with the NHS listing poor sleep, lowered libido, a decrease in appetite and constant fatigue as common symptoms.
So depression can’t just be reduced to ‘feeling blue’ or being in ‘low spirits’.
Just because so many people living with depression have honed the skill of masking both its mental and physical effects does not mean that these effects are any less severe or have any less impact because they are hidden from your view.
2) Depression isn’t a real illness
What defines a ‘real’ illness?
Physical trauma? Open wounds? Broken bones?
So many people fall into the trap of believing that depression is not a medical condition. Some even go as far as to view the condition as a sign of mental weakness; as something that you shouldn't air and share with other people.
But depression IS most certainly a ‘real’ medical condition, and it shouldn’t be used as an indicator of weakness or strength.
There are plenty of other clinical conditions, including diabetes, hypertension and cancer, that don’t necessarily have physical symptoms. But I don’t think I’ve ever heard anyone ask someone with diabetes to prove their condition or to simply ‘get over it’ using their own will-power.
There is an unhelpful tendency to view the mind as an abstract entity, completely separate from the ‘concrete’ world of the physical body. This pervasive attitude continues to influence our perceptions of mental health.
So many people seem to believe that the mind is an indestructible unit, impervious to damage because it has no physical form. Now I’m no Aristotle, but I know that whatever the mind is, it is susceptible to harm just as much as the body.
We need to remember that the visibility of a person’s symptoms is not a measure of the validity of their symptoms.
The fact that depression isn’t treated with slings and bandages doesn’t make it any less ‘real’ or valid as a medical condition.
3) Having depression is a choice
This myth is really dangerous.
It’s often linked to hyper-masculinised notions of self-control and the English ‘stiff upper lip’ attitude.
Like so many other medical conditions, depression often requires specialist treatment in order to be managed.
We don’t expect people diagnosed with long-term conditions like asthma or lupus to be experts in their conditions as soon as they’re diagnosed, so why would anyone assume that a person with depression would instinctively know how to treat it?
Doctors, psychiatrists, counsellors, and therapists spend years (often decades) learning about depression and how best to treat it, so how could anyone expect a person living with depression to ward it off with a simple wish?
Depression isn’t just a matter of willing yourself better, and the Royal College of Psychiatrists does well to remind us that:
“The fact is there comes a point when depression is much more like an illness than anything else. It can happen to the most determined of people – even powerful personalities can experience deep depression. Winston Churchill called it his ‘black dog'.”
4) Depression is an umbrella term for all mental health
While depression has arguably received more attention than conditions like schizophrenia, bipolar disorder and generalised anxiety disorder, it is not a one-size-fits-all term that can be applied to all mental health conditions.
As human beings, we like to simplify things as much as possible. It’s so much easier to choose to understand ‘mental health’ as being synonymous with ‘depression’, rather than recognising that depression is a complex condition that can occur on its own or in conjunction with other conditions like anxiety and PTSD.
But inaccurately reducing all mental health conditions to depression, or the feelings associated with depression, is not accurate and it’s certainly not fair to those seeking support with their illnesses.
You can read our article asking ‘What's the difference between depression and anxiety?’ to learn more about the elements of depression that make it different to other mental health conditions.
5) Depression is always triggered by a traumatic event
While the death of a loved one, a serious break up, or a diagnosis of terminal illness can cause depression, not everyone who experiences depression will do so because they have been through severe trauma.
The Royal College of Psychiatrists states that:
“As with our everyday feelings of low mood, there will sometimes be an obvious reason for becoming depressed, sometimes not. It can be a disappointment, a frustration, or that you have lost something - or someone – important to you. There is often more than one reason, and these will be different for different people.”
The NHS complements this statement, stating on its website that:
“There's no single cause of depression. It can occur for a variety of reasons and it has many different triggers.”
We need to adapt the way we view depression in accordance with the fact it doesn’t always have an easily discernible cause.
To do this, it will be helpful to start viewing depression less as the result of an event, and more as an event in its own right.
6) If your parents have depression, that’s why you have depression
The debate as to how much depression can be attributed to genetics and how much it can be attributed to environmental factors is heated for a reason.
It’s important to note that the Royal College of Psychiatrists has stated that:
“If you have one parent who has become severely depressed, you are about eight times more likely to become depressed yourself.”
However, it is equally important to note that there has been no conclusive evidence that genes alone can cause depression.
A recent study published in the Nature Genetics journal suggested that there are 17 genetic variants in biological European ancestry that could increase an individual’s chances of experiencing depression at some point in their life.
But Dr Roy Perlis, the co-author of this study, has indicated that these genetic variants contribute just a few percent towards a person’s chances of developing depression, stating in an interview with The Guardian that:
“It is a very small proportion of risk, this is not the sort of finding that can be used to make a diagnostic test or predict depression.”
As health organisations like the NHS are keen to point out, “there’s no single cause of depression”, and more research is needed before we can definitively say that genes alone determine an individual’s chances of developing depression.
7) Only women get depressed
While the World Health Organisation has noted that women are considerably more likely to be diagnosed with depression than men, this does not mean that men don’t get depression.
Getting a diagnosis for depression requires you to be seen by a qualified doctor, and if societal pressure is such that you feel uncomfortable doing that, then you won’t get diagnosed with depression, even if you have the condition.
A 2016 MIND survey found that 10% of UK men felt they had no one to rely on for emotional support, as opposed to 5% of UK women. Moreover, 50% of men surveyed admitted they felt uncomfortable talking about emotions, as compared to 40% of women.
The fact that double the amount of men felt a lack of emotional support, and that 10% more men felt reluctant to talk about their emotions, reflects the dangerous tendency of English society to relegate emotions to the realm of the feminine.
This is why it’s so important for us to discuss mental health more openly, so that everyone (especially men who have notoriously strayed away from seeking help with mental health) feels able to ask for help when they need it.
8) Children and teenagers don’t get depression
According to figures published by the Office for National Statistics, 10% of children in Great Britain aged between 5 and 16 live with a mental health illness, and 4% of children experience conditions like anxiety and depression.
That’s clearly one of the figures that we like to bury as a society that is built on the notion of children being ‘innocent’ and free from supposedly ‘adult’ complaints.
Dr Navina Evans, a London-based consultant psychiatrist, has provided the following statement on how to spot depression in children and young adults (as quoted on the NHS website):
"The obvious signs to look out for include a low mood and unhappiness, with tearfulness or irritability that may not be related to anything specific."
"Also watch out for reactions when something sad happens. For instance, when someone dies it's normal for everyone in the family to feel distressed. But if you feel your child's reaction is too extreme or has gone on for too long, that could also be a sign of depression."
The NHS website for childhood depression also points to advice from Dr David Kingsley, a consultant adolescent psychiatrist at Cheadle Royal Hospital's Young Persons' Service:
“If a young person is unable to function at school and has lost interest in things they were previously interested in, that's a major sign.”
9) All people with depression are suicidal
Depression can cause low moods, prolonged tiredness, persistent feelings of hopelessness and sometimes feelings of despair.
But the condition does work on a spectrum, ranging from mild depression, to moderate depression and severe depression.
While many people who have suicidal thoughts often have depression (particularly severe depression), not everyone who has depression has suicidal thoughts.
The Mental Health Foundation found that:
“72% of people who died by suicide between 2002 and 2012 had not been in contact with their GP or a health professional about these feelings in the year before their suicide.”
This is why it is vital that you contact your GP immediately if you have any suicidal thoughts, because there is so much help available to you. You can also speak to Samaritans on 116 123.
10) Antidepressants are the only way to treat depression
NHS web pages for depression only list antidepressants as a suitable course of treatment in cases of moderate and severe depression.
The NHS site suggests that it is more likely that your GP will recommend changes to your diet and exercise regime or a self-help course as the first line of treatment for your condition (depending on how severe your depression is).
Counselling and CBT (Cognitive Behavioural Therapy) are also common treatments recommended by GPs.
The Royal College of Psychiatrists has stated that CBT “is as effective as antidepressants for many types of depression” and describes CBT as a therapy that:
“... can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you.”
So you won’t be advised to take antidepressants unless your doctor feels it’s necessary.
11) Antidepressants are addictive
While some sleeping pills and anxiety medications can be addictive, antidepressants have not been proven to induce addiction in the people who take them.
Antidepressants contain no addictive substances, and people who take them shouldn't experience any cravings for them. If a dependency is developed, it will most likely be the result of a psychological reliance on the physical habit of taking the pills.
Having said this, the Royal College of Psychiatrists have noted that:
“Up to a third of people who stop SSRIs and SNRIs have withdrawal symptoms which can last between 2 weeks and 2 months.”
So while you can’t get clinically addicted to antidepressants, you can suffer with side effects after you stop taking them.
But tapering off your medication rather than cutting it off suddenly will help you avoid the symptoms of stomach upset, anxiety and dizziness that the Royal College of Psychiatrists list as potential withdrawal symptoms.
12) Antidepressants turn you into a different person
Taking an antidepressant isn’t like installing a software update.
Your old ‘system’ of emotions isn’t replaced with a new system that has been pre-designed to give what a group of scientists decided would work better.
By contrast, taking antidepressants is more like turning your computer off and on again. The same files (or memories) are there, and it’s just a case of your system needing a bit of a re-boo(s)t to get it going again.
Antidepressants are designed to get you back to being you (so think Twining’s dramatic water colour advert about your morning cup of tea reuniting you with yourself).
13) You’ll never come off of antidepressants once you start taking them
Antidepressants don’t come with a sign-up contract for life.
Your doctor or GP will keep you on antidepressants as long as may be necessary for your condition, and because your condition is unique to you, the amount of time you’ll be asked to take your antidepressants might be different to the amount of time someone else could be asked to take the same medication.
The NHS states that:
“Coming off antidepressants too soon can cause your condition to return, and stopping before you have been taking them for three to four weeks may mean the medication hasn't had a chance to take effect.”
Antidepressants are designed to treat the symptoms of depression that could otherwise stop you from feeling how you want to feel and doing what you want to do. So there's no shame in using them to manage your condition, for however long that may be.
14) Therapy won’t help; it’ll only make you feel worse
Talking about your emotions to help alleviate an emotional disorder intuitively seems to make a lot of sense, doesn’t it?
Therapies like counselling and CBT aren’t designed to make you dwell for hours and hours on the worst moments of your life so that you fall apart in the therapist’s chair and never get back up.
The Royal College of Psychiatrists states that CBT helps you to:
Identify any unrealistic and unhelpful ways of thinking.
Develop new, more helpful ways of thinking and behaving.
In reality, talking about your feelings with a professional can help you learn how to manage your emotions. One of the aims of therapy is to help you build a defence mechanism for dealing with negative emotions when you experience them most intensely, so that you can combat any dangerous side effects that might come with such feelings.
15) If you can no longer see the effects of depression, then it’s cured
Depression can return even after treatment. It’s just one of those things, like rain, that you can’t predict with 100% certainty.
A large part of managing depression is about recognising it’s symptoms, and asking for help as soon as you need it.
So many people suffer in silence and there are others who are really good at hiding what they’re truly feeling. So no apparent symptoms doesn’t mean no depression.
You can call Samaritans on 116 123. Mental health charity SANE also have a helpline you can call on 0300 304 7000 between the hours of 4:30pm and 10:30pm. Both helplines are open are every day of the year.
16) People with depression are never happy
Depression is a condition that comes in peaks and troughs.
During an episode of peak depression, someone with depression may find it hard, if not impossible, to experience happiness.
But that doesn’t mean that people with depression are unhappy all the time or that they can’t find happiness even in the toughest of times.
Reading through the mass of personal blogs and opinion pieces on the internet will soon tell you that people living with depression don’t feel sad all the time. SE Smith’s opinion piece, recently published in The Guardian, provides much insight into the topic of depression and happiness.
The NHS recommends building your self-esteem, talking more and managing your stress levels as good ways of finding happiness. If you’re really struggling to be happy, speaking to your friends and family is likely to help boost your mood too.
If you have any questions about your depression or the medications you take to treat it, you should always contact your doctor in the first instance.
More from the blog
Why we need to talk about social media use and mental health among young people
8th August 2018
Echo intern Ben Scott examines the link between social media usage and mental health problems among children, teenagers, and young adults.
The future of autism treatment: 4 recent innovations with transformative potential
12th April 2018
Find out more about the groundbreaking innovations that could pave the way towards more effective treatment for the UK's 700,000 autistic people.