Depression is a frequently misunderstood condition and people with depression are often not fun to be around. People typically want to be there for a friend who’s going through a hard time, but as depression drags on, even well-meaning friends and loved ones will ask, “Why can’t you just snap out of it?”
For people suffering with depression, this question is absurd. They would like nothing better than to snap out of it. Depression is miserable. If fixing it were a simple matter of deciding not to be depressed, they would have done it a long time ago. What’s worse, many people with depression have tried being more positive, more grateful, or more cheerful, probably lots of times and found it never works. This only compounds the feeling of failure. Telling your depressed friend to snap out of it only reinforces the feeling that her depression is her own fault.
Depression is more than just sadness. In fact, not all depressed people feel sad. Numbness is also a common symptom, perhaps more common. Depression also includes many physical symptoms such as slow movements, muscle aches, and fatigue. One theory of depression is that it’s a sort of illness without a pathogen. You feel much the same as you would if you had an infection but it just seems to go on and on. It wouldn’t make sense to tell someone with the flu to snap out of it because we understand there’s a physiological process going on that just has to run its course.
The physical chemistry of the brain is another factor. People with depression are often deficient in serotonin or dopamine or both. It’s evident that brain chemistry matters because drugs alone can relieve depressive symptoms in some people. The prevailing theory is that SSRI drugs increase the concentration of serotonin, the neurotransmitter responsible for a sense of wellbeing, in the brain. It might also be that it downregulates a receptor that inhibits serotonin production. Either way, the symptoms of depression lift by altering the chemical contents of the brain.
What perhaps confuses some people is that talk therapy, especially cognitive behavioral therapy, is also effective in treating depression. Doesn’t that mean it’s all in your head? Not necessarily. The connection between the body and mind is complex. Perceiving events as threatening, for example, or believing you have no control over negative events, increases chronic stress and anxiety, which can lead to depressive symptoms. The trick is that people aren’t usually aware of their own cognitive distortions. It often takes an experienced therapist to convince someone with depression to try seeing the world differently. This is far deeper than snapping out of it; it means learning new ways to see the world.
Depression is complex. Treatment often requires both therapy and medication, along with lifestyle changes like exercise and diet. A small percentage of people don’t respond to any kind of treatment, but most people will improve to some extent.
