Understanding Major Depressive Disorder: Common Misperceptions

This information is designed to be helpful to anyone who feels they may have or care about someone who may have symptoms consistent with Major Depressive Disorder. Let’s start by answering a few questions.

Is it Major Depression Disorder or Just Feeling Really Sad?

The traits included in the ‘symptom cluster’ called Major Depression are very common and easily confused with a normal response to stress. What makes this a ‘diagnosis’ and thus converts these normal responses into symptoms of depression? Why does this affect a person’s life so badly? Why can’t they just shake it off? Many in the past have said, "All a person who feels depressed needs is a good swift kick in the butt to get them going!" Others have said, "Giving people a sugar pill is just as effective as psychotherapy or medication." Some say that, “If everyone just exercised and said their affirmations then no one would be depressed.” Still others say, “I was depressed once and it was no big deal, get over it!”

Clearly many people are confused so let’s look a little closer and try to come away with a few common sense answers and suggestions.

"Sugar Pills ‘Worked’ for Some People!"

Well, sort of. People who suffer depression have symptoms that wax and wane. When a group of individuals were placed on a sugar pill and another group on medication, some people improved in the ‘sugar pill’ group. However, brain scanning performed on all patients showed that the protective effect of medications were not present in the ‘sugar pill’ leaving them vulnerable to relapse.

People with depression often feel differently day to day. It is one of the factors that makes it so hard to know what is going on, what works and what doesn't. No matter what form of treatment is implemented many times some people will feel a little better and others a little worse, even when nothing has really changed. Of course, many of these studies are short term and as time goes on, without implementing effective strategies, the depressive symptoms nearly always return.

Another problem with any study is that there can never truly be a ‘placebo group’. One day a person is in their home depressed, not talking with anyone and alone. Then, when they see their doctor they are invited to join a study. They visit very nice people who take great interest in all aspects of their life. They become part of a group of people who suffer much as they do and feel a part of the search to find answers for everyone who suffers depression. They are not alone and are assessed by these friendly people frequently. Great interest is shown in their every response; who they are, how they are feeling, and of particular interest, any gains they are making.

One treatment for depression is called ‘Tonglin’ a meditation practice from Tibet. This form of meditation works with the breath. On the ‘in breath’ we are to imagine all the people who are suffering as we are. On the out breath we are to wish them peace. Our brain is wired to heal when we offer ourselves or others compassion. People who join studies with a placebo group are at risk of not receiving optimal care for their illness. To offset this risk, people who run such studies offer the understanding that by participating in such a study they are helping others who suffer as they do. Also, if they do very poorly, they 'fall out of the study' and can receive the care of their choice.

Will a ‘Swift Kick in the Butt' Fix Things?

Feeling depressed does not feel good and the brain does what it always does; it tries to figure out what is wrong and fix it! Depression is an unconscious illness and feeling excessively guilty is one of the symptoms. The brain constantly searches for what may be going on. A person may go to the emergency room or see their family physician. After review of all studies performed, frequently they are told, “Everything looks normal.”

The brain continues on its search for what’s wrong, “Maybe it’s that argument I had with my partner. Maybe it is the way I am being treated at work. Maybe it’s my parent's fault as they expected too much or too little of me when I was little.” After incessantly investigating each of these possibilities and coming up empty, often the only answer that seems left is, “This is just me. I’m broken. I’ve tried giving myself a swift kick in the butt, however, even this doesn’t work." When others around the person try to deliver yet another kick, it just makes them feel worse. They begin to say to themselves, “Is this all that life has for me? I’m a lousy friend, a lousy lover and a lousy parent. I’m depressed because I deserve to be depressed.”

As you can tell, you don’t need to tell a person with depression to kick themselves any more than they already have. People may try to exercise but often struggle to even get out of bed. Usually people try all the common sense strategies that have worked in the past. Unfortunately, for some reason, the strategies this time don't seem to be working.

If this describes how you or a loved one have been feeling please reach out for help. For additional information please see, 'Taking a Wholistic Approach to Mental Illness: Getting help.'

Please discuss any of the information you would like to consider with your treatment team before implementing these strategies.

Major Depression: Everyone is Different
Depression or Something Else?
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