When I moved to Los Angeles I searched for a new therapist to help treat my depression. During my first appointment, one therapist said, "well, you don't look depressed." Um, OK, there are myriad ways depression affects your daily life even if you seem totally "normal." And, I would expect that someone who is trained to treat depression would know this. Because I showed up to her office showered, well dressed, and appeared together, this therapist dismissed my depression in the first 30 seconds of our meeting, which can feel pretty isolating for someone who has taken an active step to get help.
What she didn't know (and didn't ask) was that the shower I took to come to her office was the first one I'd taken that week. And, because I often feel anxious and ashamed for being depressed, I can usually put together a pretty good external package to present to the outside world. Perhaps I should have done what my dad did when he went for his PTSD evaluation at the Veteran's Administration, not shower, shave, wash my face, or brush my teeth for a week so I would be believed.
One quote that I found on HealthyPlace.com sums up what it's like to seem "normal" but be battling depression pretty accurately. "She was drowning, but nobody saw her struggle." Depression doesn't have a "look," and these are some ways depression affects daily life, even if you seem totally "normal."
1We Feel Guilty
On the days that I struggle to accomplish even the smallest things, like getting out of the bed, or taking the dog for a walk, I am overcome with immense feelings of guilt. If an outsider were to evaluate my life, or examine my social media feed, they're not likely to conclude that this globetrotting writer suffers from depression.
And, because of this, I feel guilty for feeling depressed when I know I am lucky to have so many advantages in life. I look at my dog, who has a chronic health condition, and believe that she would be better off with someone who would walk her every day. My dog has a huge yard, an organic, human-grade diet, and dozens of toys, but the guilt about missing one walk sends me into a downward spiral.
Psych Central reported that a study has shown that the brains of people with depression respond differently to feelings of guilt — even after their symptoms have subsided. “The scans revealed that the people with a history of depression did not ‘couple’ the brain regions associated with guilt and knowledge of appropriate behavior together as strongly as the never depressed control group do,” Dr. Ronald Zahn, a MRC Clinician Scientist Fellow, said on Psych Central.
Because of this, people who experience depressive guilt often feel guilty for everything from missing a dog walk to wars raging on far off continents.
2Mornings Are Difficult
For me, mornings are especially difficult. I often have a hard time getting out of bed, and if I didn't have a job, copious amounts of coffee, and a dog to feed, I'm not sure I'd always succeed.
"With morning depression, you may have more severe depression symptoms in the morning than in the afternoon, or evening," Healthline reported. These symptoms can include extreme sadness, frustration, anger, and fatigue."
Mornings are when I most often cycle through my "what is the point" thought process, and things feel the most difficult and meaningless. By the time I go to bed I am usually in pretty good spirits, and I mentally plan a list of things I am going to do the next day to totally kill it at life. Then when morning comes all of those things feel utterly impossible, and the guilt sets in.
3We're Good At Hiding It
Because I am already insecure and anxious about being depressed, any time I go out to dinner, hang with friends, or go to an event I can look pretty put together, and even appear to be having fun, but sometimes it is really, really difficult.
"From the outside I look like I have it all together, but the truth is I find everything exhausting," Jennifer Hazen said on the Huffington Post. "Getting up, eating breakfast, taking my kids to school ― all of it saps my energy. I walk around in a state of perpetual exhaustion."
While reading Carrie Fisher's The Princess Diarist, I literally felt like I was reading thoughts she pulled out of my brain. When she was 19 she wrote in her diary, published in the book, "I call people sometimes hoping not only that they'll verify the fact that I'm alive, but that they'll also, however indirectly, convince me that being alive is an appropriate state for me to be in. Because, sometimes I don't think it's such a bright idea. Is it worth the trouble it takes trying to live so that someday you get something worthwhile out of it, instead of it almost always taking worthwhile things out of you?"
Until Fisher went public about her battles with mental illness, I'm guessing that no one would have suspected that this was what was going through her head as she filmed the Star Wars trilogy. Many people who struggle with depression are really good actors, even if that's not what they do for a living.
4We Might Seem Flakey
I feel utterly guilty for canceling plans with someone, but sometimes it's physically impossible for me to leave my house when I am battling depression. I often make plans far in advance, and assure myself that when the day comes for X, Y, or Z, I will be up to it.
How I wish that were true. We might miss doctor's appointments, family functions, and routine beauty appointments because we just can't even. The Huffington Post reported that one woman suffering from depression went to her hair stylist after not being able to wash or brush her hair for six months due to her depression. The stylist, who noted that she is familiar with depression, worked with the woman for eight hours to detangle, style, and color her hair.
“I wanted her to know that there is someone that is here to help her,” Stylist Kate Langman told the Huffington Post. “No matter the circumstances. She needed someone she could count on and I wanted to be that person for her.”
If we flake, it most likely has zero to do with you, so please don't take it personally. Most days I'm literally doing the best I can, and I always feel bad about canceling plans.
5We Have A Hard Time Having Fun
When you're depressed, having fun is hard. Things that you normally enjoy feel more like a burden than something you want to do. While many people who don't suffer from depression often say, "just go, you'll have fun once you get there," this simply isn't true.
The idea of all the things you have to do to get to the fun activity, like get out of bed, shower, get ready, drive there, etc. can be completely overwhelming. If you do manage to make it, the pressure to participate in the fun, when all you want to do is crawl under the covers, is really stressful.
I went through a period of depression earlier this year where literally all I did was work, and watch Gilmore Girls. Every day. For a month. I turned down every invitation for fun, and to the outside eye I probably looked like a lazy, entitled brat, but it was pretty much all I could manage.
6Nothing Is "Wrong"
One of the common misconceptions about depression is that something went "wrong" to make a person depressed. While some depression is triggered by life events, most people with depression are depressed when everything in their life is fine, and no, they can't just snap out of it.
"It’s difficult for most people to understand any kind of deep depression if they haven’t experienced it. What people see with illnesses or injuries is a runny nose, blood, expressions of acute physical pain, or an X-ray of what hurts," Cynthia W. Lubow, MS, MFT wrote on Good Therapy.
"What people see when someone is seriously depressed is a person who isn’t doing anything; this person may be crying or snapping at them or sounding insecure and hopeless. These are behaviors we associate with personality and moral character — we think these are choices people are making, not an illness that has taken over their personality. Most people wonder why the unrelentingly depressed person doesn’t just get over it and may even wonder if it’s a manipulation or if the person is just lazy, weak, or giving in to something he or she could fight."
And, being depressed when you think you should feel grateful can trigger feelings of guilt. While some people tout that making gratitude lists helped them overcome depression, it doesn't work for everyone.
7Our Brains & Our Emotions Are At Odds
One of the things I struggle with the most is that while intellectually I understand that nothing is "wrong," and my depression is causing me to feel a certain way, I can't make my emotions and my brain have a conversation and get on the same page about it.
Knowing something, and then being able to actually apply it to your life when what you're feeling is the exact opposite is pretty difficult. I cry all of the time, usually for "no good reason." While some research suggests there is a way to integrate the part of your brain that deals with reason with the part of your brain responsible for emotions, it's not a commonly suggested treatment, nor are there many studies to illustrate its effectiveness.
Basically, we're doing the best we can, and if we do have enough courage to open up to you, or to ask for help, please don't dismiss our depression by telling us that we have it all together. We already know that's what you see because that's the way we've shown it to you.