In a previous relationship, when I told my partner I was getting back on antidepressants, he basically told me that I needed to "snap out of it," because my depression was affecting the relationship. If only it were that easy. Here's the thing — depression is not a choice, and telling people to snap out of it is like telling someone with a broken bone to quit their whining already.
According to Harvard Medical School, depression happens in the brain, and thus is not something people can control. "Certain areas of the brain help regulate mood. Researchers believe that — more important than levels of specific brain chemicals — nerve cell connections, nerve cell growth, and the functioning of nerve circuits have a major impact on depression." Armed with this information, researchers are now exploring possible links between poor production of new neurons in the hippocampus (the part of the brain responsible for emotion, memory, and controlling the nervous system) and depression.
And, research shows that unchecked poor neuron production can lead to Major Depressive Episodes (MDD), which actually changes the brain. Symptoms of MDD range from persistent feelings of emptiness and hopelessness, to changes in weight, insomnia, and other physical symptoms that appear without explanation. A study by NIGMA MDD Working Group at USC found that MDD causes physiological damage to the brain, and results in a smaller hippocampus.
Just how common is depression? Psychology Today reports that depression affects more than 300 million people globally, but less than 50 percent ever get treatment. Can you imagine if 50 percent of people with broken legs didn't get treated?
Here are just a few more reasons why depression is never a choice, and why it isn't possible to just "snap out of it."
Depression Is An Illness, Not A Lifestyle Choice
While depression is a medical condition, like a broken bone, finding treatment for it can be much harder than finding treatment for physical conditions. Finding someone I like and trust who provides both medication management and talk therapy, and who also takes insurance, is like finding a unicorn. If I could find either one, I'd be over the moon.
Psychology Today reported that extended schooling and a lower earning potential are responsible for many med students not choosing psychiatry as their speciality, which has resulted in a shortage of mental health doctors. Additionally, dealing with insurance companies adds another layer of frustration to the process for people trying to get help for their depression.
For example, most HMO health insurance plans require authorization from your primary care doctor to seek mental health treatment through your insurance. Additionally, the Atlantic reported that, according to the American Psychological Association, 30 percent of psychologists don't take insurance at all.
And, according to Mental Health America, one out of five adults actively seeking treatment for a mental illness reported that they are not able to get the treatment they need, in part because, on average, there is only one mental health provider for every 529 people seeking treatment.
"Once a person recognizes that they may have a mental health problem, finding support especially the right kind of support is often difficult," Mental Health America noted. Barriers to accessing care include: Lack of insurance or inadequate insurance, lack of available treatment providers, lack of available treatment types (inpatient treatment, individual therapy, intensive community services), and insufficient finances to cover costs — including, co-pays, uncovered treatment types, or providers who do not take insurance.
What's more is that people who need help for their depression often don't get it because depression can be a largely invisible disease, and many who witness depression lose patience for friends, family, co-workers, and loved ones battling their illness because they think the person should be able to change their behavior if they just tried harder. This problem in particular has motivated Lady Gaga and her mom, Cynthia Germanotta, to offer Mental Health First-Aid classes — sponsored by Born This Way Foundation and the National Council for Behavioral Health — to help people better recognize symptoms of mental illness in others, according to Mashable.
No, We Can't Snap Out Of It
The good news is that depression is treatable. The bad news is that finding treatment that is effective, affordable, and accessible is extremely difficult. You have to become your own advocate, and do your own research. You have to ask a lot of questions, especially about medication, particularly if you're drug intolerant like me. It sometimes feels like a full-time job, and managing this can be difficult for someone who is depressed.
I once had a doctor who switched my meds; he told me to simply stop taking the old one and start taking the new one. I know now that this is really dangerous because you need to be weaned off of prescription medication, but back then, I didn't know that what my doctor was advising me might be incorrect. Within a few days I was crying uncontrollably, taking dangerous risks while driving, and I couldn't stop shaking. I thought I was losing my mind, but in reality, I was intolerant to the new medication while simultaneously experiencing sudden withdrawal from the old one.
Luckily, I also had a therapist who was also a registered nurse, and she recognized what was happening right away. She advised me to refill my old prescription, and to promptly switch doctors. She basically saved my life. Now, I ask a ton of questions about any suggested medication. It might come off as annoying, but I do what I have to do to advocate for my own mental health.
Believe me, if I could snap my fingers and not have to deal with any of this, I'd be snapping my ass off. Unfortunately, it doesn't work like that.
If We Could, We Would
For me, depression feels like disappearing, watching it happen, but not being able to do anything about it. It feels like shouting for help, but no one can hear you. It feels like being blindfolded inside a labyrinth and told to find your way out. It feels like being underwater all of the time. Plenty of other writers and artists have had similar thoughts about their depression, which has helped move the mental health conversation out of the shadows.
“Depression is the most unpleasant thing I have ever experienced," J.K. Rowling once told The Times. "Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.” Carrie Fisher once asked, "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?" And, Lady Gaga described her depression to Rolling Stone as "Deep sadness, like an anchor dragging" everywhere she went.
So, I'm not alone when I say that I would love to be able to just snap out of it. Unfortunately, it's just not a possibility. But with therapy, medication, and increased awareness about what depression actually is, we might be able to work our way out of it, one step at a time.