What I Believe About Depression

Shortly after the death of Robin Williams I wrote a post called What I Wish People Knew About Depression. It was a small effort to chip away at the stigma associated with depression and to raise awareness of the complexities inherent to mood disorders. I have expounded on those statements here and rearranged them to read as a summary of what I believe about the condition. I still wish for a lot of things, but I realize I can’t make anyone understand depression. All I can do is share my perspective and hope that my words open a few minds, promote healing, and lead to more support for those who suffer.

I believe depression is complex. I believe it is a physiological condition with psychological and spiritual components, and therefore can’t be forced into any neat and tidy box. I believe depression is part of a intricate web of biological systems — nervous, digestive, endocrine, respiratory. I believe it is about the gut as well as the brain, the thyroid and the nerves. I believe healing needs to come from a variety of sources. I believe every person’s recovery is different. 

I believe untreated depression can increase the risk of developing other illnesses. A 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses (such as pneumonia and influenza), and conditions of the nervous system (like Parkinson’s disease and multiple sclerosis).

I believe depression deserves the same compassion offered to people with rheumatoid arthritis, lupus, breast cancer, or any other socially acceptable illness. I believe persons who struggle with depression aren’t lazy, uncommitted, and weak. I believe they are not trying to get attention, that they are ill. I believe the best thing you can do for a person who suffers from depression is to believe her.

I believe gratitude can coexist with depression. I believe a person can be grateful and depressed at the same time. I believe she can be fully aware of the blessings in her life even as she is crying at the dinner table. I believe depression isn’t so much the refusal to see the positive in one’s life, rather the inability to enjoy it. I believe that while depression symptoms may look like a cup-half-empty perspective, the negativity is more a result of the struggle to engage with the goodness that a person clearly identifies in her life.

I believe a person can’t un-think herself out of depression. I believe that despite impressive research on neuroplasticity and our brain’s capability of changing, a person can’t undo depression solely by shifting the focus of her thoughts. I believe while he can be mindful of forming new neural passageways, he can’t reverse a severe depressive episode with visualization and mind control alone, just as he can’t un-think a tumor from happening. I believe that depressed persons can benefit immensely from mindfulness exercises, from concentrating on the present moment, from watching one’s thoughts with some awareness, and from applying some self-compassion to ruminations. However, I believe that a person can suffer from depression even years after developing a meditation practice, that mindfulness is often not enough by itself to treat a mood disorder.

I believe medications are important but don’t provide all the answers. I believe they can begin the healing process and allow the other hard work to be done, but aren’t capable of fixing everything. I believe many depressed persons live better, fuller lives as a result of taking antidepressants, mood stabilizers, antipsychotics, and tranquilizers, but that these medications should be regarded as only one tool among many in the pursuit of wellness. I believe that millions of people are treatment resistant and don’t respond to medication. While brain stimulation technologies offer some hope for them, I believe persons who have failed to recover after trying several types of medications and alternative treatments should be met with compassion and not be blamed for their lack of progress or told they don’t want to get better.

I believe depression isn’t caused by demons, a lack of faith, or constipated energy in the seventh chakra. I believe neither reiki nor an exorcism is likely to cure depression. I believe pastors and religious leaders would serve their congregations well by educating themselves on the facts of mood disorders so that they can offer compassion, instead of judgement. I believe Jesus can heal depression just as He can heal cancer. However, when he doesn’t, I believe no one should be blamed. I  believe prayer and faith can bolster recovery and promote healing — that it is helpful to design a regular prayer practice and try to grow in faith — but that depression is no more caused by a lack of faith than is leukemia.

I believe exercise, yoga, and the right diet can mitigate symptoms but aren’t a cure-all. I believe the endorphins from aerobic workouts are as close as a depressed person will get to an anesthesia for pain, but it’s possible to swim 5,000 yards or run seven miles a day and still be suicidal. I believe a sad swimmer can fill up her goggles with tears. I believe while yoga is helpful for many, a person can walk out of the studio just as depressed as she was before Namaste. I believe eating right can facilitate healing, but a person can eliminate gluten, dairy, caffeine, alcohol, and sugar from his diet—he can exist on green smoothies–and still be depressed. I believe fish oil, vitamin B 12, and a good probiotic could very well improve the mood, but that they aren’t magical elements. I believe that exercise, yoga, diet, and all efforts at healthy living can absolutely promote emotional resiliency, but that none of them alone is the panacea.

I believe the worst part about depression is the sheer loneliness, the inability to express the anguish that rages within. I believe the smiley-face culture we live in worsens that loneliness because depressed persons are scared to tell the truth. I believe most people with depression deserve Academy Awards for outstanding acting. I believe it can be very difficult to pick up on the desperation and sadness in a person who is suffering because chances are she is the one cracking jokes in a crowd. For this reason, I believe people with depression require the support of each other, a safe place where they can be understood and appreciated for who they are. I believe there is immense power in community, that there is healing energy in the togetherness.

I believe depression is a serious brain disease. I believe it is associated with the loss of volume in parts of the brain, namely the hippocampus, which belongs to the the emotional center. I believe the more severe the depression, the greater the loss of brain volume. I believe depression can inhibit the birth of new brain cells, or neurogenesis. For this reason, Peter Kramer, M.D. believes that depression is the “most devastating disease known to mankind.”

I believe depression can be genetic. I believe there are many genetic variations than can increase a person’s vulnerability to depression and other mood disorders. I believe studies of identical twins and research of genomic biomarkers underscore the fact that depression is a legitimate, medical illness. I believe they also provide hope for more targeted treatments of mood disorders in the future.

I believe depression is aggravated by stress because stress taxes every biological and emotional center of a person’s being. I believe that stress-reduction strategies like deep breathing techniques and time in nature can help reduce the fight-or-flight responses that promote disease, that depressed people would help their brains by working less and relaxing more. I believe listening to music, visualizations, bubble baths, and massages can begin to prime the parasympathetic nervous system and foster calm, that relaxation techniques are often a forgotten part of recovery.

I believe depression isn’t always triggered by an event. I believe that it often is, but that sometimes it’s not. I believe depression can and does occur out of the blue. I believe that it’s sometimes rooted in trauma, but not always. I believe sometimes one small thing is needed to pull a person out of darkness, and sometimes everything is unable to.

I believe depression isn’t a permanent condition. I believe it comes and it goes, and in its ebb and flow are found pockets of peace that can sustain a person for the journey. I believe sometimes the only thing a depressed person can do is to wait for symptoms to subside.

I believe there is hope for depression. I believe the way out of darkness is as varied as the causes. I believe recovery comes from medication and psychotherapy, from mindful meditation and green smoothies, from running and brain stimulation technology, from deep breathing techniques and self-compassion exercises, from cognitive behavioral strategies and painting, from hikes in the woods and coffee with friends. I believe hope is born in sharing the familiar yet unique story of one’s illness, and in finding a purpose to live for — in attaching every piece of the heart and soul to some meaning in this world and in gently turning the pain and the bitterness to love and service. I believe healing happens with faith, open-mindedness, community, and perseverance.

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57 thoughts on “What I Believe About Depression

  1. Beautifully written!! I agree with all you expressed. I’ve had depression, etc. since I was 15, and my 50th birthday is Tuesday. I don’t know much else besides the ebb and flow that you described. I’m keeping this post, Therese, and will read it often. Your words are powerful and give me hope and meaning!

      1. I wish people had the same compassion and understanding for depressed like the compassipn they have for cancer or lupus patients…..

  2. Therese I read your other post called “I beautiful “ and agreed with everything you said as it reflects my own journey.
    And this post shows you really have found your voice.
    And it is beautiful.
    My depression has returned once again. Each time I am well I believe it to be true and make plans to do all the things I want to do. Only having to cancel once again.
    It keeps returning.i have paid to see psychiatrists , counselors and cbt therapists. Friends get fed up and the last time I saw my pyschatrist I think he was too as the report he sent to my GP didn’t represent what I had said at my consultation.
    I believe all these things you have said in this post to be true too. Depression is complicated. And at the moment I don’t know which way to turn to keep going.
    A big hug to you Therese for finding your voice and being an advocate to all the poor souls who can’t find theirs . As this post proves you have found yours Lizzie

    1. Lizzie, I have depression for 25 years and jumped from one therapist to another and from one psychiatrist to another. My current psychiatrist changed my diagnosis to bipolar and I feel he’s right. It’s VERY difficult to treat, btw but he told me I need mood stabilizer for the mania (soft hypomania) and MAO for depression. I do trust him.

      1. I have wondered if I am bipolar too.? I am pleased Chaim you have found someone you can trust and got the right treatment.
        My moods change quite rapidly. I am wiling to accept any diagnosis to get the right treatment.
        Lizzie

        1. I’m using one of the top psychiatrist in NYS. People think that bipolar is only when people become wild and/or lunatic.

          Actually if your depression has a strong irritability, racing thought, intrusive thought, racing thoughts; along with some problems sleeping and restlessness, it can be a bipolar indication.

          If one just feel down in the dumps and just “not in the mood” along with suicidal ideation, it can be the depression phase.

          PLEASE don’t act on my words or take them for as it is because it’s quite complicated. I’d rather you discuss with you doctor about bipolar or agitated depression as some call it.

          Hope you feel better.

  3. Spot on! Depression is complex so it only makes sense that treating it is just as complex. It becomes a whole new lifestyle when you use the mechanisms of healthy living to combat that black hole. I went 20+ years without medication thinking I could handle it using only sheer will. It takes ALL the tools you mentioned to help make better days and to get through the bad ones. Thank you for writing such an honest and organized piece. Love and Hugs to you!!

    1. I tried it to without meds . I am struggling now. Which meds? Is there anyone out there who have found ant medication that is good for anxiety depression and sleep? Lizzie

      1. What helps one person, may not help another. Also, the effective dose varies from one person to another. The best thing that you can do is see a psychiatrist. If a psychiatrist is not easily available to you, your general practitioner should be able to prescribe something for you. if the first medication does not help, do not give up. Sometimes multiple medications must be tried before the correct one is found. That is best done by a psychiatrist, but your general practitioner May have a lot of knowledge about anti-depressants and anti-anxiety medications, too.

        1. Thank you Joyce, I have tried many antidepressants and seen quite a few psychiatrists.
          I am very sensitive to medication.
          When I asked it was more to give me hope?
          I can only tolerate lose doses. I find general GP do not understand this. Sadly my GP who did has retired.
          I was on a low dose of Escitalopram which helped but I started loosing my hair and gaining weight. And all the antidepressants I have tried never helped with sleep.
          I find when ever I do have a good nights sleep my mood is so different.
          Thank you for replying . Lizzie

      2. Hi Lizzie. Just read your post. I have had depression and anxiety for 13 years. I too faught depression without medication for years but realized I was failing and also wasting valuable time. I had honestly tried several types of medication prescribed by professionals but all went against me eventually one way or another (e.g side effects). I think that over the years medication in relation to depression and anxiety has evolved significantly to date. My GP recently prescribed Duloxetine krka and for the first time, true positive results unfolded within days and also without any side effects at all! This broke the vicious cycle I was trapped in for the first time since becoming ill. My quality of life had increased to a normal state. I am grateful. Please understand that I am not a professional and the medication prescribed obviously works for some and not others. I hope this helps. Niall

        1. Thank you Niall for taking the time to respond. It is not something I have tried. May you continue to feel well and enjoy life. Lizzie

      3. Hey Lizzie. my psychiatrist has me on low dose seroquel,( 50mg morning/50mg afternoon & 100mg at bed) he said it helps with depression. anxiety and sleep too (this is also used for Bipolar) so might be worth looking into for you

    2. Are you still medication free? You don’t need to answer but I am fighting depression for 25 years now and all with medication. I did try natural means like gluten and dairy free and LOADS of hight quality vitamins and was very health oriented,

      I did have a year where I was feeling better (Don’t remember why, did have some ECT) but was not successful tapering off my meds. Unfortunately this process ended me being hospitalized for a month (never mind; it was the moth of the high holy holidays and the Sukkot holiday).

      I’m back heavy duty on meds. Did have about 39+ ECT sessions and am partially treatment resistant; requiring me to take many different meds, especially that a new psychiatrist has change my diagnosis to Bipolar and the people around me agree, myself included. I’m not very happy about it but like Therese most likely believe that you gotta do what works for you; especially when talking to a partial suicidal patient. Good luck to all of you and I pray for you, Therese.

  4. I think this is the best thing you have ever written Therese. It encompasses absolutely everything there is to know about depression. I will pass on this post to the people I know who have or are currently suffering from depression. I will keep reading this often. I have treatment resistant depression and am currently in remission after a 2 year long battle. I have had many episodes in the past (6) and will probably have more in the future. The part about the ebb and flow of depression resonates most with me. This brings hope. This means it will end eventually. If you can just wait out the storm in the meantime

  5. Probably the most concise and all inclusive article you have written on the subject. It makes it easier knowing that Someone Truly Understands.

    This needs to be reproduced over and over and spread throughout our World. You communicated the TRUTH like few before you and touched on so many vital areas for research and the resultant understanding and compassion. Yes, I hurt, but not quite so alone after Therese Borchard came into our collective view.

  6. Wonderful, Teresa. Thank you for saying all of this, for not resorting to sound bites. (As a swimmer myself, I can relate to the goggles filled with tears). For talking to the professionals and non-professionals who insist that their particular solution is the right one. But mostly, for saying, Yes, depression sufferer, it’s real but can get better.

  7. Teresa so beautifully written it’s like I was writing some of your thoughts
    Thank you for your informative posts I do so miss your videos in my inbox would love to see them start again
    Depression has been my companion for the best part of my life now at 71 I wish it would hang out in a galaxy far far away but it won’t leave me
    I now suffer from depersonalisation worst worst feeling of depression where I dissociate because things are to hard to handle
    I too am not on medication as I can’t tolerate meds have tried a few but I stop talking then when the side effects start
    I have stopped praying and blame God and have given up on faith and prayer
    This is what depression has done to me
    Again love your posts

  8. 100% agreement! It is a frustrating reality for those of us who live with depression to discover books that have the answer ie “Cure Depression with Yoga” etc. In the past I would peruse book shelves and Amazon lists and see hope, only to find yet another cul-du-sac. Our Individual story and type of depression, as you point out, is the key. Beginning with very important markers, such as age of onset and our particular clinical picture. Ultimately, exploring what depression means in terms of our own biology and life circumstances. Spiritually, I moved away from the “sin” rhetoric and instead embraced my faiths wonderful positive sages such as dear Julian of Norwich and Thomas Merton. People who live with depression need the loving kindness of their faith or personal spiritual practice. Blessed are the poor in spirit.
    Thanks so much for sharing.

  9. Therese. I take this opportunity to sincerely thank you for all your continuous open and honest hard work for the benefit all. Many times your words have guided me to a place of safety within. I thank you. I have made a decent recovery to date but still enjoy your daily words of wisdom and experience. They remind me of the pain that once was. And how my well being today is stable and good. Thank you. Thank you.
    Niall

  10. Deat Therese, I read this and found myself and all my strugglings described in a way I can only say: that’s it. Yes that is what I believe depression is. And also Yes, this is what I felt over years and years. There is all said and explained I wished to tell people but never have been able for.
    Thank you for this. Thank you.

  11. Hi, whats self compassion excercise ? Also, excercise, eating good and massages only help me for a few minutes. I still have my issues to deal with. Thank you for writing.

  12. Thanks for writing this and all of your others posts. I look forward to reading your posts and they they give me a little lift each day you put out a new one. Depression and Anxiety are very debilitating and it is helpful to read about how you and others handle it.

  13. Thank you, Therese, for such a well-written, real life authentic description of this
    thing we call “depression”. It certainly does not exist in a vacuum , but within a
    complex set of circumstances and biological abnormalities.
    It helps me to the core to read your blog and to hear from others. I have often
    thought I was the only one feeling such deep discontent and pain. I was free from
    this imbalance for 5 years, but after a traumatic change in my life, well, here it comes
    again…it is unwanted and scary.
    I pray for all. I pray for them as my brothers and sisters in a fight to survive
    and thrive. Julian of Norwich says “all is well, all is well, and all will be well.”
    I will not stop this prayer for myself and all. It takes everything within a person
    to continue and stand strong. Thank you for your strength and honesty in dealing
    with this subject called depression.

  14. Oh, Therese, you said that all so perfectly AND in such a beautiful way!! Depression IS complex, as are the many facets of treatment. We have to get beyond the stigma of having this disease. That, in itself, is debilitating to us all. With compassion and most importantly the “acknowledgment” that depression IS REAL; it DOES exist, we could all gain from that alone.
    May God Bless you for dedicating your life to such a worthwhile cause!! We are NOT alone in this illness, although it feels like we are. You have been a God-send to so many of us, Therese. May the Lord continue to guide you in your life’s work so you may continue to help us all~
    Sincerely~
    Chris*

    1. Thank you Chris for beautifully giving Therese the thanks and Appreciation she so richly deserves. I too think God gave her a bit of our “disease” so that she could understand and help others to comprehend what we go through.

      Bless you Chris.

  15. While we are here together . How do you get your husband / wife the nature of this disease?
    I have sent my husband lots of information over the years. But he cannot understand the anxiety is chronic 24/7
    And only leaves me occasionally.
    And the depression takes me prisoner in my bed?
    That all I want is to be well.
    I find it so exhausting and the battles that follow. I blame him for not understanding. But I realized the other day how can I expect him to understand? When has never expierenced it?
    I need to go back on medication but just not sure I can cope with the side effects.
    Wouldn’t it be great if someone found a cure that didn’t involve all the problems of taking tablets which are meant to make you better?
    Forgive me if this is not the place to write this. Lizzie

  16. Really beautiful! You have expressed it so well – this is what I would like to say when people ask me or talk to me about depression but somehow I can never express what I feel and I end up feeling guilty for feeling depressed and it makes things even worse. Best is about ‘being lazy’ because I really really struggle with mornings, just cannot get myself out of bed ( I read another of your articles regarding this) and its so hard to explain. Thank you and keep up the good work.

  17. This article brought about a great sense of peace in me. It hit on explaining key factors in depression with clarity and thoroughness. I am breathing more easily now thanks to what you shared, Therese.

  18. This is such a wonderful post – thank you. I’m 30, been signed off work for 3 weeks having got to the lowest point of my existence. The hardest thing for me is admitting/accepting the fact that I am unwell and need help, of which I am getting. I feel permanently guilty because when my mum says ‘you’ve had a good day’, deep down I am just in turmoil and have to pretend. Gosh it’s hard. People keep telling me that it will get better, but I don’t see it right now. But your post was so articulate in emphasising that depression is hugely complex and that ‘recovery’ is not straight forward

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