Depression is one of the most common psychological disorders there is (no longer THE most common, though-- thanks, anxiety disorders! Oof) and yet there are so many myths that persist about it. Today we are tackling the most common ones, and trying to get the real picture. No two people with depression are alike, and the more you know about its (sometimes surprising) manifestations, the more we can help each other.

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Dr. Andrea Bonior: So many of us have experienced depression intimately, whether in ourselves or watching a loved one go through it. So why are there so many myths that still seem to be persisting today? We're tackling seven myths about depression. There's no judgment here. You might believe these myths yourself. A lot of people do. And our goal is to to a deeper understanding of what depression is all about. We want to get real about the true human experience of it. If you've ever wanted to know a little bit more or have a deeper understanding of one of the most common psych disorders there is that probably has affected somebody that you love, um, you'll want to listen to today's Baggage Check. Welcome. I'm Dr. Andrea Bonior, and this is Baggage Check: Mental Health Talk and Advice, with new episodes every Tuesday and Friday. It's really good that you've joined us today. Baggage Check is not a show about luggage or travel. Incidentally, it is also not a show about the technical definition of a skort. All right, let's get started. Today we're talking about depression myths. And so the show will be 9 hours long. Grab a blankie. Now, it'll be our usual length, but let me tell you, I had a lot of myths to choose from. When thinking about what to talk about. I decided to come up with the ones that I thought were the most pervasive and potentially damaging. I didn't have an exact, calculated algorithm for this, but these are the things that I see and that I hear. I've been working with folks with depression for a long time. I know intimately the stories of how it can affect different people, how it can look different from one person to the next. And of course, no two people experience depression in exactly the same way. But we also know that there are some stereotypes that keep people from getting help or that lead to a lack of compassion or that persist as misunderstandings that make people more disconnected from those who are suffering. Our goal on baggage check is always to gain deeper insight into mental health issues, to help the science increase compassion, and to use compassion when looking at the science. So hopefully, we'll get a nice little mix of that. Let's get started on the seven common myths about depression. And if you have believed these, we'll have compassion for you too. But now you might know just a little bit more than you knew before. Number one, that depression is just about being sad. It's true that sadness can be a fundamental part of depression. People will speak poetically at times about what the sadness is like, a deep, profound sadness that is unlike what a lot of people have ever experienced. But depression isn't sadness alone, nor does everybody who experiences depression automatically think of it as being sad. For some people, depression is more emptiness than sadness. It's a lack of something. It's a hole. It's a wall. It's a disconnection, a, uh, disengagement. As I've said on this show before, a lot of people think that the opposite of depression is happy, happy, smiley, smiley. When in reality, the opposite of depression is more like a fullness. It's engaging with life, it's showing up, it's connecting. That speaks to the idea that depression itself is not just sadness or a frowny face. Of course, even for those suffering sadness within depression, it's very different than just having a fleeting sad mood. A m lot of the other symptoms of depression are even physical, feeling exhausted, feeling bone tired, needing to sleep all the time, or conversely, being unable to sleep at all, slowing down, eating much more than usual, or eating much less than usual, not having much of an appetite, feeling irritable and angry and pessimistic. One of the hallmarks of depression is what we call anhedonia, that loss of pleasure, the loss of spark. It's not exactly the same as sadness, but it feels something like a deadening, a numbness, an absence of being able to connect and be energized and find joy. And again, depression can be very physical. It can be felt like a physical weight or physical pain. And indeed, the research shows us that depression and physical pain are connected, bidirectionally that chronic pain can lead to depression. But depression alone can change the way you perceive pain and make it more excruciating. There's difficulty concentrating. There's thoughts of hopelessness and helplessness. People with depression view the world differently, so they actually experience things cognitively in a different way than when they're not depressed. All of this is to say that depression is not just being sad. So that's an important myth to start with. Number two, antidepressants are the only answer for depression. Now, I am not here to bash medication, not by any stretch. I have seen antidepressants in various types, whether SSRIs or SNRIs or some of the other atypical, uh, ones, be very helpful for people, but they are just one tool. A lot of the data suggests that antidepressants alone are not as helpful for moderate to severe depression as antidepressants combined with therapy. And in some ways, therapy alone has gains over antidepressants, especially for more mild cases of depression. But even beyond traditional treatments like therapy and medication, it's important to recognize that we are learning so much about what can be helpful with depression. From nutritional changes in terms of various nutrients, increasing the biodiversity in your gut aspects of omega three S, to the research that suggests that exercise can be incredibly helpful for depression. And I know it's a vicious cycle. It's very, very, very hard to move your body when you're depressed. But the research really suggests that just boosting that heart rate for little bit consistently can be really helpful to all kinds of self help techniques that look like therapy but can be done at home. Mindfulness techniques, acceptance and commitment therapy techniques that can be adjusted for you to do on an individual level. We've talked about some of them, especially those that help with anxiety as well. Cognitive diffusion, self distancing, detox your thoughts outlines a lot of these other lifestyle changes really can make a dent. More time outside, more sunlight, behavioral activation in the sense of making small goals of all the stuff of daily living and increasing your movement social connection is huge. Group therapy can be helpful for this, but also just spending time with trusted loved ones. Laughter often overlooked for its health effects, but certainly it's an important component of healing from depression as well. There are new advances in depression treatment, from the potential roles of psychedelics like psilocybin and Ketamine to techniques like transcranial magnetic stimulation. There's so much. And if you're suffering, it's really important to talk to a mental health practitioner about all of the options awaiting you because sometimes no knock on general practitioners, they've been dealing with so much over the past few years. But they might go to antidepressants as the number one go to when in reality, every day we're learning more about all of the different tools that we can use and that we can combine with each other to maximize effectiveness for treatment for depression. So it's not just about the antidepressants, nor do they automatically need to be part of treatment either. Number three, depression is solely from life circumstances. Okay, so this is sort of the flip side. Some people think, oh, depression is pure biology, so you just got to get on meds. And then other people think that, no, it's pure life circumstances, so it shouldn't be about meds. The truth is, for most people, depression is a combination of both. They've got maybe a genetic vulnerability combined with some life stressor type of triggers, combined with some behavioral habits that they have, combined with some cognitive patterns, the way that they've learned to think and interpret events, and it all comes together. Depression is most certainly not just from life circumstances. And for some people, the biological piece is huge. The more heavily you have inherited a predisposition to depression, the more likely you are to have it and the more severe it might be if it's been severe in your family. So let's take the biology seriously. Let's recognize that no two people are entering this world with the same genetic predispositions, not even identical twins, frankly, because we have different epigenetic forces acting on them when they're in the womb. But I did not intend to turn this into a genetics class. I certainly would not be the professor of choice for that, only to say that for some people, biology is a big part and we need to address that. It doesn't automatically mean medication, but it does mean that it's not solely from life circumstances. Myth number four positive thinking prevents and treats depression. Well, I'm going to give this one a big fat nah. You've probably heard me rail about toxic positivity. That was the very first episode of this show. It's a very pervasive myth that the power of positive thinking cures all ills. When in reality, the research shows us that positive thinking is often a misguided endeavor. Optimism can be great in many ways, but forcing yourself to think positive thoughts and try to mask or numb or avoid the negative thoughts, that's not going to do, uh, a hill of beans. Hill of beans, flying fig, what are my usual go to's there? It's not going to do much towards treating depression or preventing it. You can't think your way out of depression with positive thoughts, per se. There are lots of cognitive treatments that can be very helpful for depression, like the aforementioned acceptance and commitment therapy. But that's not about just positive thinking. That's about developing a new relationship to your thoughts. That's about disempowering the negative thoughts rather than trying to run away from them, which when you try to run away from them, as you've heard me say many times, you actually tend to empower the negative thoughts. Depression is not caused by negative thinking. Depression is caused by many things together, as we've talked about. And, um, on the thinking end, one of the causes is negative thinking becoming sticky. That is different than just saying, OOH, there's a negative thought. I need to banish it and think positive. Right? You can't think your way out of depression in such an oversimplified type of mechanism. And again, for more on that, you know about my book already. I'm not going to be an obnoxious plugger. OOH, that sounded bad. I'm not going to plug my book anymore. At least not in this episode. Okay, number five. Everyone's experience with depression is more or less the same. Nope, nope, nope. As I mentioned when I was introducing this topic, there are no two people who have the exact same experience with depression. And when I say exact same experience, I mean across all aspects of it. There are no two people whose depression was caused by exactly the same combination of things. There are no two people whose symptomology looks exactly the same in terms of the combination of symptoms and the severity. There are no two people whose treatment is going to need to look exactly the same in terms of what's most effective for them. Lots of you listening have probably struggled with depression or are struggling now, and my heart goes out to you. And I also recognize that you are not a monolithic group. That every single person who has suffered or does suffer or will suffer from depression has a different combination of factors in their particular experience, their particular story. That's not how we tend to look at depression as a culture, though. We tend to say, well, here's the picture of it. Here are the symptoms, here's the treatment, here's what caused it. We can afford instead to recognize that it's complicated and it's messy. And two people respond to different life experiences in various ways that might not look anything alike at all. Just like two people with similar genetic predispositions might have life experiences act upon them in different ways. So a shout out to the uniqueness of everyone's story, for better and for worse. Myth number six depression only exists in teens and older. It is definitely most common to start seeing depression once adolescence hits. Once young adulthood hits. There's no doubt about that. However, depression does exist in children, but it might look differently than it looks in teens, and it might often be masked. Kids who are depressed might simply be more explosive. They might seem more angry, more unfocused, more disruptive. They might not be able to put their feelings into words. That's hard for adults as well. It's often very difficult to actually talk about feeling depressed or even to recognize the symptoms at times. For some children, depression and worry and anxiety might be very intertwined. Depression might come off as shyness, or it might be misinterpreted as laziness or a lack of interest in things, or lack of caring about stuff because that's just your personality. Rather than that you've become disconnected. We need to recognize that kids can and do experience depression as well as teenagers and adults, and we need to be able to give them the vocabulary to talk about their feelings and be received with compassion and support and a lack of judgment. And finally, myth number seven if somebody seems happy and they're the life of the party, they must not be depressed. I can't tell you how many folks I have worked with over the years who were blindsided by the loss of a loved one due to suicide and they just couldn't wrap their head around it. We talked about this in a past episode when we talked about the loss of Stephen Boss Twitch. And I can say confidently that I have worked with many people in therapy as well whose friends and even close family members would be shocked to hear about their struggle with depression because of the face that they put. On for everyone else or because the ways that they try to cope are, uh, to make other people happy or to make jokes or to slap on a smile. And even people in the throes of deep depression might have occasional moments of joy that are genuine and that can temporarily make it seem like everything is okay. But in reality, it all goes back to the idea that we never truly know what somebody is going through and that we can't make assumptions about the struggles or lack thereof, that exist inside someone. We need to be open to listening to people's true real stories and to be vulnerable enough to share our own as well. So I hope this opens some new ways of thinking, even just a little bit, in you as well. And for those of you suffering, there is help. I always want to mention that in the United States, the National Suicide Prevention Lifeline can be reached at nine, eight, eight there is always hope and there is treatment. Thanks for joining me today. Once again, I'm Dr. Andrea Bonior, and this has been Baggage Check. With new episodes every Tuesday and Friday. Join us on instagram at baggage checkpodcast. Give us your take and opinions on topics and guests. And you know you've got that friend who listens to like 17 podcasts. We'd love it if you told them where to find us. Our original music is by Jordan Cooper, cover art by Daniel Merity and my studio security, it's Buster the Dog. Until next time, take good care.