What Everyone Needs To Know About Depression


More people are talking openly about their depression, but is public perception changing?


am always encouraged when people publicly share their personal experiences with depression. Many who suffer from chronic, clinical depression are speaking out, trying to start a conversation, hoping to lift the stigma that surrounds a misunderstood mental illness.

According to the World Health Organization, depression is common worldwide, with an estimated 350 million people of all ages affected. That’s a lot of depression, and people talking openly about their struggles is a fantastic start. I see fellow sufferers rallying behind them and expressing gratitude that they no longer feel alone. What I don’t always see is a noticeable shift in perceptions of those personally unaffected by depression. In fact, I sometimes wonder if non-depressed people are even listening to the conversation.

A couple of years ago I read an essay in which the author confessed to feeling that she was losing herself in her first year of motherhood. While the piece resonated with many readers, a quick glance at the comments showed how easily people jumped to the conclusion that the new mother was mentally ill. That was disturbing, but one comment stood out:

“Depression is massively narcissistic.”

I still haven’t stopped thinking about the ignorance of that statement. Only someone who has never experienced a major depressive episode would say something so cruel, especially to the mother of a ten-month-old baby. And even if the author was mentally ill, depression is not even a symptom of narcissism. I’m sure some narcissists suffer from depression, but not all depressed people are narcissists. Depressives may behave in ways that appear selfish, but selfish behavior in the face of illness is not narcissistic. In fact, narcissism is categorized by the DSM-5 as a “personality disorder,” while depression is considered a “chronic illness.”

I’d like to explain what depression is like based on my experience. This is not for the benefit of fellow depressives, but for people who have never been depressed. This is for people who believe that depression implies narcissism, weakness, or laziness. This is for people who think that depressed people can simply “snap out of it.” If you’re one of those people, please stay with me. I’m going to put you in my (sometimes) sad shoes, walk you through it, and ask you to try — really, really try — to imagine what the slow, dark spiral feels like.

• • •

One day you start feeling a little sad but don’t understand why. Your life is great! You have all the stuff that’s supposed to make you happy, but you don’t feel happy. You might feel a little guilty because of the starving children in Africa. Maybe you tell yourself that you’re coming down with something, that Mercury is in retrograde, or that it’s just a phase.

But it isn’t a phase. After a couple weeks you don’t feel just a little sad anymore. You’re crying over your morning coffee or in a bathroom stall at work. Now you feel sad, guilty, and embarrassed because you can’t hide your sadness anymore, and you don’t like crying in front of your coffee. You love your coffee. It makes you happy and you don’t want it to think less of you.

At this point, you can still pretend to be normal when you’re at work or out with friends or yelling at spending time with your kids. These things probably even make you feel better for a while. They’re exhausting and you might need to curl into the fetal position and nap more often than you care to admit, but you can still fake it when you have to. You can still function.

A couple weeks later you stop going out with friends and yelling at your kids because you don’t have the energy to fake it. Nothing brings you joy or makes you feel better for even a little while. You still go to work, but you can’t focus and your boss is starting to look at you funny. Now you’re sad, guilty, embarrassed, and scared, because you don’t want to lose your friends or your kids or your job.

You finally tell your partner that you’re in a funk, that you might be depressed or something. Your partner nods and makes comforting noises and for a few minutes you think they get it. Then they say, “Are you gonna go grocery shopping this week?” You realize they don’t get it. Now you feel sad, guilty, embarrassed, scared, and alone. And that seems perfectly rational because you’re the one who can’t get your shit together. You are alone in your depression.

One morning you wake up and can’t get out of bed because you can’t imagine going through another day with all those feelings crashing around in your head. You call your boss and say you don’t feel well. You tell your partner that, too. And then you stay in bed and feel relieved that you don’t have to fake it. You tell yourself you just need sleep, lots of sleep, and then you’ll be okay again.

But you don’t magically become okay again. The longer you stay in bed, the more you want to stay in bed. Bed is a safe place because you’ve surrendered. You’ve stopped faking it and you no longer have to deal with anyone. Between dozing and staring at your arm hair (because you’re too fucked up to watch TV or read a book), all that sadness, guilt, embarrassment, fear, and aloneness start to seem less defined.

Those feelings don’t go away, though. Instead, they morph into one big feeling: despair. You realize that something is really, really wrong with you. You wonder if you’ll ever be okay again. You wonder if you even want to be okay again. Life seems like so much work, more work than you can imagine doing, ever.

Finally, after a time, even the despair goes away and you feel nothing. You look back with morbid nostalgia on the sadness, guilt, embarrassment, fear, aloneness, and despair. You crave sleep because in dreams you feel something.

This is the heart of depression: a shitload of nothingness.

You can’t sleep, so you root around in the medicine cabinet and find some old Ambien. You take one and you finally sleep, for a while. When you wake up you take another, and later, another. You start counting the pills left in the bottle and wondering if you should just take them all and sleep forever. You tell yourself that your partner, your kids, your friends, and your coworkers would be better off without you.

If you’re lucky, this line of thinking starts to scare you. You pick one thing in your life that makes you feel like an asshole for even considering suicide. Maybe it’s your family, or your work, or your cat. But it’s something.

You ask for help, which feels like the hardest thing you’ve ever done. Talking to your partner, finding a doctor, even picking up the phone and dialing a number, seem impossible. Everything seems impossible. But you do it anyway because the alternatives are either more nothingness, or real and permanent nothingness, and you’ve decided you don’t want that.

If your luck continues, you get the help you need: a good doctor, a proper diagnosis, a plan of action that works for you. Maybe medication, talk therapy, or a combination of the two.

You begin doing all the work, the hard-as-fuck work that will let you feel something, anything, that makes you want to live. If your doctor prescribes medication, it may take weeks to kick in. Talking to a therapist brings back all the sadness, guilt, embarrassment, fear, aloneness, and despair, and that feels counterproductive.

You have some good days but mostly bad. If you keep working, the good days come more frequently. Your meds start working. Therapy becomes easier. You keep doing the work no matter how hard it is. You learn a bunch of stuff about depression that you never wanted to know.

Eventually, you feel like yourself again, or close enough. If you’re smart, you keep working because you don’t want to end up back in bed. And then you know what happens? You live the rest of your life knowing that depression is an illness, and while you might be in remission, it could sneak up on you again. Or not.

You never know if the nothingness will take over again.

• • •

I was lucky, but I wasn’t very smart. When I felt like myself for a year or so after my first depressive episode, I stopped taking my meds without telling anyone. I felt fine. I was doing everything right: eating healthy, exercising like crazy, exploring Buddhism, practicing mindfulness. For a while, I was okay.

Then I spiraled again, but I didn’t recognize the signs. Finally, when I wanted nothing more than to stay in bed forever, I went to my therapist, sat in his office, and cried for the whole forty-five minute hour. I started the work all over again: medication, talk therapy, waiting for the good days to outnumber the bad.

That’s what depression looks like for many people. We are not depressed because we are narcissistic, lazy, or weak. We know we are difficult — even infuriating — to be close to or to live with. So we often cling to denial as tightly as people who don’t understand that depression is a life-threatening illness, or people who believe that depression is a behavioral issue. It’s not a behavior at all. You cannot choose how to behave when you feel nothing inside.

For me, the cycle repeats itself even though I’ve never again gone off my medication. Every three or four years, my antidepressant/anti-anxiety cocktail loses its punch. I catch it as quickly as possible and I start new medication.

I am so grateful that the people closest to me are understanding and empathetic instead of ignorant and judgmental, because this is me for the rest of my life. But not all people who suffer from depression are as lucky as I am.

So, mentally healthy people, please remember this: Empathy from those who live with depression is wonderful, but sympathy from those who can’t really know how it feels? That’s a gift of selflessness and compassion.

An earlier version of this essay was originally published on Role Reboot.

Laurel Hermanson

Laurel Hermanson is STIR’s editor-in-chief. Read her riveting bio. Follow her on Twitter.



  1. I have been in that place… and have friends who have gotten pulled even deeper into the quicksand and cold. “Narcissism” I can imagine only because it – D – locks you in a death embrace with the self, and our “self” just then has Nothi g – on a big Silver platter -to offer. So lucky if we have one thing – child, parent, creature – depending on us to breathe.

  2. I am in tears after reading your article. Tears of knowing the pain, the dark spiral (I call it my black hole- the force pulling me in is so strong) the aloneness of it all too well myself. Not being I was not diagnosed til probably 10 years after my depression began. I look back now on those early years of motherhood and wonder if my marriage might have survived if I got help. At the age of 53 I finally got the diagnosis of Bi Polar (it was the 1st time to actually be evaluated by a psychiatrist instead of my midwife) and believe I am finally on the right meds. I have lived mostly in the depressive stage. I was so close to ending it many times- only to end the pain. It’s when you get to that point you are least able or likely to ask, to reach out for help in any way. I felt so alone. I have been in therapy now 2 years and also have a peer counselor. I have only met with her 3 times but wish I knew she was available to m from my diagnosis- She has been there and survived. I am not alone. She knows firsthand the pain, the hopelessness, the isolation. I have added recovery, episodes, triggers and tools to my vocabulary. I am just starting to talk to my sons and my sidter about my illness. I know they may be affected. I have reframed the verbal and physical abuse I suffered from my dad. I am convinced now he was undiagnosed bipolar, as was his mother. I believe my sister is (not the one I have revealed my diagnosis to ) It is so hard to talk about- to reveal I have a mental illness.
    If I had cancer I would seek support and get sympathy and care from those who love me. I look forward to the day we treat those with mental ilness as we treat those with cancer or any physically debilitating illness. I long for that day.

  3. Your article strikes a real chord with me. Unlike you though, I cannot get therapy. I went through the therapy route. Twice. The first time after my assessment, the Mental Health Center closed my case between my assessment and my next appointment three weeks later. Without informing me until I went to my appointment.
    Oh, I pitched a fit. I was doing everything I could do to get myself the help I needed after my hospitalization. And I eventually got a therapist. Then another one. Then another one. Then another one. I went through 7 therapists in 3 years. With months of nothing between them. I finally gave up. The therapist Merry-Go-Round was doing me no good. Without consistency, how am I supposed to build trust? I might see one therapist twice, another 4 times, and another 5 times before they are gone. Then add in the months of doing without a therapist between therapists.
    I had another hospitalization last year. Again I went to MHC for my appointment. We were brought in as a group for orientation where they described the services they offer. And then we were informed it could be 2 months before we saw the psychiatrist for our meds. The hospital released us with only a one month supply.
    We were offered to let our personal physicians handle our meds and I and two others took that option. But out of the 27 people in that group, I was the only one not offered therapy.
    How does that help me? It doesn’t.
    So for the last year and a half, I have battled my depression daily on my own. And there have been some close calls. Because feeling nothing at all forever seems a better choice than what I go through when I reach my darkest.
    I have spent the last year plus trying to educate what very few people are close to me what it is like to be me, with limited success. But maybe now I am starting to get through to at least one of them. She still doesn’t understand, but at least she is starting to “See”.
    But yeah. I battle my demons daily. And I know it’s a war I will never win. At most, all I can hope for at the end of the day is a draw. Only to start anew the next day.

    1. I’m so sorry. That’s horrible.

      I got lucky because I’ve been seeing the same psychiatrist for 15+ years and I have good health insurance. Even with that safety net, I spent eight days in a private mental hospital in 2010, and it was a nightmare. I will write about that one day, and the upshot will be that mental healthcare in this country has changed over the last ten years and it is failing people who are asking for help, often desperately and in crisis mode. We treat mental illness differently than any other chronic illness. Insurance companies pay at a lower rate for mental healthcare; psychiatric beds in hospitals are vanishing because they aren’t profitable; emergency rooms aren’t equipped to treat psych patients, so they turn them away. It’s shameful.

      I hope you find the help you need, and I wish you luck on your journey.

      1. Thank you Ms Hermanson.
        I’ve been lucky in one way. There is a Bulletin Board I belong to that is full of wonderful, caring people. Some are in the Mental Health field. Some are like me, diagnosed Bi-Polar among other mental health issues. And they have been my rock these last several months. And these people like me. A new experience for me. They won’t let me withdraw into myself. They get worried when I disappear. Another new experience because I’ve been completely alone the majority of my life. And their friendship is as real to me as if there were in my town. They have been my shoulder, my rock. They encourage me, cheer for me on my little wins that to everyone else would be nothing of note. But they understand, because a lot of the members are just like me. I even shared this article with them after reading it. They are the biggest reason I’m still alive today because if it hadn’t been for them, I would have checked out 3 months ago.
        But they let me be me. And they have put up with my inane ramblings these last months to keep me from my usual withdrawal and kept me engaged.

        Unfortunately, South Carolina is one of the worst states in Mental Health care. The community hospital just closed it’s mental health floor. Now our only choice for hospitalization is the state mental hospitals in the county I live. The state hospitals that just a few months ago allowed a patient to be hit by a car and killed.
        The system here is a total failure. Were it not for my online friends, I’d be lost because I’m not playing the musical therapist game again, and I sure as the devil will not go into the state run facilities.
        And yes, mental health care is treated differently than any other illness. It still carries a stigma that, until ‘normal’ people get it, it will continue to carry. And being epileptic is just as bad in this state, so I get a double whammy.
        I’m back in school at age 54 to try to get off disability so I can get on up out of this miserable state. Somewhere I will be treated more as a human being than a useless piece of wasted space and resources

        1. Good brother. It is not an “either” “or.” It is so great you are in school to learn new things. AND it is great to have the security cushion of disability. You can earn money from working AND keep disability; talk to people online about it. Obviously you can’t work full-time or make loads of money. But you can make enough money for an actual professional, qualified therapist. And you can make enough money for modest happinesses: a new puppy? A cool new Parrot Drone? a used laptop to take to Starbucks? Art supplies? Keep learning, inspiring bro!

  4. The best first person account of what depression really feels like and how an episode occurs. I will keep this forever.

  5. Its great to see people sharing their story on heir depression, it gave hope to me when i was still suffering with depression and it will probably give hope to those out there when they are in need of it

  6. Thank you for writing this very personal article. People who don’t know anyone with this horrible disease just don’t get it. I don’t necessarily blame them though. If I didn’t experience this hell for myself I don’t know that I could do more than empathize. You definitely described the feelings and thoughts of what we go through. I hope that we both have continued success with treatment for MANY more years to come.

  7. This was a tough read. I am one of those that are trying to understand. I have someone close that is going through depression and it is rough. I am now trying to get a better understanding so I can try to not make it worse. I know that I can’t really make her days get better but I know I can at least try to comfort her and from reading this try and be more compassionate. Which I admit, I lack. So thank you for this article. I hope the best for you..

  8. Thank you Laurel. I read your article because of the link on Nanea’s website. You both have such great voices and platforms. Thank you for voicing what some of us are unable to due to our daily struggle with the deep, dark abyss.

  9. Thanks for putting depression into terms that those who’ve never felt it might be able to begin to imagine. It isn’t self-serving or “massively narcissistic.” If you developed pneumonia no one would chide you for being unable to function. Depression is an illness, not an exercise in self-indulgence.

    I’ve experienced anxiety and depression since childhood, and PTSD due to a long-term abusive marriage and my daughter’s near-fatal illness (a few months of not-sleeping in a hospital room will do that to you). I, too, have struggled with feeling “sad, guilty and embarrassed” because I felt that I had no real right to be depressed. That others had it worse. That maybe I was just a big baby who ought to count her blessings.

    Three times in my life I went into therapy; at times I also used medications. The third round of therapy finally took, probably because I had finally extricated myself from that marriage. After a few years of treatment I was able to find joy, real joy, for the first time in my life.

    These days I recognize symptoms and can, thankfully, stop them before they become full-blown spirals. I’m also fortunate to have a new partner who is loving and supportive and will do anything in his power to help me help myself.

    My daughter is also a depressive, and was ultimately diagnosed with bipolar II. That illness (Guillain Barre syndrome) left her with a couple of permanent physical issues, including chronic fatigue. After years of un- and underemployment and being on disability, which left her deep in medical and personal debt, she was lucky enough to find a customer service job she can do at home.

    She has chosen to blog about depression/disability and personal finance because so many people in this situation don’t earn much money and have trouble making ends meet. However, when you look for help all you find are blogs and articles that say your money issues will be solved if you just skipped one latte a day or took a second part-time job. You also find articles that scold you for not having begun to save for retirement, even though you barely earn enough to keep the lights on.

    So Abby writes about how to do the best you can with the money you have, and posts frugal hacks that are actually workable. (As opposed to, “Sell all those expensive toys you bought back when you were a spendthrift, and use the money to start an emergency fund!”) Most of her readers understand that things aren’t the same across the board. Sometimes, though, people will post comments along the lines of, “Well, if you just used a slow cooker/cleaned a little bit each day/set aside $100 out of each paycheck then you wouldn’t have to spend so much on convenience food/live in a dusty and cluttered home/wind up in debt when the car breaks down.”

    Life as a depressive doesn’t generally fit neatly into such categories. It’s more a question of finding what works for you and not wasting time (and precious energy) on tactics that will never bear fruit. And, of course, taking care of yourself with therapy and/or medication.

    Again, thanks for putting this out there.

  10. Wonderful piece. I have suffered with anxiety since I was a child but did not realize this until about 15 years ago. I just thought everyone felt like they were walking on broken glass every day. Every so often, the anxiety becomes unbearable and then the depressive cycle begins. I’d like to share an unfortunate experience with an involuntary admission. I had moved to a new area with very limited job opportunity. I was offered a job with a non-profit for a cause that was near and dear to my heart and one that I had extensive volunteer experience in. I was promised training. Training never came and I struggled day after day at the job hoping to figure it out. I became so depressed suicidal ideation crept in. I wanted to succeed and benefit the agency. Tried discussing the need for training with the hiring manager but no training was given. One night, I was so distraught I told my husband that I might as well kill myself if I could not succeed in this job. We argued and I left the house to cool down. I was not drinking or doing any type of drugs or medication at the time. He was concerned I might hurt myself while driving. Called the police. I returned home. Police came to the door. Questioned me about threats of killing myself. Said I was having a hard time at work, with relocation, with my marriage. Was standing by the kitchen counter where cutting knife block was – cop told me to move away from the knives. I told cop, “Are you kidding me? I’m not going to stab myself or anyone else.” He said he didn’t know that and then decided I had to go to the hospital. At no time was I ever a danger to anyone else nor did I really want to kill myself. I just wanted the situation to be different at work. Cop handcuffed me and put me in his car. Drove me to the hospital. Had to wait at hospital in a locked room to be interviewed by an MD. Then had to be interviewed via video by a social worker who determined that I needed to go to a mental facility. What I needed was someone to hold me and tell me to quit the damn job! Maybe something to calm me down at that time. This experience catapulted me into a deeper depression and now I felt totally abandoned by my husband and the world. Had a probable cause hearing after one day and night at the mental facility and pleaded for my release. Thankfully the Judge agreed I was sane and needed counseling and probably a new job and released me. Still working on my marriage, got a new job but that experience haunts me. To add to the insult I was stuck with hospital bills. I have never not paid a bill but I am refusing to pay the mental hospital bill. It did not help me only traumatized me. The only lesson, if there is one, is perhaps more compassion for others who fall down and are kicked rather then helped up. Involuntary admission is not to be taken lightly. I understand the therapist who interviewed me via video from the regular hospital emergency room was covering his ass and thought he may have been helping me, he caused so much additional anguish his actions were enough to make me actually go through with a suicide attempt if possible during that confinement period.

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