September 24, 2024
“Depression is something fairly well known in the public consciousness,” says Dr. Brendan Guyitt, Clinical Psychologist, London Health Sciences Centre (LHSC). “But there are still common misconceptions about it that continue to circulate.”
“Depression is one of the leading causes of disability in the world and impacts anyone of any socio-economic background, gender, race, or age. Depression doesn’t discriminate,” says Dr. Guyitt.
Dr. Guyitt shares more truths behind the common misconceptions of depression.
Misconception: Depression is just a sad mood.
Truth: “There are a lot of symptom variations for people with depression. There are similarities, and not everyone experiences every symptom, but the symptoms extend beyond sadness,” explains Dr. Guyitt.
Additional symptoms include:
- loss of interest or pleasure in previously enjoyed activities,
- changes in appetite,
- changes in sleep,
- agitation,
- slowing down of responses (mental and physical),
- fatigue,
- low energy,
- feelings of worthlessness, hopelessness, and/or excessive guilt,
- a negative view of themselves, other people, and, sometimes, the world,
- thoughts of suicide or suicidal ideation.
“It’s also not just about the symptoms, but the severity of the symptoms,” says Dr. Guyitt.
This can include losing or gaining weight from the changes in appetite, and how much a person is sleeping (or how little) and how those changes are impacting their life. Ultimately, the symptoms have to be causing significant distress and/or impairment for the person in daily life.
Misconception: To overcome depression, a person just needs to focus on being happy.
Truth: “It is not as simple as focusing on ‘being happy’ because depression is more complex than simply feeling sad,” says Dr. Guyitt.
Depression can look like procrastination and avoidance because it takes all of a person’s energy to get through the day. It can look like exhaustion (mentally, physically, emotionally) where a person needs to sleep much more than normal. It can look like disconnection – like emotional numbness or social isolation. There are also feelings of worthlessness, excessive/inappropriate guilt (meaning they place unnecessary guilt on themselves), self-criticism and blaming themselves for things they are not responsible for.
It is a complex disorder and requires more intervention than simply having a person focus on “being happier.”
Misconception: Depression only comes from negative life events.
Truth: Life events are one aspect of what may cause a person to develop depression.
“There is ongoing research about this, but there is some indication there may be some genetic factors to developing depression. There is also a possibility of strong family influences as well,” says Dr. Guyitt. “While growing up, a person may learn perspectives and behavioural patterns that confer vulnerability. Just like we learn helpful skills from parents and peers, we can also learn unhelpful responses.”
Misconception: Depression comes from major life events.
Truth: Dr. Guyitt notes that sometimes depression can be triggered from one major life event, but often we are quite resilient when it comes to dealing with those major events.
“Research shows, more often, it’s day-to-day stressors that can bring about depression. For example, it can come because of constant financial strain from an inconsistent work history, or constantly feeling unwanted around peers, or pressure to maintain a high level of performance. The chronic nature of stress has a significant impact on people, and it all adds up” notes Dr. Guyitt.
Sometimes the impact of stress can be quite slow, so by the time a person notices there is something wrong, it can be harder to get back to their typical self and regular habits.
Dr. Guyitt says. “It’s a model of burn out – where a person runs out of resources, coping mechanisms and resilience, hopelessness and depression may set in.”
People are not machines, and stress and life events have an impact on us. Things pile up and it can become a self-reinforcing cycle.
Misconception: People with depression are weak or lazy.
Truth: “These are beliefs often held by people suffering with depression – they compare themselves to others and develop a negative self-image,” says Dr. Guyitt. “The idea is that other people have it ‘figured out’ and if the person with depression was not so weak or lazy that they would not be struggling. There is something wrong, but it is not about being weak or lazy, it is about depression.”
Misconception: Depression always comes with suicidal thoughts.
Truth: Depression can come with suicidal ideation, but it is not the only mental health concern in which people struggle with suicidal thoughts or a plan to harm themselves.
Not everyone experiences every symptom of depression, and they may not experience suicidal ideation.
However, mental health, including depression, is complex. There are many possible comorbidities (the presence of more than one medical condition) that appear alongside depression, with anxiety being the most common.
“Often with anxiety and depression, we see them tend to work together – if you are not able to do certain tasks with depression, you think about those tasks and see them piling up, which can cause anxiety,” explains Dr. Guyitt. “And by the same token, if you experience a lot of worry and anxiety, you might be limiting your activities and if you aren’t doing what you want in life, depression can set in.”
Support at LHSC
Through the Centralized Access Point Community Intake referral process, a person aged 18 and older can be referred to adult outpatient services by their primary care provider. The intake process consists of an initial assessment that will help determine a treatment plan appropriate for the individual.
A person could be matched with any of the services through the General Adult Ambulatory Mental Health Services or also psychiatry support.
Some patients may also choose to incorporate medication as another support as they attend therapy, and some patients may choose one or the other.
“What is often recommended is to combine both medication and therapy for however long an individual needs it,” notes Dr. Guyitt. “Ultimately though, it’s the patient’s choice on what is best for them.”
Dr. Guyitt says that a lot of depression is about avoidance – avoiding things that are uncomfortable or a new challenge. “A person’s life can shrink over time because of this. We want people to get back to doing what brought them joy before or trying new things that might help them in their journey out of depression.”
One of the programs available is Cognitive Behavioural Therapy (CBT) which looks at the unhelpful thought and behavioural patterns that people get stuck in and helps them understand and recognize those patterns. CBT is also available in the community.
“One of the ways our brain works is by using confirmation bias. In depression, this can look like believing that you are a ‘failure’, and then your brain only picks out examples that reinforce that thought pattern. In CBT, we want to help people form new patterns of thinking that offer a larger picture instead of the narrow, negative frame,” says Dr. Guyitt.
Related community resources
- Suicide Crisis Helpline (across Canada): 988
- Indigenous Hope for Wellness Helpline: 1-855-242-3310
- CMHA Reach Out Crisis Line: 1-866-933-2023
- CMHA Support Line (therapeutic listening line): 519-601-8055 (or toll free at 1-844-360-8055)
- Kids Help Phone: 1-800-668-6868
- Free resource for CBT treatment through Ontario Structured Psychotherapy West Region that a person can be referred to.
If you or someone you know is in crisis and needs immediate support, please call 911 or go to your nearest emergency department.