Is Depression ‘Normal’?

As a therapist, I get asked this question over and over again, “Is depression a ‘normal’ part of life?”  The answer is quite paradoxical:  It is ‘normal’ for people to get depressed, but depression is not a ‘normal’ state of being.  So while it may be normal for some of us to be more susceptible to depression and its symptoms, being resigned to live with the negative effects of depression—day in and day out—is notthe norm.

Depression presents differently in every individual, in terms of its origins, the types of symptoms experienced, and the frequency and duration of those symptoms.There is depression that is caused by traumatic or overwhelming life events that happen to us (exogenous depression), and there is depression that is caused by biochemical or genetic events that happen within us (endogenous depression). In both types of depression, developing symptoms is a normal physiologic and emotional response to maladaptive circumstances.  So why do we judge depression so harshly?  And why are we so reluctant to seek treatment?  Our judgment of depression contributes to the stigma associated with it; and this stigma creates an environment in which we are afraid to get help for fear of being judged.  It is a vicious cycle that can lead to devastating outcomes for the individuals suffering and their families.

Depression is elusive.  It strikes some of us and not others.  It is neither a moral weakness nor a character flaw.  It is not a reflection of inadequacy or failure.  The bottom line is that depression is a condition that reflects vulnerabilities in our brain systems which affect our ability to live effectively and happily.  But depression, like other brain-related conditions, is complex and difficult to understand given that we still know so little about the brain.  Sure, we have started to link depression to different areas of the brain, and to specific neural pathways and neurotransmitters, but we still can’t predict who will be affected or how long one will experience the symptoms.  And those symptoms vary greatly.  Sometimes they affect memory and ability to think clearly.  Sometimes appetites and sleep patterns change.  Sometimes we feel sad and hopeless while other times we feel agitated and on edge. Depression can even cause physical pain.

Given that depression symptoms can manifest in so many different ways, it can be difficult for us to even recognize the condition.  Once we do see it, it can be equally difficult to accept, both for the individuals suffering and their loved ones.  As humans, we don’t like questions without answers or problems without easily identifiable and feasible solutions, and depression can sometimes stump us.  Yes, we have highly effective treatments for depression, but there is no ‘one size fits all’.  This illness has no simple solutions.  There are no guarantees that once the symptoms abate they will never reappear.  Diagnosis and treatment are processes that take time and often require trial and error.  This can be frustrating for all involved—the consumers and the families that love them.  But we have to hang on to hope.  We have to press on and continue to do all that is necessary for a positive outcome…no matter what.  Solutions do exist, symptoms can improve, pain can go away, and support is available.   None of us live in a vacuum.  We are not alone!   There are people all around to support individuals with depression and their loved ones, to support recovery without judgment.

October is National Depression Screening Month.  If you or your loved one is experiencing difficulties that may be due to depression, contact your doctor and request an evaluation.  One quick office visit may start you on a path to recovery and an opportunity for a full, normal, happy life.

by Susan Writer, Ph.D.