7 Things Your Friends Who Struggle With Depression Really Wish You Understood

1. Living with depression isn’t a battle, it’s an ass-kicking.

First of all, the basic verbiage that most people use when talking about depression is barely related to what it feels like to actually have it. Often, you’ll hear about someone “struggling” or “battling” with depression, but for many, it’s rarely a battle. A battle implies two forces duking it out in an effort to win something. Depression is really more of an ass-kicking. It’s basically a guy who jumps your defenseless mind in a dark alley, armed with brass knuckles and maybe some knives. Therefore your goal becomes less about victory and more about minimizing internal damage until your attacker gets tired and leaves you alone. And worse, depression tends to bring along his friends, who are equally nasty and brutal.

Anxiety, for example, is an MMA champion in its own right. Pre-anxiety, I could handle all kinds of extremely stressful situations with—well, maybe not ease, but definitely with some type of fortitude; with anxiety, I got panic attacks just from being inside Wal-Mart. And let me just assure anyone who has never had a panic attack that they are terrifying. Imagine having a heart attack, then don’t change anything. Except it can happen with little to no provocation or warning.

2. Depressed people usually know that they’re not exactly rays of sunshine. Pointing it out just makes them more self-conscious and amps up their already impressive self-loathing.

Most of the time, depressed people are entirely aware of how pathetic their lives are becoming. For instance, if you’re depressed, you probably know on an intellectual level that making a bowl of cereal shouldn’t feel like running a marathon, and you know that there are probably plenty of people in the world who don’t think you’re the worst human alive, and you know that you’re probably not going to feel so unbelievably awful in every conceivable way forever, but none of those things feel true. And ultimately, you lose your ability to distinguish between which things in your life are actually worth the negative reactions your body conjures up, and which are just your depression Incredible Hulking around in your skull. So telling someone with depression to smile more often is kind of like telling someone having an asthma attack to take a deep breath. Not only is it ineffective, it’s a jerk move.

3. Lack of will is not the same as a lack of want.

I literally spent years studying depression and anxiety in college before they happened to me, and they were things that I thought I’d understood beforehand. I mean, I could imagine what it was like to feel endlessly sad, and hopeless, and helpless, and isolated because those were all things that had been a part of my human experience at many points in my life.

But I’d never experienced an absolute lack of will. I’d obviously known what it was like to be too exhausted to go to class or whatever. But when my depression got bad, there were a lot of times when I just had no will to shower, or eat, or pee—basically to do anything that involved getting out of my bed. And I mean all of those things very literally. I. Could. Not. Get. Out. Of. Bed. Even to fulfill basic biological needs. The difference between that and just being in a funk or feeling a little down is more than just apples to oranges. It’s apples to freaking chainsaws.

4. If a person’s depression is bad, it’s probably not going away on its own any time soon.

This was a fairly excruciating lesson to learn firsthand. Maybe if I’d genuinely understood how bad depression could get, I would have gotten help, you know, before failing out of college was a legitimate concern. By the time I’d dragged myself to a counseling center and then a doctor, I was barely functional. I’d developed this bizarre hot and cold relationship with food, I was lucky to sleep four hours a night, I’d started avoiding friends and family whenever possible. It took six months of therapy and an equally long and painful search for the right drug combination, just to take enough of the edge off of my special cocktail of mental illness that I could slowly claw my way back to a semi-normal existence.

5. Antidepressants are absolutely NOT “happy pills.”

In the land of misnomers, “happy pills” not only takes the cake, it throws the cake into a woodchipper and buries the crumbs in the desert. Anyone who has ever run the gauntlet of depression and/or anxiety medication knows that they most certainly do not make you happy. In fact, in the matter of weeks it takes to get them absorbed into your system, it’s entirely possible for your bad feelings to not only get worse, but more raw. I can remember more than one occasion wherein after taking a new drug for a week, I was calling a friend at three in the morning, downright weeping because I couldn’t filter my emotions.

I was alternating between total devastation and consuming rage with very little understanding of what was causing it. Basically, my brain was an exposed nerve, I was terrified that it always would be, and I was too far gone in those moments to be able to talk myself out of believing it. I needed to call someone else to make me see reason because I was incapable of parsing it out myself.

6. If a doctor decides a depressed/anxious person needs meds, they’re going to have to try a lot of wrong ones before they find one—or one combination—that works.

Also, “works” is in the eye of the beholder, and the search can be miserable.

With depression, there is no go-to treatment that will automatically fix everyone. The best most doctors can do is to guess what therapy or medication may work for a patient, then if they’re wrong, move on to something else. And that’s not for lack of knowledge or care on their part. There are just way too many factors that can be affecting the way a person feels. Maybe one of a guy’s neurotransmitters has gone wonky, or maybe there’s an external trigger to his distress, or maybe it’s tied to his insomnia or another pre-existing condition. So perseverance is key.

But perseverance is extremely difficult when your body is constantly adjusting and readjusting to different forms of chemical intervention. Constipation, dizziness, nausea, extinguished sex drive, insomnia, exhaustion…none of them are fun, and all of them are common side effects of most antidepressants.

And bonus! The withdrawals are worse. Especially if they’re cold turkey (which FYI, is a very dangerous idea for certain medications) Think vivid, vivid nightmares while sleeping and random hallucinations while awake. So if someone you care about is depressed, and you’re someone who is prone to believing they’re just being overdramatic, you’re probably wrong. If they’re willingly subjecting themselves to that particular circle of hell, you can bet your ass that something deeper is going on, and it has nothing to do with mental weakness.

7. “Crazy” doesn’t have to be a bad word.

This one is probably going to be controversial, but it’s still important. There’s a certain amount of cloak and daggerness that comes with depression. Partially, this stems from the all-consuming self-loathing that naturally comes with the territory, as well as the resulting tendency to remove oneself from loved ones, but a lot of it comes from the pervasive stigma that still comes with mental illness. And that’s too bad because, for me, there was something very freeing about admitting to myself that my mind’s litany of negativity wasn’t real—that it was just my crazy talking. It helped me aim my frustration at the appropriate target.

I’m now four years deep in depression and anxiety, and I’m still not past it. I’ve done the drugs and I’ve done the therapy, but even those only got me back to limping through my life. It sucks. And it sucks a lot out of me. And I know I’m not the only one. Hopefully, though, my experience can help someone else be a little more patient and compassionate when their depressed friend doesn’t feel like going out. Dealing with the world is just too hard sometimes.

The fact is that we live in an age that still isn’t comfortable talking about invisible illnesses, and as a result, huge percentages of people are living in the proverbial closet, being smothered by demons that no one else can see. Whether it’s major depression, post-traumatic stress disorder, panic disorder, generalized anxiety, obsessive-compulsive disorder, or any of the other shitstorms the human brain can stir up, the least society can do for those who have to endure them is to acknowledge that the struggle is a real one, and attempt to empathize. And that can’t happen unless and until we open up the conversation and make it easier for the truth to come out, regardless of how ugly or bruised it may be.