What Depression Really Looks Like—and How You Can Help a Depressed Friend or Loved One

It might seem like common sense to assume that depression is something that shows—that the sadness reflected inside of the people struggling with it will manifest outwardly. But this isn’t always the case. As one THUMP writer who lives with depression explains,

The image of a depressed person is often dominated by the cliché of a sad person sitting in the corner, unable to have any fun. But if you aren’t depressed yourself, then think about it: Maybe the depressed person isn’t the person lingering at the dancefloors with a dour expression on their face—they could be the happy-looking person right next to you.

It’s an important reality to realize, because without open communication about the severity of depression and a recognition of what the people living with it are going through, these seemingly happy people will continue to struggle alone in silence. They will continue to bite their tongues in fear that they will be ridiculed or not taken seriously thanks to the many misunderstandings surrounding the illness, putting on a brave face for the people around them without ever working on healing themselves.

While some mental health challenges, such as Borderline Personality Disorder (BPD), seem to be equally prevalent across genders, depression is a bit different. Although it can affect the lives of both men and women to a similar extent, a wide body of research suggests that women are twice as likely to experience depression than men—a finding that seems to be rooted in the fact that they tend to ruminate more often.

Rumination plays a key role in the development of depression, with studies showing that areas of the brain associated with this kind of deep thinking are hyperconnected in people living with depression. But with the right treatment and a therapist that understands how to harness the positivity in rumination, this tendency can be used to aid recovery, making it important to understand the differences between depression across genders for these treatments to be as effective as possible.

Therapy must also take into consideration the effects that our cultural expectations of gender roles have on depression and its treatment. The different ways that men and women are expected to react towards negative emotions are likely the driving factors that influence the differences between how each gender copes with depression.

When struggling with depression, women have been shown to use more adaptive coping techniques than men and also have “greater perceived control over depression” than men, while men use less adaptive coping skills and are less likely to seek help than women. And this makes sense: women are culturally expected to express their negative emotions and probably better at coping with and seeking help for them than men are.

Ultimately, understanding how your loved one might react to you addressing their depression based on their gender can help you better guide them towards treatment. For example, approaching a male loved one about addressing their depression might require a gentler approach and a bit more persistence than approaching a woman, as they have lived their whole lives in the face of cultural expectations that thrust them away from emotional confrontation and acceptance.

Sadness and depression are two completely different animals, yet many people don’t recognize the distinction between them. If you’re among them, it’s nothing to be ashamed of—what’s important is learning how to define the fine line between the two and becoming aware of people who are experiencing more than just simple sadness. As Barbara Kingsolver, author of The Bean Trees, so aptly wrote:

There is no point treating a depressed person as though she were just feeling sad, saying, ‘There now, hang on, you’ll get over it.’ Sadness is more or less like a head cold—with patience, it passes. Depression is like cancer.

Indeed, in any given year, approximately 3.3 million adults in America live with chronic depression, which lasts for at least two years. Even after a full recovery, the chances of relapse for any person who’s experienced at least one episode of depression is around 50 percent. This doesn’t mean that you need to constantly keep an eye on your loved ones who have battled depression, but these are important facts to keep in mind to help you remember that recovery isn’t an end goal so much as a continuous effort for many people with this mental health challenge.

What you can do to help your loved ones is remember to show them your love and support, and make sure that they feel accepted the way that they are. Do this regularly, because depression is an all-encompassing illness that can mask your world and make it easy to forget that people care about you. No matter how unresponsive they are, or how much you feel like you’re not getting through to them, continue to remind them that you care, because once you stop, it can be easy for them to think that you’ve given up on them.

“Some friends don’t understand this,” said Elizabeth Wurtzel, author of Prozac Nation: Young and Depressed in America. “They don’t understand how desperate I am to have someone say, I love you and I support you just the way you are because you’re wonderful just the way you are.”