Recognising the Faces of Depression

If asked what a depressed person looks like, most people will make a sad face or pretend to cry.

But in actual fact this is only one of many faces of depression, and some of them may just surprise you. I’ve been down the depression road myself, so I have firsthand experience that it isn’t quite that easy to pin down …

Faces of Depression 1: The Stereotype

Most people equate depression with sadness or teariness.  And while that can be true, the truth is that the sad face is just one of the MANY faces of depression.

I know what I’m talking about: I was diagnosed with depression at the end of 1998. In hindsight, it wasn’t my first episode; and at that point in time I’d been suffering for at least three or four years BUT I didn’t recognise the signs. I wasn’t constantly in tears so surely it wasn’t depression!

After what I went through, I’m passionate about raising awareness of what depression looks like – so it can be identified earlier and end so much needless suffering (by the person with depression, AND their loved ones!).

“The descent into depression is often gradual, which makes it much harder to recognise,” says Clinical Psychologist Claire Pang, a Chinese Psychologist in Brisbane.

It fools you into thinking that this is how life is, how it has always been, and how it will always be, that there is no way out.

Contrary to popular belief, one of the most common faces of depression is a big smile …

Faces of Depression 2: Happy

On the outside, the person with depression may seem fine, even happy and joyful – but inside is a different story.

In my case, my friends and family were shocked when they learned I had been diagnosed with depression.

Why?

Because all they ever saw was my happy, smiling face.

Although I was miserable inside, I just couldn’t understand WHY. How could I explain it to anybody else, when I couldn’t understand it myself?

It felt like I had every reason in the world to be happy: a wonderful husband and children, a lovely home, and comfortable lifestyle. But somehow, I wasn’t.

I no longer found enjoyment in life, and stopped many of my hobbies and interests.

Like so many others with depression, I hid my pain behind a smile – which took an enormous amount of effort.

Even when I was having a really bad day, I didn’t phone or visit anybody. I was so ashamed. I tried to ignore my feelings, hoping that they would just go away.

Sure, in public, I was still the life of the party. Always ready with a smile or a joke. But inside I was a mess.

So I began avoiding people. I withdrew from my social circle, and interacting with others, because I knew keeping my mask firmly in place was incredibly taxing and tiring – and I just didn’t have the energy …

Faces of Depression 3: Tired

Putting on a happy face every day was exhausting.

I felt so lethargic and found it hard to generate enthusiasm for anything.

When you’re tired all the time, it can feel like your are in a bit of a fog. I found it hard to concentrate – I would lose my train of thought in the middle of a conversation. I would go to the supermarket to buy three things – but do you think I could remember what those three things were?!

I just didn’t have the attention span to read a book (which I normally love), and would only flick through a magazine listlessly.

People with depression commonly have difficulties with sleep – though it can go either way – too much sleep, or too little!

Personally, I wanted to sleep ALL. THE. TIME. I did the bare minimum to get through each day, managing to get meals on the table, look after our two pre-schoolers, and generally keep the household running – but it took every last ounce of strength I had.

I hated waking up in the morning. In fact my first thought was to count the hours until I could escape under my quilt again! I could have happily done a Sleeping Beauty, and slept for 100 years.

I went to bed early; and had a nap every afternoon (my kids were small enough to have afternoon sleeps at that stage). But this was no ordinary catnap; I felt virtually comatose and it was incredibly difficult to wake up.

And no matter how much sleep I got I never felt any better.

Others with depression go the other way and suffer from insomnia, finding it hard to go to sleep, or that they are wide awake in the wee hours of the morning.

Either way, the person with depression ends up absolutely  exhausted!

I don’t know if you have ever noticed what happens to people (adults, not just children!) who are over-tired. They become quite cranky …

Faces of Depression 4: Angry

Have you ever heard the saying, that depression is “anger turned inwards”?

I hated that saying. Angry? Are you serious? NO WAY. I was NOT angry! (Much!)

Growing up in a household with an abusive parent overwhelmed by severe mental health issues will do that to you I guess. I didn’t realise it, but I had a LOT of anger, stuffed deep inside. In my family of origin, my mother was the only one permitted to be angry. So for years I buried my anger and rage.

Angry is only one word; here are some others that are just as fitting to this face of depression:

• Cranky
• Cross
• Irritated and Irritable
• Grumpy
• Annoyed
• Frustrated
• Mad
• Irate
• Fuming
• Sharp
• Caustic
• Steaming
• Aggressive
• Resentful
• Hostile
• Upset
• Furious

Before I was diagnosed with depression, my poor hubster must have felt like he couldn’t do anything right! I thought HE was being mean and nasty – never realising that in fact, *I* was the one that was incredibly hard to live with.

And it wasn’t just my husband that annoyed me!

I would get upset over anything and everything, and I was easily offended by innocent remarks that other people made. I was incredibly sensitive, and took everything personally.

Faces of Depression 5: Brain Dead

Not only was my head enveloped by a little thunder cloud of anger, I felt like I was in a bit of a fog, full stop.

I liken depression to being lost in a swirling mist, where everything is in shades of grey and it’s all a bit fuzzy. (I was used to jokes about being a bit brain dead … I’m a blonde after all!)

When I was in the thick of depression, I found it really hard to concentrate – even on things I loved. I didn’t really feel like writing, I didn’t feel like reading. I had the attention span of a gnat.

Conversation became a challenge, because I could hardly put a sentence together (I know, SO not like me!). I was constantly losing my train of thought. As a result, my relationships suffered (in addition to the fact that I was constantly exhausted from the effort of trying to put on a happy face to seem “normal”).

I was easily distracted and forgetful. I forgot appointments – which is fair enough if it was for a visit to the dentist, but I even did it for things that I normally liked doing!

Problem was, as this all happened around the time I had my two children, at first I blamed it on “pregnancy brain”. I’m sure you’ve heard the joke that a pregnant woman loses half of her brain cells. It was like mine didn’t bother coming back!

But brain cells weren’t the only thing that I’d lost …

Faces of Depression 6: Loss

Losing my ability to concentrate was just the beginning of the things I lost during that time. Here is a list of some of the others, commonly experienced by people with depression.

Loss of Appetite

When I am tense, stressed or depressed, I lose interest in food. Everything tastes like cardboard; I only eat because I know I “should”, and to quell the hunger pangs. Not suprisingly, this meant I lost weight. On the upside, when I am heavier you know that I am in a good place mentally and emotionally!

It is important to note however that not everybody is the same. Some folk may go the opposite way, and turn to food for comfort when they have depression, and so gain weight.

Loss of Libido

‘Nuff said 😉 !

Loss of Sense of Humour

I’ve previously shared about how I was an easily irritated and over-sensitive little petal when I had depression. Part of this was because I’d lost my sense of humour, and my ability to kid around and just have some fun!

Loss of Motivation

This is one of the classic signs of depression – when you are no longer interested in things you used to enjoy. Without motivation, life just seems incredibly dreary. I was overcome with apathy!

Loss of Friendships & Social Life

When you consider that on top of having no energy, I also lost my sense of humour and my interest in life itself … is it any wonder that I lost some friendships along the way?

Faces of Depression 7: Shy

Have you noticed a pattern yet of the connections between the various faces of depression?

For example, the tiredness contributes to the feelings of anger, being brain dead, and loss of enthusiasm.

The overwhelming sadness makes you feel tired, and lose your joy in living.

And it’s the same with the shy face of depression. Being sad, brain dead and tired all the time means that you can’t help but withdraw from people. You just can’t be bothered.

Others interpret this as you being shy, reserved, or even snobby.

Yes, I avoided other people while in the grips of my depression, but on those occasions I did venture out, I felt really left out of the group. I couldn’t keep up with the witty repartee, and conversation was extremely taxing. I didn’t feel I had much to offer others, so I withdrew into my shell.

All of my relationships suffered – I subconsciously tried to protect myself from the pain, by distancing myself and withdrawing from my husband, my children, my friends.

If you have a friend who has not been their usual cheery self for some time, or they seem more subdued, don’t hesitate to ask the question: Are you okay? If they want to talk, this opens the door for them; if not, they know you care – and if and when they are ready, they know who to turn to.

They might not be ready yet, because of the next face …

Faces of Depression 8: Shame

You may be wondering why, with so many symptoms of depression – here we are up to the 8th face already! – nobody picked up that something was wrong with me.

The reason for this is that I tried to hide what was going on (or rather, not going on as I’d withdrawn so much!).

I was overcome by SHAME and felt incredibly guilty that I was so miserable.

On the surface my life was great!

I was so ashamed that I wasn’t happy, when I had it all.

I think this just goes to show that although depression CAN be triggered by circumstances, there is also a biological / genetic component. Just as heart disease or breast cancer runs in some families, so depression runs in others. I knew that my mother had battled a form of depression (bipolar disorder, and other mental health conditions) all her life; and I’d heard that my grandmother had experienced two “nervous breakdowns” (depression) when my mother was young, so obviously there is a predisposition in my family.

There is such a stigma attached to depression too. When I was finally diagnosed, although there was relief (not only did I know what was wrong with me, but it could be treated!), there was also an element of embarrassment and shame. A diagnosis of depression is not something you want to shout from the rooftops!

At first I was quite selective about who I told, as I feared the reaction of others.

Fortunately, most people were supportive and tried to understand (even if they didn’t really) so I really needn’t have been so anxious about telling others.

But as it turns out, even the fear and anxiety I was experiencing was very much a part of the depression that had me firmly in it’s grip …

Faces of Depression 9: Anxious

Although I was fearful of what others would think now that I had finally been diagnosed with depression, fear and anxiety were definitely not new to me.

It seemed my stomach was always upset – churning from anxiety. Not surprisingly, I didn’t feel like eating and when I did, food tasted like cardboard. And yes, I lost weight.

Each morning, as I thought about the day ahead, the nerves would set in. I would worry and grow nervous about even simple or seemingly small things, like a trip to the shops, or the need to drive to a different suburb, or even make a phone call (well – more nervous than usual when it came to the phone – I’ve mentioned my phone phobia before!).

Shopping in particular seemed to trigger a lot of anxiety for me – I avoided smaller stores and boutiques. My heart would start racing, my palms would grow sweaty, and I would become shaky – the whole box and dice! I just hated feeling like I was the centre of attention in the little stores, and dreaded the shop assistants watching me or even offering a greeting.

The other aspect of shopping which bothered me, was the fear of making the wrong decision. This was something that in my mind, really blew out to epic proportions. Should I buy this shirt or that one? I was almost crippled by the fear of making the wrong decision. While it was true that at the time we were on a budget – it really wasn’t worth all that angst!

Doing the grocery shopping was a nightmare – so many decisions to make! Should I buy this brand or that? Would I regret not having that particular item in my pantry?!

Choosing gifts for others was a trial, as I constantly doubted and second-guessed myself.

I can see why in the “old days”, a person with depression was said to have trouble with their nerves.

My fear and nerves meant that even minor things became incredibly important and I wanted to get it “right”. I’ve always been a bit of a perfectionist, but depression seemed to amplify this tendency.

My anxiety about being “perfect” meant that I demanded a lot of myself – and of others. I became critical, picky, and negative …

Faces of Depression 10: Negative

Do you know anybody that is a real Negative Nellie?!

It’s true, some people are just more pessimistic by nature – but if they weren’t always like that, it could be depression has changed their outlook on life.

I know, because it’s what happened to me when I had depression.

It didn’t matter what great idea my husband or a friend came up with, my specialty was pouring cold water all over it! Whether it was a plan to go out, do something with the house, or … I would focus on all the faults and potential problems. It was like the joy or the positives escaped my notice entirely.

Nothing others did was ever good enough. You know how women (especially new mums) often find fault when their husband cleans up the house or does the washing, because he doesn’t do things the “right” way (ie her way)? And then he wonders why he bothers – so all the work then falls back in her lap again? I reckon half the time, the reason she can’t appreciate his efforts (even if they aren’t very good) is due to postnatal depression.

So in addition to being sad, cranky, anxious, vague and all the rest of it –  I was critical and picky too. What a joy I must have been to live with (not)!

The thing is, I was just as tough on myself.

Depression turned me into a rampant perfectionist, and I placed impossible demands on myself. The children always had to be clean and neat, the house spic and span. I didn’t go out unless I’d done my hair and make up.

If it all sounds like too much work, you’re right, it was! No wonder I became withdrawn and more tired than ever, which made the depression worse. It was a vicious cycle.

Faces of Depression 11: Hate

 

I don’t know about you, but I hate the word “hate”!

Hate is such a strong word – it makes me feel uncomfortable even writing it. But “dislike” just isn’t strong enough.

Sad to say, but people who are in the grip of depression are full of hate. Hate for themselves, as they wonder why they feel the way they do; and even hate for their nearest and dearest.

The reason for this is that as they desperately cast around, seeking something or someone to blame for whatever the heck is wrong, it is their loved ones that tend to fall into the line of fire.

In my case, the hubster copped it (my poor darling!).

Even though *I* was the one that was angry, negative, and all the rest of it – my thinking was so clouded, that I thought he was to blame for all our (okay, my) problems.

It wasn’t that I ever truly hated him; but I had definitely lost that loving feeling. (I wrote more about this in my post “Have I Fallen out of Love – or am I Depressed?“)

This became glaringly obvious when I started taking medication and getting better – because all of a sudden I fell in love with him all over again. (Thank goodness he was still around for me to fall in love with – a lesser man might not have gone the distance or put up with me!)

Depression made me turn into a creature of hate. I hated my life. I hated getting up in the morning. I hated myself.

It sounds sick now.

Which coincidentally, is the last of the Faces of Depression I want to share with you.

Faces of Depression 12:  Sick

It’s a fact – people with depression are more likely to feel ill, and have aches and pains.

Now I’m no scientist, so please excuse my lame explanation … but apparently, if a brain scan is done on a person with depression, the pain centres in the brain are lit up like a Christmas tree.

Meanwhile, the pleasure sensors are dulled and much less active.

What this means is it’s NOT just all in your head – if you have depression, you really are more likely to suffer from aches, pains, and generally feel below par.

It may manifest in a variety of ways.

For me, it was severe headaches. It was like a menstrual migraine (which I’ve experienced most months ever since I turned 30), but nearly every day.

And surprise, surprise – when the depression started to clear up, so too did my headaches.

It might sound like a pain (pardon the pun), but it turns out the sickness and aches are often a blessing in disguise; just one of many reasons why it’s important to keep on top of your health.

Many years ago, I read somewhere that according to the World Federation for Mental Health, 69% of those diagnosed with depression reported physical symptoms as their chief complaint and this led to their eventual diagnosis.

So imagine – if there were no physical symptoms, they would never have been diagnosed, and would still be suffering!

And don’t forget too, that if you are feeling tired, your immune system is not working as well as it should either – resulting in a seemingly never-ending stream of coughs, colds, and tummy bugs (or you could just have a small child in your household 😉 ).

In conclusion (and if you’ve made it this far, thank you!) – depression has many faces, and I’ve only touched on twelve here. But I hope in the process I’ve shed some light on how debilitating it can be, even though it is for the most part, an invisible illness.

Being diagnosed with depression is not the end of the world. In fact, it is the start of becoming well.

My story does have a happy ending … twenty-odd years later, I’m still living with chronic depression but you’d never know. In fact I hardly remember those dark days, it seems like ancient history now!

If you have recognised the faces of depression in yourself or somebody you love, there is no need to suffer in silence any longer. A chat with your GP, a psychologist or counsellor could soon have you on your way to loving life once more.

If this post has upset or distressed you in any way, please call Lifeline on 13 11 14, or head to www.beyondblue.org.au.