The overwhelming response to my previous blog – “7 Things Everyone Should Understand About Depression” – highlighted the number of people affected directly or indirectly by depression as much as it reflected the prolific silence surrounding this illness. This silence is unique to mental illness and understanding why is important, because advancement in the treatment of a disease relies heavily on strong advocacy, a role usually headed the loudest by those suffering from the disease.

The entertainment industry shows us a perfect example of this. When Christopher Reeve sustained a spinal chord injury, he and his family poured their time and resources into research. When Michael J. Fox was diagnosed with Parkinson’s disease, he did the same. On the other hand, no one had a clue (not even some of his closest friends) that Robin Williams suffered from depression until his suicide. And here was a person who was easily able to stand in front of large audiences and talk about countless controversial subjects, just not depression. We will never know what his thoughts were about this but I have 7 ideas, drawn from my experience, why he and many others who suffer from depression find it so hard to speak out.

1. Stigma – What does this mean for someone with depression? There are commonly held negative beliefs about depression that make people with the disease reluctant to share that they have it. One of the big culprits for this is the language often used to describe this illness. “Nuts,” “crazy,” “not quite there,” “a misery” or a “head case,” are not ways we would choose to be labeled. There is also the misperception that someone suffering from depression cannot perform well in the workplace. The result is that competent people with depression will often keep it quiet at all costs, for fear of the potential effects on their work environment and job security.
2. Guilt – I know that when I’m depressed I’m less of a partner, mother, daughter, sister and friend. I’m hard enough on myself without being reminded of all the people in my life I should be thinking of. This does not help my depression. Depression is an illness unaffected by how much we love those in our lives. For many, feelings of shame are a part of living with this disease, limiting their ability to talk about it.
3. Faking it – When I’m depressed I don’t feel normal but I desperately want to. I spent many years acting “normal,” when I felt anything but. I also held the false belief that talking about my depression would add to the time spent in negativity. My experience now is that this is the exact opposite. Being okay to be out, can be extremely empowering.
4. No words – Symptoms of depression include difficulty in finding words to describe our feelings as well as problems with thinking clearly and coherently. One of the reasons depressed people don’t talk about their depression is because they simply can’t. When I write about depression, it is never during times when I am depressed.
5. No motivation – The simplest act of getting out of bed or showering takes enormous effort for a depressed person. Tiredness and apathy are defining symptoms of this disease.
6. Self hatred – The attitudes towards depression are very often shared by sufferers themselves. Two symptoms of depression are negativity and pessimism. It’s not hard for us to believe we are weak, self-indulgent and self-centered rather than sick. We don’t need much encouragement to hate ourselves. Self-loathing is already part of the disease.
7. No desire – Having the desire to talk about depression implies that one has hope, even if it is the smallest glimmer. Feeling hopeless is another symptom of the disease. It is almost impossible for a depressed person to see life from a positive perspective. If we could, we wouldn’t be depressed. Why talk about something when resolution seems futile?

Depression is a disease of the mind, the very thing a spokesperson needs to be in good working order. Certainly there are many people with depression who are, for various reasons, able to speak out about their disease but our ultimate strength in advocacy will come from others stepping up, whether it is for a loved one, a friend or from simple kindness.