There’s a lot of misconceptions about what depression looks like and how it affects people – particularly how it affects those with chronic depression. Situational depression – depression that occurs after a tragic or saddening event – that makes sense to most people. But depression that isn’t triggered by anything at all – this can be perplexing for those who haven’t experienced it firsthand.

Depressed usually doesn’t mean sad. In fact, many people of us who are depressed regularly experience other emotions. On good days, it is possible to experience a sense of pride and accomplishment, a moment of peace, a bout of happiness and even euphoria or joy. On bad days, when those feelings do not exist, sadness isn’t the automatic replacement. Hopelessness, worthlessness, or emptiness are much more common. When things get really bad there isn’t usually a “woe-is-me” kind of feeling like many might imagine. There’s numbness. There aren’t thoughts like, “What am I going to do?” as much as, “There’s nothing that can be done.” When we’re in this state, we walk around like zombies, forgetting that it is possible to feel something. Our depression tells us that we’ll feel like empty shells of ourselves forever. We have difficulty smiling, talking, or doing things we usually enjoy because our inner selves seem to have vacated our skin.

Depression has physical effects.One of the big signals for many of us about how well we’re managing our depression is our level of fatigue. When we’re in a depressed state it’s like we’re got heavy weights tied around our shoulders, wrists and ankles that make every little task much more difficult than it should be. Walking to the pantry, to the refrigerator, to the microwave, and back to the pantry can be exhausting. We often feel like our head is in a fog, making it difficult to think clearly or process quickly. Our vision can be impacted and we can feel like we’re walking around with blinders on or we’re peering through a dark mesh eye mask. We become clumsy and drop things. When we’re in this state, we move slower than sloths.

It can be hard to make a decision. I remember one time my husband asked me if I was going to eat now or later. I got so flustered and frustrated with that question. I couldn’t decide. I was sort of hungry but not starving. I wondered if he wanted to eat now or later. I over-analyzed whether or not he would be annoyed if I didn’t eat when he ate. I literally couldn’t answer the question and I felt angry that he had put me in a position where I was expected to. What the hell do you want from me, husband?! Making the simplest decision can feel like too much.

Irritability can a side effect. And it can be ugly. I don’t know if these extreme reactions are caused by chemical imbalances or extreme fatigue or some other reason, but I just know when depression is bad, this is an unpleasant side effects for our friends and  family. The closer they are to us, the worse it is for them. They can get yelled at for asking when we want to eat dinner. It can be bad and we know it.

Self-harming thoughts are common even if those type of actions are not. Depression lies. It tells us that everyone around us would be better off if we were not here. It forces us to consider how we could make ourselves disappear. It flashes images in our brains, behind our eyes, showing us in detail what our disappearing act would look like. It bubbles up under our skin and begs us to cut it out. It itches and tugs and insists on being released. It begs us to tear ourselves apart. We might not engage in the behaviors but we cannot help but think about them.

Practicing gratitude can be counterproductive. In a severely depressed state, being reminded of how good we have it doesn’t help. In fact, it can actually be harmful. Being surrounded by amazing family members might make us feel like we don’t have anything to offer those around us and like we are bringing everyone we love down. We might feel like we don’t deserve our good job and our cozy home. When there aren’t horribly sad events occurring in our life, we might feel like a failure for feeling depressed when we “don’t have a reason to.” When we’re at our lowest low, pointing out all the good in our life can push us further down. Practicing gratitude only benefits those who are healthy.

Chronic depression doesn’t go away. Ever. This is a battle we’ll continue fighting for the rest of our lives. This fact pisses some of our friends and relatives off. They can get angry when we don’t “get over it” and continue to act depressed long after they think we should. They might be frustrated about the depression itself, but their fury usually gets directed toward us. Medical note – yelling at us won’t make our depression go away. However, just because we can never fully escape our depression, it doesn’t mean things are always bad. Depression ebbs and flows and there can be great periods of time that are full of love and light.

Chronic depression can be confusing and frustrating and hard to understand. It is a disease that needs to be monitored and managed and better understood.