6 Things You Should Never Say To Someone With MDD

As I’ve written about before, I am a relentless advocate on behalf of people suffering from mental illnesses.

Not only have I had many friends who suffer from a varied number of diseases, from bipolar disorderto anxiety to schizophrenia (I once collaborated on a book with a schizophrenic man, and we got to know each other well), but I myself have my own mental-health challenges.

I suffer from mild to moderate anxiety, and I have suffered from major depressive disorder (MDD) for 30 years (maybe longer — I had my first suicide plan at 16, but that doesn’t mean I wasn’t showing signs before then).

I’m fortunate to have an incredible support network of family and friends who for years helped me deal with the episodes, which had been known to last as long as three months. In 2006, I finally received the help I needed, in collaboration with therapist Chuck Eisinger and Dr. Mayur Pandya. I had resisted medications for years because I accepted the societal stigma associated with taking medications for mental illnesses. Once I started taking them, many of my symptoms dissipated.

I can proudly say the days of my three-month bouts of self-hatred and depression have been gone for 10 years. While I understand there is no cure, I now have the tools at my disposal to handle the depression when it comes up in healthy ways instead of self-destructive ones.

But the societal struggle for acceptance for people like me persists. People have trouble understanding what an MDD episode feels like (and, Good Lord willing and the creek don’t rise, they never will), and it sometimes leads them to say things that, well, aren’t helpful. They don’t mean to make you feel worthless, but sometimes it just seems inevitable.

So I’m going to try to help. Here, in no particular order, are 6 things you should never say to someone suffering from MDD:

• “No, really, what’s wrong?”

This may be the hardest one for people to understand. This one usually follows a “What’s wrong?” to which the MDD sufferer has probably answered “Nothing.” The concerned person, who sees the sufferer in obvious pain, truly wants to help. So they press for an answer because surely some thing caused the person to be so despondent. Those feelings don’t just materialize out of thin air.

Except that, with MDD, that can be exactly how the feelings materialize. The hardest part for most people to understand is that MDD is depression is a completely different problem than situational depression (i.e., depression set off by some trigger event — the death of a loved one, breaking up with the love of your life, etc.).

MDD is caused by a chemical imbalance in your brain, which means its effects are difficult to treat and the source often impossible to identify — if there even is one. The question reinforces the idea you should have a reason, and that you are inherently bad if you can’t come up with one.

It often leads to the person to come up with random and unrelated reasons why he’s depressed. It delays diagnosis and frustrates friends when solving the “problem” doesn’t actually solve the problem. It’s a lose-lose for everyone involved.

• “You just need to keep yourself busy to keep your mind off things.”

This one’s a little more complicated than the first. Though distraction can be an appropriate strategy for dealing with MDD, it won’t work in isolation. More often, “busyness” only puts off the descent into the abyss. MDD sufferers can’t be active 24/7 (there has to be sleep in there somewhere), and it’s in those quiet moments that the disease creeps insidiously into the subconscious to torment you.

If you’re MDD depressed, this advice, though well-meaning, is frustrating because the mind is exactly what’s tormenting you. It’s not something you can ever completely escape.

• “How you feel each day is a choice. So choose to be happy.”

You see this psychobabble nonsense everywhere. I’m not saying attitude doesn’t play a part in how you view life (I’m a big believer in the power of the mind to affect your body in physical as well as mental ways). But this statement is essentially a flowery way of saying that MDD is a choice, and you’re choosing to be miserable.

You can see how ridiculous that is, right? Who would choose to be miserable? It invalidates legitimate feelings of depression and makes the person feel even worse.

• “You’re not even trying”

Oh, really now? You know, for a fact, that I’m not trying to rise above the despair and bring myself out of the abyss? Good to know you can read my mind and decide how hard I’m battling this crippling disease.

As one friend put it, “Sometimes crawling out of bed and taking a shower is the best a person can do for the day, and it takes all the effort they have to do so.” That’s not an exaggeration. MDD can be immobilizing. So if I’m not performing up to the standards you set for me, tough. I’m doing the best I can.

• “Remember, there are people in the world who have it much worse than you.”

I assure you the MDD sufferer is aware that other people in the world have it much worse off than they do. Many of us have homes, families that love them, health insurance — and we’re aware of the places in this world ripped apart by war, pestilence, gun violence, homelessness and other plagues upon humanity.

But let me clue you in on something: Just because other people in this world are suffering doesn’t mean we’re not suffering, too. So this comment may make you feel as if you’re giving us a boost, all it does is make us feel as if we’re horrible people for not worrying about all those other worse-off people. You want to deepen our depression? Make this point (or don’t — please don’t).

• “Suck it up. We all have troubles.”

This is a statement with which no reasonable person could — or would — disagree. Everyone has crosses to bear. And believe me, most MDD sufferers understand that more acutely than others. Some of the people who suffer from this crippling disease are some of the most empathetic people I’ve known — and they are the first to help others in a crisis.

But MDD sufferers’ “troubles” are with the one organ of the body where these problems can render them completely unable to help anyone — even themselves. Invalidating their significant pain and suffering only exacerbates the problem and reinforces their sense that no one hears their cries.

Look, we understand that you’re trying to help us get through this horrible time in our lives, and we do appreciate it. But do so without using these comments, and you’ll be a far bigger help to us than you know.