The Truth About Depression No One Talks About – and Strategies to Help Break Free

We often think of depression as one singular thing, but there are different types. A major depressive episode can happen once and clear up, or it can be chronic, with episodes that come and go throughout a person’s life. According to the DSM (Diagnostic and Statistical Manual of Mental Disorders), depression has nine possible criteria, but you only need five of them to be diagnosed. This means that depression can look different from person to person.

However, the key depression symptoms include a persistent low mood and a significant loss of interest or pleasure in things that usually bring joy. And here’s something we often forget: to be classified as depression, these symptoms need to persist for at least two weeks. That’s important because it means that experiencing feelings of sadness or low energy for a few days—say, 10 days—is within the realm of normal human emotions.

If we understood that better, maybe we wouldn’t panic every time we feel down. Maybe it wouldn’t spiral into a deeper depression. Think about how we treat a virus: we don’t assume we’ll always be sick just because we caught a cold. We take care of ourselves—we rest, we drink fluids, we eat nourishing foods. We don’t expect to feel better instantly, but we trust that healing is happening. Likewise, understanding that temporary feelings of sadness are a normal part of life allows us to approach them with self-care and patience, rather than fear and resistance.

As humans, we’re wired to focus on what’s wrong. Evolutionarily speaking, it made sense—our ancestors needed to stay alert to identify and remove threats to survive. But in today’s world, this negativity bias means we’re more likely to fixate on what’s missing in our lives rather than appreciating what’s there.

The problem is, when people experience depression, they often over-identify with it. Instead of thinking, I’m feeling down today, they think, I am depressed, this is who I am. And that makes it harder to pull away from those feelings. Depression loves depression—it feeds on itself.

One treatment that can help break this cycle is mindfulness-based cognitive therapy, which helps people learn to experience sadness without attaching too much meaning to it. Research shows that mindfulness training tends to work incredibly well when people with chronic depression practice it during a lull in their symptoms. It teaches them how to feel sad without assuming it means they’re sliding into a major episode. Imagine if we could all learn how to just be sad without fear. It could change everything.

I often say that without hopelessness, depression wouldn’t be depression. Think about this: If I told someone in the deepest throes of depression that by tomorrow at 8 a.m., they would feel completely fine—and they believed me—what would that do to their mood for the next 12 hours? My hunch is that it would change things. They might still feel down, but they would behave differently because they knew the pain was temporary. They might go for a walk, watch a movie they love, or simply wait it out without falling into despair. That hope—that knowledge that this isn’t permanent—can make all the difference.

One of the most important lessons I teach my patients is that you can’t wait until you feel better to start taking care of yourself. That’s one of depression’s cruel tricks—it makes you believe you need to wait until the motivation comes. But that’s not how it works.

If I took a perfectly happy person and made them adopt all the behaviors of a depressed person—poor sleep, no exercise, isolation, junk food—they would become depressed within a week. So, if your body and mind are already in that state, the way to start getting out is to start reversing those behaviors, even when you don’t feel like it.

One of the most important lessons I teach my patients is that you can’t wait until you feel better to start taking care of yourself.

And I know—it’s not easy. When I tell my patients to go for a short walk, they often say, If I could do that, I wouldn’t be depressed! That’s valid. But the trick is starting small. Maybe today, you just walk to the end of your driveway and back. That’s it. And you do that not because it’ll magically cure your depression in an instant, but because each small action gives your brain a tiny hit of dopamine—the same neurotransmitter that depression medication often targets. Over time, these small steps add up.

If I could wave a magic wand and have people do just one thing to help with depression, it would be daily exercise. Some research shows that under certain conditions, exercise can be just as effective as antidepressants and therapy in treating depression. But again, I know it’s hard to start, which is why we have to meet ourselves where we are.

Other key lifestyle treatment strategies include:

• Sleep: Aim for a consistent sleep schedule, preferably around eight hours per night.
• Nutrition: Fuel your body with nourishing foods and avoid excessive sugar and alcohol.
• Sunlight and Nature: Spending time outdoors—even for 10 minutes a day—can significantly improve mood.
• Social Connection: You don’t need a huge circle, but having at least a few meaningful relationships is crucial.
• Purpose and Values: Align your daily actions with what truly matters to you. Even when you don’t feel like it.

If I could wave a magic wand and have people do just one thing to help with depression, it would be daily exercise.

I always remind my patients: You don’t need to want to do these things. You just need to do them anyway. Think about how you go to work or take care of your kids even when you don’t feel like it. You do it because it’s necessary. Caring for yourself needs to be just as non-negotiable.

And above all, there is hope. Depression lies and tells you that nothing will change, but change is always possible. The first step is believing that—even just a little.