6 Reasons I Won't Tell You I'm Depressed

“I never would have guessed you were depressed. You always seem so happy.”

“Really, depression? I had no idea…”

These are common responses when I mention depression has been part of my life. I hear the same reactions when we lose someone to suicide:

“Can you believe it? I never even suspected he was struggling.”

When the truth emerges about people who struggle with mental illness, others are usually shocked. However, I’ve come to expect the disbelief and surprise. After all, as someone who hid depression and anxiety from the world for years, I know firsthand how hard we work hard to hide mental illness from others. We wipe away our tears before walking out the door of our homes, and we try to keep our heads lifted high in public. We wear superhero masks and put on Emmy-worthy performances day in and day out. Though every person has unique reasons for sharing or not sharing struggles with depression, here are the top six reasons I don’t tell others I’m depressed:

1. It’s awkward.

This is sad but true. I remember the first time someone shared with me her struggle with depression, and I bumbled through an awkward response of “I’m sorry…I um, I have to go.” At the time, I didn't understand depression and knew very little about it. I had no clue how to engage in a conversation in something I didn’t understand. It made me uncomfortable.

Since then I have gained plenty of firsthand experience about depression and have a much more caring, empathetic response. I’ve also experienced those bumbling, awkward responses from the other side of the conversation; I’ve been the one to witness others stammer and blush and suddenly forget how to talk when depression comes up. Though the awkwardness doesn’t bother me much anymore, I do think twice about how someone will respond before mentioning depression.

2. I don’t want to come across as needy.

Unfortunately, the stereotype “depressed” person is "weak," needy, and perhaps clingy. In an effort to avoid this stereotype at all costs, we keep our struggles to ourselves. We strive to keep up our reputations as strong, independent individuals. Isn’t this the American ideal?

Yet herein lies the misconception that strong means not needing others—and furthermore, that neediness is equal to needing help. For a long time, I avoided talking about depression because I believed needing help made me less-than and weak, in the end only to discover true courage is practicing vulnerability and asking for help.

Adobe stock photo

3. I’m afraid there’s something wrong with me.

Ashamed. Horrified. Scared. These are the emotions that plagued me in the pits of depression. Because depression is difficult to understand and has no cut-and-dry medical explanation with a formula to get better, it’s easy to fall into the lie that depression is an inherent flaw within me.

Depression carries the critical inner voice causing us to doubt our sense of value and our sense of belonging. "A freak. A failure. Of no value," it whispers in my head. With the pressure to conform and my natural aversion to vulnerability constantly weighing on me, of course I choose to keep my depression from others.

4. Some days I can’t even admit to myself I’m depressed.

Given the fears discussed above, it’s no wonder I try to convince myself I’m not depressed! On my best days in depression and on my worst, there is almost nothing I have wanted more desperately than for depression to be gone. I have wished for a magic cure, I have prayed and begged God to “take it away,” and I have spent hours on the internet looking for solutions to this mood disorder.

I have wished depression never existed, and I have wanted to forget about it altogether. I have tried to ignore it, to run from it, to numb myself to it—and on these days of denial, hiding depression from others simply comes as a byproduct of trying to keep it hidden from myself.

5. When I’m with you, I genuinely may be happy.

This may sound odd, but when I greet my friends and see coworkers in the hallway, I genuinely am happy in that moment—happy to see them, happy to know them, happy to spend time with them. In those moments, I am happy. I want to hear about their week and tell them about my day. I smile and crack jokes and do more than my share of laughing because I truly enjoy their company. It simply isn’t the right context to mention my depression, especially if I’m not feeling the full weight of it at the moment.

Because most interactions with others happen in these more superficial, thirty-second conversations, it makes sense that many would view me as a generally upbeat and happy person. The truth is, in the moments I interact with others I may be genuinely happy, but these moments do not necessarily represent my overall mental and emotional well-being.

6. I don’t want unsolicited advice on how to get better.

Well-meaning friends have suggested everything from antidepressants to praying and reading my Bible more. They have told me about their Aunt Milly and what cured her depression and the miraculous recovery of their friend Billy Bob. 

For obvious reasons, this can be very annoying to those with depression. Everyone’s experience of depression is different, and what helps one person will not necessarily help someone else. It can also be exasperating because it can unintentionally imply that we aren’t already trying everything we know to get better. We probably already googled that therapy or pill or herbal supplement you’re telling us about, and we probably read about five articles on it while we were busy avoiding people!

Ways to Make the Conversation Easier

Though I've learned to become comfortable talking about depression openly, there are still ways people can make the conversation easier:

• Create a nonjudgmental attitude/safe atmosphere
• A focus on listening, not telling
• Genuine desire to learn and understand
• Phrases like “Tell me more about that” or “I’d like to learn more about depression and would love to hear about your experience”
• An environment where others are vulnerable about their struggles as well (a "me too" culture)
• The ability to relate but not compare (ie, “I/someone close to me has walked through depression, and I know it can be really difficult” versus “My brother was depressed but it wasn’t that bad”)
• After listening, asking “How can I help?” or “What helps on the hard days?”
• A “thank you for sharing” or acknowledgment of how much courage it takes to talk about taboo topics like mental illness.

Perhaps you’re familiar with the road of depression, or perhaps you’re walking alongside someone with depression. Regardless, I hope this list provides some insight—and please know, we are thankful for you. We are thankful for the conversations about depression, even if they’re a little awkward at first! We are thankful for community because even though we don’t always like it, we cannot do this alone.

Thanks for letting me tell you I’m depressed.

How the Cardiovascular System Helped Me Find My Purpose

Music played from my laptop next to the couch. I pulled my blanket up to my chin and listened and prayed. A friend came to mind, and I thought about how she was a conduit, a vessel for the Gospel. My mind turned over the word "vessel" and since my friend is also a nurse, wandered to thoughts of blood vessels and the body's vasculature.

All at once, something clicked inside me, and I sat straight up. When I thought of my friend—and myself, and everyone—as blood vessels, something suddenly made sense to me. Bear with me while I give some backstory.

It's been a year since I have moved back to the United States. A year full of struggles, depression, hope, and growth only reentry could bring (it was so crazy I even wrote an ebook on it). One of the things I struggled with during the transition from life overseas to life in Waco, Texas, was finding purpose in my location and vocation Stateside.

While in Cambodia, I learned the missionary lifestyle is not so different from—or more important than—the lifestyle of a believer back home. However, this knowledge didn't prevent guilt from creeping up on me when I moved to the States. I felt guilty for abandoning those I loved in Cambodia, and I questioned whether I was weak for not staying there. The attention and applause the American church gave to missionaries no longer applied to me. Without a clear-cut outline defining my goals and my purpose, I felt lost, out of place, and particularly unimportant. 

Though the Lord has since provided incredible community, a sense of purpose and contribution, and relentless reminders of His love, in the back of my mind I have still believed that what I am doing here in the United States is less important—less vital—to the Kingdom than what I was doing in Cambodia. We often call missionaries the people on the "front lines," but where does that leave the rest of us?

When I thought of people as blood vessels, as conduits supplying life to other body parts, I realized it didn't matter what my location was. I could be a capillary in the pinky toe all the way in Cambodia, where the vasculature isn't as dense, or I could be part of the aorta at the hub of the heart. I could be a coronary artery, feeding the heart itself and keeping it strong so it could continue sending out blood to the body. I could be a femoral artery, a little farther from the heart but not in the boonies of the fingertips. Regardless of where I was, I was neither less important nor "more" vital than any other vessel. "More" and "less" do not exist as long as I pulse with the heartbeat of the One who gives life.

The goal of the cardiovascular system is to keep the body alive—all parts of the body. The aorta has no purpose if no arteries supply the brain; likewise, capillaries in the brain have nothing to give if the carotid is not functioning. My purpose is the same in both places, though it may look different. It may involve giving more of my financial resources (now that I have a paying job again!) and less time traveling to remote villages that have no blood supply yet. It may look like resting and soaking up the extra access to life-giving friends and community, hearing the Gospel preached in my own language every week, and feeling the pulse of His heartbeat, strong and regular as it reshapes my attitude and habits and life to be more like His.

When I was in Cambodia, I thirsted for community and soaked up every bit I received. I treasured phone calls and found Jesus to be my closest companion as I sought Him on my knees (in front of the oscillating fan, of course). I desperately hungered for the encouragement and prayers sent to me through friends and family and strangers, all the way from the heart of God to mine. I could not have survived without this. I am forever grateful for those who served as vessels at every step of the way: from the aorta to the arcuate artery, allowing hope to flow to me in the pinky toe of Kratie, Cambodia.

Here in the States, I am deeply grateful for community, for the people who draw near to the heart of God and who urge me to do the same. My soul feasts on the abundance of spiritual resources, and I am refreshed and restored. And I hope I too am a conduit. I hope I too am a vessel allowing hope to flow through me straight to the one who needs it, or to trickle from me to another to another to another, eventually reaching a girl on the other side of the world who is on her knees seeking the One who fills our deepest needs. I hope I get to play a part in her experiencing community and purpose and forgiveness. I hope she would know there is One who loves her, and this One who loves her most is there with her, on the floor in front of the fan, ready to refresh her soul.

To those who have been and to those who are conduits and vessels, thank you. What an honor to serve Jesus alongside you.

Lessons from the Bedside: Constipation, Oversharing, and Mental Health

No, not oversharing about constipation. As a nurse, is there ever oversharing about bowel movement woes? There's nothing like the feeling after a really good, healthy poop.

Several months ago, I was talking on the phone to a friend from nursing school and was explaining how it's been a long journey learning to process things with others instead of holing them up inside me like a squirrel hoarding nuts for the winter. 

"Sometimes," I told my friend, "I forget to process things and go back to shoving them deep inside and trying to forget about them. It's so unnatural for me to talk about everything and process it. Every time I go to counseling, I have to relearn to open up. The longer I go without consciously processing things, the harder it is to start again."

My friend graciously agreed, and then the perfect analogy popped into my head.

"It's like I get emotionally and mentally constipated," I decided. "And sometimes it gets so bad it's impacted, and I need an enema to get things going again..."

Too cute. I couldn't resist. (Stock photo from Adobe)

Thank God for nursing friends who, rather than being grossed out, laugh richly and loudly at these kinds of things. In fact, I'm pretty sure she even said she was a big fan of the analogy. Nursing friends. They are wonderful.

Like bowel movements, everything in life flows a little easier when we regularly practice owning and processing emotions, events, and struggles in life. The longer we push the need aside, the tougher it is to begin. When I was a child, I spoke so few words I could remember everything I said to everyone and when I said it. Naturally, I figured everyone else was the same way and wondered why some people would tell me the same stories over and over again. I genuinely believed they were intentionally telling me the story for the fifth time because they thought I needed to hear it five times. I didn't realize until much later it was possible to talk so much you actually forgot what you said and to whom you said it! Though I have since conformed and routinely have more conversations than I can recall, it's still not my natural bent to process life out loud. It's taken a long, long time to develop this habit that's so easy for other.

Of note, conversely, some face the challenge of oversharing and lacking boundaries (the opposite of constipation would be "the runs"). This, as you can imagine, can get really messy, really fast. The nurses who are reading this know what I'm talking about. Sometimes we walk into rooms and have to wonder: "How in the world did they get stool in that spot??"

Sometimes, life gets a little crazy and our ability to process life gets put on hold. Traumas or deaths or major life events alter our habits, and in those times all we can do is lean on each other. We turn to each other the best we can, give supportive care, and clean up the messes as they come. From my own experience, I know we often feel ashamed and judged for our involuntary reactions when life overwhelms us. There was a season after returning from working in a Cambodian hospital I broke down every few hours and breaks between classes were spent in the nursing building's chapel crying. I was embarrassed, but I didn't have to be. Sometimes we lose control. It's temporary, and it's okay.

Unlike bowel movements, learning to share appropriately—enough, regularly, and with boundaries—is a trial and error process. It's one I'm constantly challenged by and one I think we will all continually be adjusting and tweaking throughout our lifetimes.

So I'll keep trying and tweaking. A little daily stool softener like Colace may resemble a phone call to my best friend or a journal entry spilling my thoughts. A little laxative like lactulose or milk of magnesia may take the form of a therapy session. A little antidiarrheal like Imodium may look like the restraint not to tell that person my deepest fears or post a blog about a wound that hasn't yet healed.

The analogies could keep going and going, but the main point is this: we all get a little constipated or have diarrhea mentally and emotionally, and this is okay. Health is the goal, because we all know it's true:

There's nothing like the feeling after a really good, healthy poop.

Lessons from the Bedside: Life After [a Patient's] Death

Recently I took care of a patient who died.

The patient went quickly and without pain, but for some reason the death shook me more than usual. The next day, I found out a different patient had decided to go hospice. At home in my bed, I cried as I thought about how I'd gotten to know these dear people, and how their lives had or were coming to an end. Not in a painful or sudden or traumatic way, but coming to an end nonetheless.

Admittedly, lately I've been working extra shifts at the hospital and have been slightly overwhelmed by nursing in general, and maybe that's why these deaths seemed to affect me more than usual. Saddened by the loss of life, I sat in my bed begging my body to fall asleep while tears slid down my face. Sickness, sickness, death, sickness. Though I love my patients dearly, I was worn out.

Stock photo from Adobe

All I wanted was to help people succeed. It's what gives me the most fulfillment and satisfaction in life. In high school, I played competitive soccer. I only scored once the entire time I played, and the one time was sort of a fluke! I didn't care, though. My favorite position was center mid-field, where I could receive the ball from our defense, take it up field, and set up a scoring opportunity for our forwards. I may have scored only one goal myself, but I couldn't keep track of my assists. When I could create space on the field and send the perfect pass—just the right position, speed, and timing—for a goal, I was just as thrilled as if I had scored myself. Their success was my success. Nothing brought me more joy.

These setups for success were the kind of work I wanted to do every day, and working in a hospital, staring sickness and death in the eye every day, felt like just the opposite.

These thoughts swirled in my brain the next day as I drove around town after dropping by the hospital to say goodbye to our now-hospice patient. I cried in the car, and I told God I was sad, and I questioned what role I had as a nurse in helping others succeed.

In the car at a stoplight, tears slipping down my face, I wondered. I wondered if I had a limited view of success. I wondered if to the patient and to God, success didn't mean staying on this earth. I wondered if it meant them crossing over into eternity and feeling His embrace. I wondered if being one of the last faces someone sees, one of the last hands they hold, one of the last voices to say a prayer for them on this earth—I wondered if this was helping them succeed in moving to the next place they were meant to be, the place we were really all made to be: the presence of the Most High God.

This realization crushed me. I wept like a baby at that stoplight, and I can't help but cry a little now as I remember that sweet moment. We can only see part of the soccer field, and perhaps sitting with someone at the end of life is akin to assisting them with the most epic goal of their existence, the moment they see God face to face.

To be frank, though this perspective helps me process the experiences of this week, it doesn't make death any easier. It doesn't mean I won't cry the next time I have a patient who dies or who make the difficult decision to go hospice. It's easy for others to remind me it's special and important work to care for people in their last months, days, and moments, just like it's easy for others to tell me my work as a bedside nurse is honorable and impactful. Speaking or hearing these words is not the same as living out the moments at the bedside. People like to say nursing is a calling, but even if it is a calling for some, it's still a job. There is still the wear and tear of cleanups, medications, assessments, the moment-by-moment deepening of relationship between nurse and patient in every interaction, and the moment-by-moment decisions and realizations a patient is declining. The sweetness of helping someone succeed does not remove the deep sorrow of death.

Yet, I am thankful there is sweetness and not only sorrow.

Today, I'll keep hoping. Hoping for what's to come, for the day we'll all be on the other side of death, when there will be no more sorrow, only the sweetness of the presence of Jesus. Yet until then, I'll keep praying, and I'll keep crying. And I'll keep doing my best to be a part of the setup for success.