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Depression Can Sneak Up - Even When You're a Therapist

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Seth J. Gillihan, PhD - Blogs
By Seth J. Gillihan, PhDClinical psychologistOctober 10, 2019

Depression can affect every aspect of your being—body, mind, emotions, spirit—so you’d think it would be hard to miss. And yet, I know from personal experience that it isn’t always so obvious when you’re depressed.

A couple years ago I found myself fighting a prolonged and mysterious illness, with symptoms like poor sleep, brain fog, and profound fatigue. Frequent doctor visits yielded no answers or relief, and I was forced to cut back drastically on my work hours.

I had many symptoms of depression, like frequent crying spells and an inability to stay interested in anything I tried to read, but I attributed them to my physical illness. When I started feeling hopeless and wondering if life were worth living, I finally realized I’d sunk into a major depression.

If a clinical psychologist like me can miss all the signs, I know there are many others whose depression goes unrecognized. Depression is often an insidious condition, progressing slowly and gradually without announcing itself. It’s like the proverbial frog in the pot of slowly heated water—the gradual temperature progression hides the fact that the frog is being cooked.

What’s more, all the symptoms can be attributed to something else—crying to sadness or loss, insomnia to stress, low energy to physical ailments like in my situation. Each symptom also tends to show up on its own, rather than as part of a bundle of symptoms, so you’re even less likely to know that you’re experiencing the syndrome we call depression.

There are additional factors that make it easy for depression to sneak up on you:

Stigma: If you have negative beliefs about “people who get depressed,” you might unconsciously not want to recognize the condition when it shows up in your own life.

Similarity to past experiences: Every symptom of depression, like sadness or fatigue, can be experienced in a milder form when we’re not depressed. You might not distinguish between your symptoms of depression and similar things you’ve felt in the past.

Wide range of symptoms: Your symptoms might be different from what you imagined depression to be like. For example, maybe you thought depression meant crying all the time, whereas you feel more numb than sad. Or perhaps you didn’t know that a loss of interest in sex could be a sign of depression.

Unrecognized triggers: You may have experienced losses that affect your mood without your awareness. For example, when a friend of mine moved out of the country, I didn’t realize how much I was missing our talks during our early morning runs together. Losing that connection and consistent support may have been one factor that led to my depression.

Delayed onset: Depression symptoms might come long after major life events—months after losing a parent, for example, when the cards and condolences have stopped and the reality of life without Mom or Dad sinks in. It can be harder to recognize depression for what it is when the factors that led to it are farther upstream.

Thankfully depression is often highly treatable. If you wonder whether you might be experiencing depression, schedule to talk with your doctor or a mental health professional. You can also refer to this questionnaire to see if you have some of the nine symptoms of depression. As I found, getting the right treatment makes all the difference, and good treatment starts with the right diagnosis.

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About the Author
Seth J. Gillihan, PhD

Seth J. Gillihan, PhD, is a licensed psychologist with a private practice in Haverford, PA. He is author of The CBT DeckRetrain Your Brain, and Cognitive Behavioral Therapy Made Simple, and co-author with Dr. Aria Campbell-Danesh of A Mindful Year: 365 Ways to Find Connection and the Sacred in Everyday Life. Dr. Gillihan hosts the weekly Think Act Be podcast, which features a wide range of conversation on living more fully.

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