How Depression Affects Daily Life
Being sick can be expensive. But conditions like depression carry other significant costs too — ones that affect you professionally and socially. Depression can change how you show up at work, at school, with your friends and family, and with yourself.
Depression affects all aspects of daily life. It can make daily tasks like getting out of bed, dressing, or eating just too hard. Making simple decisions can seem impossible. Major depression can even affect your cognitive functioning — how you take in information and use it — like remembering where you parked your car, planning your day, or paying attention while trying to watch a movie.
Imagine you’re fueled by a battery. You use the battery’s energy reserve to do well at work or other necessary tasks. Later, you may have other things you need to do, but your battery is running close to zero, and you can’t recharge it. Russ Voltin, MD, a psychiatrist in South Charleston, West Virginia, explains it like this.
“The person is able to function at work and then comes home and either goes straight to bed or is sobbing,” Voltin says. “I’ll have patients come in, full of guilt, because they’re short with their children, and that just makes them feel worse about themselves.”
But is stopping work the right solution? Many people do so because their battery isn’t getting recharged and they can no longer deal with it. Unfortunately, losing the social connection from work can result in even more isolation, which in turn worsens depression.
“I left a job — and working in general — after 15 years because my mental health became too bad to continue,” says Lynne Vail, a mental health advocate in Ottawa, Canada. “The relationships I had formed with others disappeared as my absence grew.”
What’s ‘masking’ and how does that come into play?
It can be hard to live with depression, but people can hide it really well when they feel they need to. Someone with depression may even think of this as “fake it till you make it” — a phrase often used in reference to getting ahead in life — but this is not the same situation.
This mentality is called masking or “camouflaging.” You may act as if everything is OK at work, in social situations, and even with friends and family, despite feeling numb or miserable. And then once you’re alone, the mask falls and you crash.
Masking your depression might seem to make sense in the moment as it helps you function, but it can backfire. First, it takes a lot of energy to mask. So, when the mask slips — likely when you least expect it — your colleagues, loved ones, and friends may have no idea that you have been having such a hard time. If you mask with your doctor or therapist, that too can have consequences. They may believe your treatment is really helping you, rather than trying to find the right therapy or combination of therapies.
“I have patients who mask in my office,” Voltin says. “I’ll ask, ‘How are you doing? How’s the medicine working?’ They say, ‘Everything’s great.’ And then six months later, they show up with their spouse. Their spouse says, ‘This medicine is not working. It hasn’t been working.’”
This means better treatment may be delayed by months, if not longer.
Dropping that mask is easier said than done, though. Vail says she “overshared” with someone she saw as a mentor and lost that relationship. This is one reason why some people are often afraid to drop that mask.
Adeline Johnson, a 70-year-old transgender woman with depression living in Portland, Oregon, knows this too well. But she’s working on letting that mask drop.
“I mask pretty much all the time,” she says. “Lately, like in the past eight or so years, it’s gotten better. I’ve finally admitted to myself that I was no longer able to pretend — to others and myself — that I was happy in my body or my activities.”
What Makes This Type of Depression Difficult?
Treatment-resistant depression (TRD) is challenging in many ways, including the added personal cost. People with this kind of depression often have more appointments with doctors, therapists, and other health care providers. This means more time away from work and family, as well as more time trying treatments to find the right one. They may take more medications, which can cause more side effects and visits to the emergency room. All this takes a toll.
Studies show that people with TRD have a lower quality of life and more depressive symptoms.
If you have TRD, you may improve for a short time when trying a new treatment, only to have your symptoms come back — sometimes stronger than before. It can be discouraging when progress fades and symptoms return. Some people may start to feel hopeless and are less likely to try again, adding to the cycle of this kind of depression.
What Withdrawal Looks Like When You Have Depression
One common symptom of depression is withdrawal from life. But it’s not something that happens overnight.
“It’s such a gradual illness,” Voltin says. “It’s not like [you] wake up that way.”
Instead, as the depression continues and worsens, your life gets smaller. You might:
- Spend more time in bed.
- Turn down invitations and avoid social activities.
- Stop participating in activities and hobbies.
- Cut down on learning or opportunities at work.
People become more and more socially isolated.
“They’re spending more time turning down invitations to go out,” Voltin says. “They’re turning down their friends, and they’re cutting their social network. The depression is allowed to fester even more.”
If you have depression, you can become anxious too. For example, you might accept a social invitation but then be anxious about handling it or needing to cancel.
Withdrawing professionally is also common. It can show up as not pursuing further education, not applying for promotions or better jobs, or doing just the basic minimum at work to avoid being fired. As cofounder of RWRN, a national nonprofit serving Holocaust survivors, caregivers, and first responders, Rachel Weingarten has seen how withdrawal caused by depression affects first responders and caregivers.
“They’ll often cut back on educational opportunities because it’s really difficult to navigate bouts of depression,” says Weingarten, who’s also trained in psychological first aid. “They’ll often say everything feels too hard right now and find ways to deprioritize their own goals or upskilling and instead step away and most times never return to it.”
How to Minimize the Personal Costs of Depression
Taking steps to cut the personal costs of depression can be scary, but it can be of great help. Here are just a few tips that could help you get started:
Seek professional help. Getting a full checkup and discussing what types of treatment might help can help improve your quality of life, not just your symptoms.
“The earlier you identify the depression and you seek treatment, the better the outcome,” Voltin says. “Depression is an illness, not a weakness of fortitude.”
Stick with the therapy. It can take time to find the right treatment. Stick to it or be ready to try something else. Be open and honest (no masking!) with your therapist or psychiatrist, so you can truly work together.
Strengthen your relationships and social support. Relying on her personal relationships helped Johnson.
“I was 60 years old when I decided enough was enough,” she says. “I explained to my wife (over 40 years wed at the time) that I really would feel happy if I could wear women's clothing. It was cool to finally let someone know. The lightness cutting through the depression and self-doubt was amazing.”
As for social support, enlist the help of friends and family. Try to make simple plans, ones that seem doable without a large investment of time and energy. Add to them as you feel comfortable.
Speak with your employer. In the U.S., you have the right to ask your employer for reasonable accommodations under the Americans with Disabilities Act. This could mean having flexible hours, if possible, asking that you have time for scheduled appointments, adjusting your workload, or even taking sick leaves if needed.
Takeaways
Depression can exact a high personal cost. It can cause you to withdraw from work and social relationships. Hiding how you feel (masking) may help you function in the moment, but you can only do it for so long. It can also delay the care you need. Recognizing that depression is a true illness and taking realistic steps, such as asking for support from your health care providers, loved ones, and employers, can help you drop that mask and keep you connected.
