Depression: debunking common misconceptions to better understand the condition

In everyday language, the two terms are sometimes used interchangeably. However, they do not refer to the same thing: “Depression is really a medical term. It corresponds to a diagnosis and an illness, whereas feeling down describes more of a normal mood state,” explains Dr Juenet.

The duration and intensity of the symptoms, as well as their impact on daily life, help to distinguish between the two. A bout of low mood, even a pronounced one, may last only a few days. In depression, the symptoms become more entrenched over time and lead to a disruption of normal functioning. The person is no longer able to live, feel or act quite as they did before.

And contrary to another common misconception, being depressed does not necessarily mean being sad. Some people instead feel an emotional void: “They no longer show any joy, but not necessarily sadness either.”

There is no single form of depression. Whether mild, moderate or severe, it can also manifest itself differently depending on age. In children and older people, it is sometimes expressed more through physical symptoms, such as pain or digestive problems.

Certain forms also have specific characteristics. This is the case with seasonal affective disorder, which is triggered by reduced daylight in autumn and winter. It differs from a simple bout of low mood in its impact on daily life: “The difference lies in the symptoms becoming severe enough to impair quality of life,” explains Dr Juenet.

Treatment-resistant depression, meanwhile, refers to a lack of improvement despite being prescribed at least two different antidepressants at appropriate doses. “It is estimated to affect 10 to 15 per cent of people with depression,” says the psychiatrist. Other treatment strategies may then be suggested. 

Treatment depends on the situation and the severity of the depression. For mild to moderate depression, “the first-line treatment is not antidepressant medication, but psychotherapy,” explains Dr Juenet. Cognitive and behavioural therapies (CBT) rely in particular on exercises designed to change certain thought patterns and gradually restore the ability to take action.

In severe cases, antidepressants may be necessary, sometimes in combination with psychotherapy. Their effects become apparent “after around fifteen days to three weeks”. In cases of treatment-resistant depression, certain brain stimulation techniques may be considered. 

The relationship with the therapist also plays an important role. Without trust, it is difficult to open up. If the rapport isn’t right after a few sessions, Dr Juenet advises discussing this and, if necessary, changing therapists.

Finally, one misconception in particular deserves to be dispelled: depression is not inevitable. It can be treated and recovery is possible. Whilst a first episode increases the risk of a relapse, “once depressed, always depressed” is completely false, the psychiatrist points out.