Going public with depression?

Decisions about ‘going public’ with depression are complicated ones to make. Almost all the young adults we interviewed described struggles figuring out if, how and when to show their depression or tell others about it.

Most people described developing a ‘mask’ to cover up depression at one time or another. Some did so for specific reasons, such as fear of being forced to go to the hospital for treatment or of drawing attention to themselves. Others isolated themselves with depression: as Kate put it, ‘I kept my cards close to my chest’ and ‘didn’t really share my life’ with friends or family. Nadina kept depression to herself to stay in control and remain ‘in charge of, you know, how my mental health is handled.’ Brendan also masked his depression when he was younger, but has worked hard to ‘come out of the closet’ about it as part of making it less of a big deal in his life.

Brendan feels that part of learning to work with his depression is to stop hiding and be open about it.

Age at interview 21

Gender Male

Age at diagnosis 15

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Some young adults masked their depression because they worried about how others — particularly parents — will react to or be affected by it if they let it show. Some were concerned that showing depression would cause pain to others. Pete worried that nobody would want to ‘be around a person that is depressed because… they make you feel depressed too.’ Jackson didn’t want to be a target of abuse. (See also ‘Depression and work‘ and ‘Depression and school‘ for more about masking in those settings.)

Violet keeps her depression from her daughter to protect her.

Age at interview 23

Gender Female

Age at diagnosis 22

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Casey worries that if he tells other people about his depression it will exhaust them.

Age at interview 22

Gender Male

Age at diagnosis 15

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Nadina is concerned that if she tells her mom about depression, her mom – who also struggles with it – will both worry and feel at fault.

Age at interview 23

Gender Female

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Stigma

In the United States, depression has had a long history of stigma (defined as ‘dishonor or disgrace’) associated with it. In the last 30 years, there has also been a lot of activism, public awareness campaigns, and new approaches to addressing depression that have lessened the burden of stigma – at least for some people, in some ways. People we interviewed talked about the negative impact of stigma, and also about how they notice stigma is beginning to lessen or how they are working to (in Shayne’s words) ‘bust it.’
A number of people we interviewed named stigma as a reason for masking their depression. Jason described how a competitive college environment leads to a lot of ‘alphas’ worried about revealing any weakness. Sophie talked about being the butt of jokes, Jacob about embarrassment at school, and Elizabeth about worry that her depression diagnosis would have a negative impact on her schooling and career. Mental illness can be stigmatized in many different cultures. For example, people from both Asian and African American cultures discussed how depression is specifically stigmatized in those communities, and several people noted how mentally ill perpetrators of violence have increased stigma for everyone else who has depression.

Tia didn’t want to get a diagnosis because depression is frowned upon for African American women, and she did not want the diagnosis in her file.

Age at interview 25

Gender Female

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Sally talks about how depression is a mental illness, and the fact that violent acts that are sometimes committed by mentally ill people increases stigma around depression.

Age at interview 25

Gender Female

Age at diagnosis 19

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Pete thinks telling people about his depression would hurt his reputation.

Age at interview 25

Gender Male

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Stigma does not always make people keep their depression in the closet. Some people become inspired to overcome stigma as part of improving their own health, emphasizing that depression is not their fault, or making things better for everyone struggling with mental health issues.

Shayne works to address stigma head on, and finds a lot of fellow travelers as she does so.

Age at interview 27

Gender Female

Age at diagnosis 13

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Brendan sees that everyone is weird in different ways, and defies stigma.

Age at interview 21

Gender Male

Age at diagnosis 15

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A few people described seeing signs that stigma is decreasing in specific ways – for example, on college campuses, in social media, or in particular communities.

Myra notices that there is a little less stigma than before in the African American church and media.

Age at interview 28

Gender Female

Age at diagnosis 27

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Masking depression

Masking depression can be a struggle: one person described being overwhelmed in public and having to leave the room she was in, and another said his depression sometimes ‘bursts out’ when he is outside. Masking can also become a skill people use effectively — making up excuses when feeling bad, becoming a high achiever, or adopting a permanent smile. As Ryan summarized, echoing what a number of others said, ‘I kinda know how to put on faces for people.'

Elizabeth hid her dark thoughts very well, until they became overwhelming.

Age at interview 28

Gender Female

Age at diagnosis 17

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Maya is able to act upbeat even when her depression is bad a skill she sees as connected to the insincere culture around her.

Age at interview 27

Gender Female

Age at diagnosis 15

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People talked about the eventual price they paid for masking depression, and the need to relieve the stress of doing so by closing the gap between their inner and outer lives. As Devin summarized, ‘the more you hold everything in, the more it’s going to get worse.’ One participant described a breaking point when a friend was suicidal, and she realized it would be dangerous to let her parents keep believing she was a healthy, high-achieving young adult. Others said it was a relief to finally ‘let things fall apart’ and stop masking.

Kate says she still keeps a lot in, but feels better being more honest with others.

Age at interview 21

Gender Female

Age at diagnosis 12

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Jeremy talks about doing better once he started to reach out.

Age at interview 22

Gender Male

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Telling others about depression

When it comes to telling friends or intimate partners about depression, people we talked to had different approaches. Some preferred to talk about their depression right away and not ‘waste time’ with people who might not be accepting. Several people noted they prefer to wait until the relationship is a bit more established; others talked about the risk of other people acting insensitive when hearing about depression and only disclosing to people they think will be most understanding. Colin noted that even when he does tell people, he prefers not to give too many details.

Joey’s relationships with others improved when he told them about his depression, and he often learned they are depressed too.

Age at interview 28

Gender Male

Age at diagnosis 26

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For Crystal, telling significant others about her depression is a sign of commitment.

Age at interview 20

Gender Female

Age at diagnosis 15

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See also ‘Therapy and counseling‘, ‘Depression and everyday tasks‘, and ‘Depression and work‘.
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