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Young Adults’ Experiences of Depression in the U.S.

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.

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Age at interview: 21
Sex: Male
Age at diagnosis: 15
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I think more when I was a teenager, I definitely did that, you know, I had a very loud, happy-go-lucky public face that, you know, is very charming and I still do that every once in a while because it wasn't completely unauthentic to me, but yeah, I know I do it less recently. 

For me, part of what resolving my depression means is essentially being able to-- I mean I guess not resolving because as I said, I think it's going to exist forever. It's not like I'm going to beat it, it's just learning to work with it, you know. And that means not having to be in the closet about it, so to speak. You know, not having to, you know, hide my depression when it's there, just be like-- You know, it will be like, "Yeah, my allergies are acting up. Yeah, my depression is acting up." Like you know, it's just a thing.
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.

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Age at interview: 23
Sex: Female
Age at diagnosis: 22
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I have overall made a great effort to hide any sadness that I have been experiencing. You know childhood and innocence is just so fleeting. I’m so happy to see her happy all the time that I would never want to, you know, dull that. You know she should be care free, she should be just, you know bright, with excitement for everything, I, I never want her to be negatively influenced by what I am going through. So I’ve always you know waited to cry until she was going to go to bed or you know went to the bathroom for a minute to regain my composure you know asked, any, anything that I could do so that she would not witness that. 
 

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

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Age at interview: 22
Sex: Male
Age at diagnosis: 15
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I feel like I’m a very kind of private person in general, I have my like my emotions or my understandings of things and I tend to keep them to myself until they’re fully formed because it can take me awhile to like figure out what they mean to me . And I think this is partially because, like, I realize, on some level, that if I were to, in these periods of depression, be like “here’s how I’m doing, here’s what’s up” like, it would just be exhausting for the people I was near and that is, is hard because there are some ways that I would really like to be more, like, I don’t know, like open with my feelings and communicative and, and whatnot.
 
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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.

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Age at interview: 23
Sex: Female
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I feel like part of me is afraid to vocalize that I have had this issue because for one thing, I’m afraid of scaring my mom because my mom is awesome and she’s you know, she’s one of my best friends and she’s always felt like she’s passed on her anxiety to me. So I feel like she’d be really upset if she thought she’s kind of passed depression on to me, which I don’t think is the case. But it might be something that she thinks and…

I have, we have been talking about me seeing like a therapist or something because especially what happened to me like this past quarter trying to complete school and what not. It’s just a lot of bad events, like one after another. So I definitely can tell that she wants to help me , but I’m just kind of worried about you know (laughs) getting in to her with things, well mom, you know, I’ve had suicidal thoughts in the past and they kind of came up like this past quarter, I really think like, you know, I need to be seen. And you know I’ve said things like to her, like that to her without mentioning the suicidal part. Because I really just don’t wanna freak her out.
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.

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Age at interview: 25
Sex: Female
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And did you get a diagnosis from your doctors who offered you that?

No. That’s why I did not proceed with their help because I did not want to be labeled, I did not want that in my file at all.

Okay.

So that’s where me had, dealing with it myself came in because I did not want to be labeled.

Okay you know I, know that depression has, you know, it’s a sensitive topic and it’s in some kind of parts of the culture it’s stigmatized.

[hmm]

Do you feel that that is a stigma? Yeah and in your culture particularly? 

Yes, yes it’s not something that’s easy to talk about. I feel like African Americans or maybe woman I don’t know, I can’t speak to men. We deal with you know a lot and not having a support group makes it more, makes it harder cause we kind of have to deal with everything ourselves or you know, on our own and I would say I think I’m depressed which is it’s something that’s kind of frowned upon or something that’s.

Frowned upon by? Like your friends, your family, your community?

The community. It’s not something that’s in the norm, I guess you would say. I don’t think people are educated on it much.
 

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.

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Age at interview: 25
Sex: Female
Age at diagnosis: 19
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On top of all that depression is considered a mental illness, so mental illness in itself is like a stigmatized thing in America. Like with all these shootings and everything and all these things that have been going on you’re like, oh he had to be mental, he had to be crazy, he was crazy because he had depression. Like the Sandy Hook thing that happened. He, yeah, he had depression, he had anxiety, he probably, they just talked about him having anorexia, he had Asperger’s, he had access to guns. He had all these different things like, there were so many triggers for that, but when it comes down to it oh no, no, no he was crazy that was what it came down to, he had mental illness. So he was crazy. So everyone is like, quick to jump to conclusions when you say like, I have a mental illness or you have a mental issue or you’re seeing a therapist.
 
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Pete thinks telling people about his depression would hurt his reputation.

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Age at interview: 25
Sex: Male
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I think if someone knew that I was depressed, especially me. I’m like a very large, a very strong guy. If they knew I was depressed, that would tarnish my reputation. That would make me, that would make me feel and it would make me be seen as weak. I don’t want anybody to see me as weak, even if I believe it. But that’s, you know, neither here or there, but it’s telling people is just something I wouldn’t do because it, I feel like it would tarnish my reputation and people would see me different. Now of course my doctor wouldn’t see me that way, but again for me the less people that know, the better, at least until I deal with it.
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.

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Age at interview: 27
Sex: Female
Age at diagnosis: 13
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I want to break, I want to break the stigma. I want to show people, you know, like, I am for the most part a very well-functioning adult in society. I feel, I don’t know. Right now I feel that way [laughter]. Yeah I want people to know because I want to show people that there’s someone in their life that has a mental illness and that it affects everyone. I mean, it affects me on a daily level. But you know, it’s important that people know, that people know that these people exist. That they’re everywhere, you know. I meet. It’s funny because I come out about my mental illness pretty frequently, and a lot of, I’ve met a lot of people that tell back at me that they have a mental illness. So I know a lot of people with mental illness because I’ve been so open about it, which is really cool. I really, it’s really nice to have a series, like. It’s good to have people who understand, you know. It’s really good to have people who understand. And it’s cool that there are, I mean it’s not cool that so many people have mental illness, but it’s also cool that there’s such a support system, you know, that can exist if you’re open about it. 
 
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Brendan sees that everyone is “weird” in different ways, and defies stigma.

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Age at interview: 21
Sex: Male
Age at diagnosis: 15
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Yeah. No, no. There's this stigma of-- about mental illness. People still lurking things that people with mental illnesses are dangerous, you know, that they'll hurt you or that they're contagious and they'll make you crazier. Like my, my personal view, honestly, is that there is no sane, there's no normal. Everybody has little idiosyncrasies that are-- that made you a little bit off from some idealized picture of normal. And some of them have-- some of them are certainly problems if they interfere with your ability to live your life. But the stigma around the people who suffer from that needs to change because they're victims and because to a certain extent we all are to a certain extent not sane. We all have our weirdnesses and that should not be used against us.

I think I've been lucky to be in some remarkably supportive environments since about my high school career some of them not so much. Also because as a straight enough white guy like you get a lot of sort of credence in social spaces. And because, you know, I always identify as punk and everything. I was always the one who was kind of like no, no I have a mental illness like and fuck you if you think less of me for it. I'm like, if there was lots of stigma, I was always the guy who is going to challenge you on that stigma [laughs].
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.

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Age at interview: 28
Sex: Female
Age at diagnosis: 27
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Well, I notice that people didn't really start acknowledging depression until I was maybe 18… that's when I noticed a general acceptance of depression rather than just being like, you ain't depressed about nothing. All you got to do is pray and find your joy in the Lord and yada, yada, yada. Our church choir had a song about that, let's see, I don't remember the name of it, but the lyrics were, "I almost let go. I felt like I just couldn't take life anymore". I don't remember the lyrics after that, but that was like the first acknowledgement of depression in the church that I'd ever heard of. And it's like whoa, they actually think this is an illness. They actually realize that this probably isn't something that you can just pray away, you know?...

…. I've noticed in the media a lot, a lot more especially African American oriented publications, there's more of an acknowledgement of depression and mental illness than as opposed to, like, 10 years ago, honestly, you'd barely see a blip of it. You would only see it maybe once or twice every, gosh, hundred couple of articles, something like that.

Yeah.

So, I am noticing more of an acknowledgement which is great. I just kind of wish the whole prayer thing would be done away with, [ha].
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.

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Age at interview: 28
Sex: Female
Age at diagnosis: 17
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Yeah I think that I was in such a dark place that and this might sound strange but and maybe I’m, maybe I was naive to think this but I felt like I was almost hiding it really well. Just because my, my thoughts were just so dark and so negative that I thought, “Maybe if I just act ok, maybe if I go out with my friends, maybe if I get an A on this test, it will seem like I’m ok.” And I clearly was not at all and I think my parents did know that, being the professionals that they are. But I will say that I did a decent job of hiding it for a while.
 

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

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Age at interview: 27
Sex: Female
Age at diagnosis: 15
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By the time I got into high school I was pretty good at masking my feelings. I’m fairly good at sort of keeping up an upbeat persona regardless of how depressed I am, even when I am fairly nonfunctional. If you see me out and about most people see me as pretty confidant and pretty well adapted and they’re like, “Oh, you know, you’re such an optimistic person and you’ve got it all together,” and stuff like that. And I think a lot of that for me comes from the fact that we have a fairly insincere culture when it comes to emotions. I mean, especially if you work in something like service. I mean, service with a smile. And foreigners a lot of times comment on how, how strangely friendly everyone in the states is and sort of how we have this sort of culturally mandated exuberance, you know, we can’t just be like, “Oh, you know, things are ok, they’ve been kind of tough lately.” Everyone is supposed to say, “Great, everything. It’s going to be the best day it’s ever been and it’s going to be the most beautiful and so successful.” And so I’ve sort of taken that on which I think can make it difficult sometimes because people don’t recognize that you’re suffering, especially when you are able to sort of meet your obligations that it can be harder for people to identify you as someone that has depression. 
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.

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Age at interview: 21
Sex: Female
Age at diagnosis: 12
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When I was in high school and I still had that kind of disconnect between what I wanted other people to think me of, think of me as, and what I thought of me as [cough]. Very few people got to see what I viewed as my weakness of being very self-conscious, being very self-critical. And now as I approach people I'm a bit more whole because the mask that I have is a bit closer to who I actually am. But I do still keep a lot of things that I perceive as weaknesses very close to my chest. So, you know, a lot of people could probably guess that I have depression, anxiety, and what have you. 

I've worked on not having such disconnect between the inner me and the me I present to strangers. Because, you know, I have figured out that is a sign of depression, and the worse your mask, the farther away the mask is away from you, the worse you're going to, you know, hate yourself. You have to be honest with the people around you a bit more. You have to be a bit more trusting with your real self.
 
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Jeremy talks about doing better once he started to reach out.

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Age at interview: 22
Sex: Male
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It’s something I’ve dealt with since I was a child… 

…sometimes just not feeling like I fit in at all and… 

…or that anybody ever made me feel that way in my family, and my family loves me dearly but just that disconnect without having, I don’t know, sometimes not feeling like anyone understands me… 

And, I’m doing a lot better now than I was before. I was in some pretty dark places just not reaching out to anybody, not talking to anybody about my issues, and that’s a big thing too is, if you don’t talk to anybody it just makes it even worse you don’t, you know, you don’t let it out, don’t let anyone know what’s going on people close to you may not, may not have any idea about your predicaments or what’s going through your head. 
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.

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Age at interview: 28
Sex: Male
Age at diagnosis: 26
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I felt that was the only way I could even get through it was, would be to tell people around me that I’m on it. But a lot of people just know, I mean I’m pretty close to most of my friends, I guess except for acquaintances. I mean, if I’m friends with somebody it’s usually like a pretty close relationship and so they were, I mean, they were probably aware of it before like I was a lot of the time. And I definitely have no problem telling people that I was on as SSRI just because I actually learned a ton of people that were on it that never said anything about it, like, there’s like, it was almost like half the people that would say I am on medication and they were like, oh yeah me too. Like, almost half it seems like. I was just constantly shocked at how many people who were like, oh yeah me too, what are you on. Like, what. You had no indication that they would be on it or it didn’t seem like the kind of person, but yeah. I don’t know. It’s kind of just, at some point I realized the pattern and I was just curious on like, how many people are out there that are doing various medications of various kinds and like, yeah, most of the time it was an SSRI. Very rarely would it be something for something else. 

No kind of fears about disclosing?

No. I don’t know. I’m a pretty open person. I mean, I’m somewhat of an exhibitionist. I, you know, most of the time the window blinds are all the way to the top. You know, I don’t. I don’t feel, I mean, I’m sure I have secrets but most of my life, it’s like, I don’t feel like I need to keep it under lock and keys. I mean, I’m not, I don’t have like trade secrets or anything. It’s like, I’m not worried about anything getting out and if it does, it’s like, you know. I don’t know. I think that’s a response to, I see a lot of people in this world hold a lot of like secrecy around love stuff and a lot of people are embarrassed about everything and you can’t talk about money, you can’t talk about this, you can’t talk about that and it’s like pretty much the opposite of how I view things. I feel like a lot of the problems are because people aren’t open with their true feelings and so I’m, you know, not afraid to be like are you on medication, because then that like opens up a whole new conversation that I never would have had and like, you know, this person could never have had this conversation before and been wanting to have it and like, relate to somebody else knowing that they have the same problem as you I think helps a lot, like, to know that it’s not just you going through it.

Yeah.

Because there’s a lot of people, you know, even if it’s like an obscure problem or an obscure issue you’re having, it’s like you’re surprised how many people have a relatable situation to it that can help you out.
 

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

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Age at interview: 20
Sex: Female
Age at diagnosis: 15
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It’s really ok to just tell people that you know you’re figuring things out on your own and I’ve found that, that’s been actually really positive in my life just because people have shown to be more committed to me when they understand I’m really trying to be in a, to get myself in a better place where I can be fully committed to them and that shows that there’s care on both ends. And so I definitely do respect that. So anyway that’s my.

Yeah and some honesty it sounds like, and you’re really self-disclosing and clear.

Yeah I think so.

Yeah.

I mean they don’t, they don’t, not all of them know all of the details but I mean it’s definitely enough to say you know, “I care about you enough that I want to you know really seriously whole-heartedly, take care of our relationship and our interaction with each other and part of how I’m going to do that is take care of myself so that way I can be better able to enrich what we have.” And under that everyone I have been with has been very understanding so.


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