If you have experienced depression while living what appears to be a fairly nice life, you’ve probably had someone ask you, “What do you have to be depressed about?”
Sometimes people who ask this question are genuinely curious because they think that depression is necessarily “about” something and they just don’t understand what, in your case, it could be “about.” Sometimes, though, people who perceive your life to be better than theirs feel resentful and jealous and, upon hearing that you are suffering from depression, demand to know what could possibly be wrong with your life that could cause a mental illness.
The origins of depression are complicated and still not very well-understood. One model that’s gained ground lately is called the diathesis-stress model. The term “diathesis” refers to a vulnerability, which could be genetic, biological, environmental, or psychological. “Stress” refers to a catalyzing event, a life stressor that can increase one’s chances of developing a disorder (the diathesis-stress model has been used to describe more than just depression).
One specific type of diathesis that has been researched concerns a specific gene, known as the serotonin transporter gene or 5-HTTLPR. Some studies suggest that people with a particular variant of the gene are more likely to develop depression, but only if they have a significant life stressor. If not, then there’s no difference between people with the different variations of the gene.
The results are mixed so far, but this is just one example of a way in which having “something to be depressed about” can indeed provoke depression. But it’s not the whole story. People without significant life stressors can still get depression, and people who do have life stressors are still much more likely to get depression if they have that genetic predisposition–the diathesis.
Diathesis can come in all sorts of forms. Having learned poor cognitive coping skills as a child could be a diathesis. Having abnormalities in the brain’s neurochemistry could also be a diathesis, although the “chemical imbalance” theory of depression as we’re used to seeing it is more or less bullshit.
Some types of diathesis might be considered to count as “something to be depressed about,” such as living in poverty, having a chronic health condition, or having an unstable or abusive family life. Others, such as having genetic predispositions or brain abnormalities, would not count as such for most people. Asking someone what they have to be depressed about is therefore not very useful.
But moving away from the science of depression’s origins, I’ll state the obvious: no matter how well you know someone, you never know everything that’s going on in their life. Not even if it’s your kid. The person may have a significant life stressor that’s triggering their depression that they just haven’t told you about, and they probably won’t if you sarcastically ask them what they have to be depressed about. If you’re genuinely curious, a better way to phrase that question is, “I’m sorry to hear you have depression. Is there anything that’s triggering it for you?”
The important thing with that is to never ask questions like you already know the answers. The question, “What do you have to be depressed about?” comes along with the implied answer, “Nothing.” Even if you don’t think it does. That’s how many people are going to hear it. So don’t get too caught up on the literal meaning of the words you are saying, and think about how they’re going to be interpreted.
The hypocrisy of the “What do you have to be depressed about?” question becomes blatant when you consider our typical response to those who do, by all accounts, have something to be depressed “about.” What tends to happen is that when we feel that depression is to be expected in a given situation, we also frame it as “okay.” Normal. Natural. It’ll pass on its own and we shouldn’t interfere.
This might explain the controversy over the decision to remove the bereavement exception from the newest edition of the DSM. Previously, people who were grieving had a two-month “window” during which they could not be diagnosed with depression, which often looks very similar to bereavement. With the publication of the DSM-5, this exception was removed. Lots of people were Very Concerned that this means that we’re “medicalizing” a “normal” process such as grieving.
I know I probably over-rely on comparisons to physical health, but that’s because they can be very illuminating. If you’re subjected to a some loud noise and you get a headache, or you work out strenuously and get extremely sore muscles, few people would suggest that you shouldn’t take medication to ease those pains just because they happened “naturally” (whatever that means). Being extremely sad, even “depressed,” as a response to a loved one dying is definitely “natural,” but that doesn’t mean it can’t interfere with your functioning as a person, and that you don’t deserve help dealing with it.
I’m not necessarily saying that high levels of grief should be diagnosed as depression, though. I’m just pointing out the hypocrisy of expecting people to produce compelling “reasons” for being depressed, but then refusing to consider people who do have compelling reasons to be depressed, even if they show all the symptoms.
My final gripe with the “What do you have to be depressed about?” question is that it’s often a way of trying to rank human suffering. What do you have to be depressed about? Some people are abused by their parents. What do you have to be depressed about? Some people are starving. What do you have to be depressed about? Some people have cancer.
Well, if you, personally, were abused by your parents, are starving, or have cancer, I wouldn’t fault you for feeling that the concerns of people with depression aren’t as serious as yours. That’s your right. But there are no measurements with which we can assess how bad someone has it. There is no Standard Life-Shittiness Unit. We need to stop looking for one, and treat every individual’s pain as legitimate.