Depression is draining. It takes many forms, reeking havoc for people in a variety of ways making the subject tricky to just generalize entirely. Some people have good days and bad days. Others struggle with major depression where “good days” feel far and inbetween. Even further, some only experience their depression in infrequent bursts surrounding long periods of stress, loss or even weather change.

Because depression is so tricky and often times hard to pinpoint specifically unless diagnosed by a professional, the treatments to remedy it can vary too. Therapy, medication and experimental modalities are only a few of these, all of which come with their own side effects.

These effects can be permanent and intrusive or sometimes minimal and uncircumstantial; the issue is that one or more results are never guaranteed. According to the World Health Organization (WHO), 350 million people worldwide suffer from depression. Despite having such a large amount of people affected, those suffering from depression often times are left feeling isolated and frustrated by what they are going through.

This can be even more frustrating when you have to deal with responses from those that want to support you but who also don’t experience the illness. Though well intentioned, these comments and questions are actually very harmful and only extend a stigma against mental illness. As a result of this stigma, people can begin to feel further alienated, notes the National Alliance on Mental Illness (NAMI).

So how can we work together to end these stigmas and better understand those dealing with mental illness? By being mindful of conversations between people you know who are suffering with depression and avoiding overused misinformed comments, we can better reach an understanding of one another and learn better ways of communicating.

Depression is just being really sad, right?

To be frank, no, but people often get the two confused because the two can often appear the same.

Psychology Today outlines this issue saying that sadness is a normal human emotion and something we’ve all experienced and will again at some point or another. Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing events, experiences or situations.

In other words, we tend to feel sad about something. There lies an object of our sadness, a reason for it. This also means that when something changes and our emotional hurt over the reason fades, we will no longer experience this sadness.

Depression, however, is an abnormal emotional state, a mental illness that affects our thinking, emotions, perceptions and behaviors in pervasive and chronic ways. Depression does not necessarily require a difficult event or situation, a loss or a change of circumstance as a trigger.

In fact, it often occurs in the absence of any such triggers. Depression includes components of sadness, yes, but it’s tangled with fatigue, suicidal ideation, the inability to function or complete tasks of daily living, low or increased appetite and many other symptoms that drastically separate the two.

Have you tried …?

Yes, probably. People diagnosed with depression have likely gone over numerous options that would best suit them for treatment with their doctors and counselors. Those remedies might include counseling, which is recommended as the first line of treatment.

If that doesn’t work, they have likely tried medication for bringing their baseline mood up and increasing their ability to function. And if that medication doesn’t work, they’ve probably tried different psychiatric drugs prescribed to them to see if those can be more effective.

Aside from actual medication, people are very likely to have pursued acupuncture, yoga, massage, crystals and whatever else someone’s sister’s cousin who beat their depression has recommended to them too.

Again, the issue is that a lot of these remedies are never a guarantee. Something might work for one person that didn’t work for the next, they might all work or none of them at all. Dealing with depression is trial and error. You have to find the things that work for you, which can be tiresome and tedious and only made worse when people assume you are just sitting around patiently waiting for your depression to make an exit.

Cheer up!

This seems to come with an implication that depressed people are to blame for their own mental illness, that if they just tried harder, they wouldn’t be depressed anymore. It’s shaming and also frustrating for people who are struggling with a really low mental state. Imagine if someone cut off one of your limbs and then suggested that you just try growing it back.

“Cheering up” just isn’t that simple.

In fact, a 2014 study published in the Journal of Personality and Social Psychology, shed light upon on the idea that telling others to look on the bright side is unwelcomed and counterproductive even when it’s done with the best of intentions.

The researchers, led by the psychologist, Denise Marigold of the University of Waterloo, found no evidence that ‘positive reframing’ or this cheer up treatment is helpful for people with low self-esteem.

So not only is this language hurtful and demeaning to those suffering with this illness, it doesn’t even work either.

It’s all in your mind

Yes and no. Depression is related to imbalances of brain chemistry, and in that sense, it is literally in your mind. But depression is far more complicated than that. Yes, it can involve neurotransmitters, hormones and other chemicals produced within the body, including those that are a bit difficult to quantify and measure.

But with a wide spectrum of depression, this isn’t always the case. Sometimes it is a response to medications; anesthesia, for example, can cause depression for days, weeks and even months after surgery. Depression can even affect you physically, causing gastrointestinal problems, disordered eating and a list of other health issues.

Aside from the fact that it’s insulting and oftentimes hurtful to act like being attacked by your own mind isn’t real, it’s also factually incorrect to say that “it’s all in your mind” to someone who is experiencing depression.

I can’t imagine …

No, you probably can’t. Unless you too are suffering with mental illness, this is kind of an obvious and unhelpful statement. Even then, this is difficult because depression is different for everyone.

It’s an individual journey for each person. Often people who say this seem to mean it in a comforting way to perhaps validate your feelings but it also comes off in a dismissive way. It’s not just that they can’t imagine what you’re going through, but that they’re implying your mental illness is something imaginary.

Can’t you just be cured?/I thought you were fine now that you were on meds?

Depression is a mental health condition that can become a friend for life. Sometimes that means going to therapy and remaining on meds for the rest of your life, and other times it requires constantly adjusting your treatment and more medications and doctors visits. You may have breakthrough depression where even with treatment you still have setbacks.

You may have treatment-resistant depression where nothing really works for you and managing your mental illness is a struggle.

Studies show that most patients with depression eventually relapse and become depressed again – even if they’re still on the antidepressants that helped them recover in the first place.

Experts say they have theories but no definite evidence as to why this occurs.

“One of the problems with psychiatry and mood disorders, in particular, is that we don’t know what the broken part [in the brain] is,” says Dr. Jennifer Payne, director of the Women’s Mood Disorders Center at The Johns Hopkins Medicine in Baltimore.

Whatever the case, it’s difficult to voice to others that you are are working towards a goal of mental health. This isn’t always concrete and can widely vary based on the individual in question.

Feeling like you need to constantly explain yourself and your progress can feel demeaning and ostracize you from your family and friends for fear you’re coming off as overdramatic.

The best thing you can do when speaking with a friend or family member who is suffering from depression is to be open minded, listen and help them feel like they have support through the process of managing their depression.