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.
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.)

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.
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.
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.
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.”
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.
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.

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