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Depression

Why Don’t You Get Chicken Soup When You’re Depressed?

Personal Perspective: Responses to mental vs. physical illness can be different.

Key points

  • People often respond more easily to physical vs. mental pain.
  • Yet, mental illness is just as debilitating as any other illness.
  • Depression deserves the same degree of sympathy as a strictly physical ailment.

“I can tell you’re suffering,” the pain management doctor says as he palpates my aching back. “I’m sorry you’ve had to go through this.”

“Wow, your back is so tight,” my physical therapist tells me. “It must be hurting you a lot.”

“You know, back pain can seriously interfere with quality of life,” the pharmacist says with a concerned look on his face as he hands me several prescriptions. “I hope you find some quick relief.”

In the past few days, I’ve been on the receiving end of so much understanding and compassion that it’s been almost overwhelming. My back is in endless spasms, and I know I look like I’m in pain—I’m fidgeting all the time, and my pale complexion is even ghostlier than usual. I’ve tried not to complain too much. But try as I might to hide it, the pain loudly announces itself to everyone around me.

And everyone around me has been fantastic.

I should be immensely grateful for this, and to some extent, I am. The sympathy that’s been pouring in does ease the pain somewhat. But I can’t help but compare this heartfelt response to my physical pain with the sometimes tepid, often complicated response I usually get to the deeper and more debilitating pain that’s caused by my mental illness.

Back spasms, uncomfortable as they are, can’t begin to compete with the unmerciful anguish of depression. And yet, where’s the flood of sympathy then? It’s mostly a trickle of concern from those few who know me well enough to realize the hell I’m going through. Or else it’s a sort of angry worry because the person doesn’t know what to do or say. I really want to understand this discrepancy because I believe that people are mostly good and don’t want me to suffer.

But still, I don’t often get the response I need. Take my latest episode of depression—more a mood blip than an episode, really. It followed on the heels of a spate of computer debacles and lasted several days. I was in a seriously lousy mood, accompanied by all the familiar bad behaviors: nonstop eating, oversleeping, isolating. I canceled plans with my friends, explaining that I was too depressed. Their responses left me wanting more—more deep concern, more expressions of empathy, more “Tell me where it hurts.”

Instead, I got the standard dose of advice (“You’ll feel better if you get up and take a shower”; “It’s a nice day: Why don’t you go for a walk?”). I even got anger from one of the friends I’d canceled on, despite my abject apologies (“You could come if you really tried”). It left me feeling more alone than ever.

So why does physical pain receive more genuine acknowledgment and compassion than mental pain?

Why does the response seem so much easier for people? I can think of two possible reasons:

  1. More people have gone through physical pain, so they can imagine what it’s like.
  2. Physical pain can be measured and quantified, so there’s no question of its validity.

Neither of these reasons satisfies me.

In fact, mental pain is not at all uncommon; depression is actually the world’s leading cause of disability, according to the United Nations Health Agency. Suffering is a hallmark of the human condition and has been from the moment we were ripped from the womb. We all know it to varying degrees.

As for objective proof of pain, my back spasms result from soft tissue injury that doesn’t show up on imaging tests. Rather, the pain is subjectively reported, meaning I’m the only one who really knows it exists. Those around me have simply chosen to believe me when I say how much it hurts.

I’ve finally come to a simple conclusion: The reason for the discrepancy must lie in fear. It may be as primal as fear of the dark. No one wants to admit that the devil exists—and that’s what depression is: a malignant force that wants to steal your soul. It’s easier to try to lure the demon away with well-meaning but misguided advice. Or to downplay its evil power by not recognizing how serious the threat really is.

Plus, depression isn’t easily fixed. That’s a big problem for some people, especially—dare I say it?—men who want to take immediate action against the problem. You can make an aching back feel better with massage, physical therapy, and pain medications. The relief may not be instantaneous, but it’s a whole lot quicker than the weeks, sometimes months, it takes to respond to a psychotropic drug.

The unfixable is as bad as the unknowable, and mental illness is sometimes both. But that doesn’t mean it ought to be ignored, or downplayed, or deflected. I’d love to hear my doctors and friends acknowledge my depression with as much eager sympathy as I’ve received for my spasms. Maybe in the future, as more people come to realize that depression is also a physical disability, there will be more a satisfying response. Until then, I guess I’m left with saying, “Oh, my aching back.”

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