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hawthorne: depression is an invisible pain  

people would describe me as energetic and outgoing, although i’ve had times where the last thing i wanted to do was talk to people. i carried a heaviness that dampened my motivation to do what i needed to do.

statistics canada reports that since 1990 mental disorders have accounted for “14 per cent of years of life lost due to disability.”
you might think it would be easy to know if you’re depressed. you’d be stuck in bed with a box of tissue unable to get up and face the day.  
it’s not as simple as that for everybody. i know from personal experience. i am a curious mix of optimistic, warm and exuberant like my mom and quiet and reserved like my dad. growing up, i was a top student, public speaker, sprinter and had some great friends. by all accounts, i had a solid start in life to become an independent and hardworking adult.  
i was set up for success, but i didn’t always feel successful.  
i had nagging feelings of disinterest and low mood where i just didn’t feel like myself. people would describe me as energetic and outgoing, although i’ve had times where the last thing i wanted to do was talk to people. i carried a heaviness that dampened my motivation to do what i needed to do.
statistics canada reports that since 1990 mental disorders have accounted for “14 per cent of years of life lost due to disability.” a 2021 poll by mental health research canada in partnership with health canada confirmed that mental health is a growing concern with canadians facing more depression than ever before. the same poll found that only about half of those people with depression have reached out for help. the global pandemic has brought mental health into the spotlight with the medical community and policymakers recognizing the need for breaking down stigma and improving access to care.  
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for me, i had a defence mechanism to avoid any questions about my problems or concerns: i always smile. it’s not a fake coverup because smiling does make me feel good. but if i was really honest with myself, i knew something wasn’t right. i would have low days when i felt as though i was just going through the motions. then i’d occasionally do a self-assessment survey about depression and tick off the boxes, thinking that’s likely my problem.
despite this self-diagnosis, i’d talk myself out of asking for help from my doctor because i would think ‘what have i got to feel unhappy about?’ i’m a journalist who is passionate about my work, i have a wonderful family, i make excellent hummus.  
to fix things and boost my endorphins, i’d rely on my commitment to exercise, eating healthy whole food, and being social with friends. these all make me feel good, but didn’t lift that dark mood that often pulled me down. then i asked a naturopath for advice, and she said that i wasn’t depressed. i was “not what depression looked like.” i came away thinking maybe i just needed more relaxation and sleep in my life. 
but all the stress-relief, nutrition and exercise, while good for me, still didn’t keep the heaviness at bay. depression can be an invisible pain.  
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i finally told my sisters that i probably have depression. they’re both understanding and open-minded people who want me to be happy. i asked them what they thought about medication for depression. they both agreed that i should try it when i was ready.  
so, i talked to my family doctor about my depression. i ended up in tears at the appointment because it felt like i was confessing a secret that i needed to own up to. maybe it was admitting weakness that made me feel vulnerable and exposed. she was so matter of fact about trying medication that i sat in the chair with relief. we talked about the type and dose and what to expect with any side effects. it all made sense to me.  
what are family doctors doing to encourage people to talk about mental health? the model of care leaves little time for discussion about overall well-being during patient appointments, despite the evidence that mental health is a serious and common issue. my experience for a routine physical, for example, has been a blood pressure check, height and weight with the clinic assistant and then nervously sitting in a small room for the doctor’s consultation. if you write questions down and take them into the appointment with you, that will help keep you focused to make the most of the time.
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self-advocacy is so critical, even if you feel vulnerable. talking about your struggles with depression to your family doctor, or a clinic doctor if you don’t have a family doctor, is an important first step to getting help. as a health journalist, i hear from patients who admit that they shrugged off symptoms and just carried on, until the situation got worse. what i’ve learned is that there’s no benefit to waiting in silence.  the canadian mental health association says that voicing your concerns with a primary care professional is the route to a diagnosis and help receiving talk therapy, support groups and medication.   
more than a year later, i’m feeling good on the medication, a selective serotonin reuptake inhibitors (ssri), which is one of the most common antidepressants. i’ve told my close friends that i take this regularly and that it’s really helped. i was worried the medication might numb me to things both happy and sad, but that’s definitely not the case. i think overall i feel calmer and more capable.  
find out more about the signs of depression and avenues for help at the canadian mental health association.  
karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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