In a growing world of misinformation, it is important to distinguish fact from myth. Particularly on the topic of mental health, there are many misconceptions with what is true or false when discussing mental disorders. To keep this discussion focused, this post will be dealing with misconceptions pertaining to major depressive disorder (MDD). MDD is a common mental disorder that is characterized by a depressed mood or a loss of pleasure/interest in activities, for most of the day, nearly every day, for at least two weeks (World Health Organization). With this simple definition, The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), goes more in depth to the symptoms that one with MDD would experience. Having five or more symptoms from the DSM-5 is required to be diagnosed with the disorder. This already addresses a common misconception that MDD is equivalent to sadness. Sadness is simply one possible symptom of MDD with the DSM-5 going more in depth with potential symptoms a patient may face. Within MDD, there are many more misconceptions that are discussed as if they were known statistical fact when in reality much of our understanding of mental disorders is still being explored every day. This blog post will work to address a two of these misconceptions, addressing studies that have explored these exact issues. Beginning with the implications of race within the disorder and following with “depression being in your mind”.
For a number of societal reasons, the sentiment that MDD is a “white person disease” has been spread and has led to many other ethnicity groups feeling underrepresented in mental health advocacy. An organization has gained traction through social media with the hashtag #DepressedWhileBlack, leading the founder Imade Nibokun to have an interview with Vice discussing the community that has formed around her project. Nibokun speaks of her experience of being raised with the thought process that “white people are weaker than black folks due the oppression [black people] have faced for hundreds of years”. In a study by Dunlop et al. (2003), the prevalence of depression among preretirement adults from different racial and ethnic backgrounds was analyzed through survey answers to a Health and Retirement Survey. Dunlop found that depression is more prevalent in minority groups, African American and Hispanic populations, than White Americans. The findings of Dunlop et al.’s study corroborates with a main sentiment of Nibokun’s #DepresssedWhileBlack, dealing with the intersecting experiences of being an African-American while simultaneously having MDD. Nibokun anecdotally mentioned that her worst depression episodes were triggered by unemployment and historically African-Americans experience unemployment at much higher rates than white people. MDD is a complicated disorder that can manifest due to several factors, but in no way should race be a determining factor for whether or not someone can experience MDD.
A common way to disregard patients suffering from MDD is the saying “it is all in your head”. The biggest issue with this saying is that it belittles people suffering from MDD, implying if they had a stronger will they could just get over it. MDD can physiologically change your nervous system to prevent you from being able simply “get over it”. These changes can feature a disturbance in the several neurotransmitters such as serotonin and dopamine that can lead to pathogenesis of the disease (Pan et al., 2018). Treatments for MDD typically attempt to target this neurotransmitter imbalance by introducing selective serotonin reuptake inhibitors (SSRI) that would lead to a greater number of serotonin existing at neuronal synapses. These have varied results in terms of effectiveness but contribute to oppose the hypothesis that depression is all in the mind. Differing from the neurotransmitter focus, there is a cytokine theory of depression in which inflammatory signaling molecules in the brain can also cause depressive symptoms (Zainal and Newman, 2021). A cytokine is an immune cell that is focused on affecting other immune cells to induce the inflammatory response in response to pathogens in our bodies. An increased prevalence of cytokines in our brain was found to positively correlate to MDD developing up to 9 years later. Major depressive disorder extends beyond our mind and moves into the brain, requiring more than will power to overcome.
References
Dunlop, D. D., Song, J., Lyons, J. S., Manheim, L. M., & Chang, R. W. (2003). Racial/ethnic differences in rates of depression among preretirement adults. American journal of public health, 93(11), 1945–1952. https://doi.org/10.2105/ajph.93.11.1945
Mayo Foundation for Medical Education and Research. (2019, September 17). Selective Serotonin Reuptake Inhibitors (SSRIs). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825#:~:text=SSRIs%20treat%20depression%20by%20increasing,reuptake)%20of%20serotonin%20into%20neurons.
Pan, JX., Xia, JJ., Deng, FL. et al. Diagnosis of major depressive disorder based on changes in multiple plasma neurotransmitters: a targeted metabolomics study. Transl Psychiatry 8, 130 (2018). https://doi.org/10.1038/s41398-018-0183-x
World Health Organization. (n.d.). Depression. World Health Organization. Retrieved April 4, 2022, from https://www.who.int/news-room/fact-sheets/detail/depression
Zainal, N. H., & Newman, M. G. (2021). Increased inflammation predicts nine-year change in major depressive disorder diagnostic status. Journal of Abnormal Psychology, 130(8), 829–840. https://doi.org/10.1037/abn0000716.supp
On Psychology and Neuroscience 
This is a great post, thank you for sharing! Lately I’ve seen quite a few conversations on social media about how depression has become “a popular disorder”, somehow implying that it doesn’t need that much attention anymore. But I think that, even though people are more aware about it now, like you’ve pointed out, there are still a lot of misconceptions surrounding it and they need to be countered with reliable information.
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I have recently conducted a study in a seminar class pertaining to the public’s perception of the personality traits that those with psychological disorders may have. MDD is one of the disorders that we investigated, so I found this blog post to be very interesting and informative. Before reading your post, I was unaware of the racial misconceptions associated with the disorder, and I found that you did a great job of expressing the issue that such misconceptions can present. I also liked your final sentence that suggests that psychological disorders are not as easy to overcome as some may think – this is a notion that more people need to understand.
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Hi Lior!
Thank you for this post that explains the way mental health disorders can be disregarded both because of race and failure to understand that the disorder has the ability to manifest through biochemical markers not associated with mental will power.
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Great blog! I wonder how damaging the misconceptions around mental heath disorders primarily Depression, are for the people who actually experience it. Also considering all the cultural misconceptions surrounding MDD I wonder how that manifest in the quality of treatment given to people of color with depression. Do psychologist and psychiatrist also hold misconceptions about their patients and does that effect the way they decide to treat them.
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Really great blog post, it was really interesting to see how different societal norms affect how different minority groups deal with MDD. As a person of color, I can say that mental health is not largely talked about, and throughout many communities, there is the stigma that MDD is a “white person disease”. I also agree that MDD should not be a racialized disorder, as it affects all kinds of people. Something that I found really interesting was the treatment process of MDD, as they use SSRI’s, as well as the cytokine theory of depression, was very interesting to read about.
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After reading “You are what you eat,” I was drawn to this post because I wanted to learn more about depression. There is certainly a connection between the two posts as they both focus on developing a more accurate understanding of the complex phenomena that is depression. With respect to this post, I really liked how you explained how many people prematurely and incorrectly assume that depression is sadness. I find that many people are quick to generalize and believe depression is sadness when in reality there is so much more to depression than just sadness. Furthermore, I found it very interesting to learn about depression in the context of race. I do agree (even though I’ve never really taken the time to think about it) that depression is also prematurely and incorrectly assumed to be a “white people” disease. As a Latinx person, thank you for explaining how minority groups experience depression too. It was also interesting to learn how events like unemployment, which African American and other minority groups have experienced at higher rates, can trigger depression. Lastly, the biggest takeaway from this post was how unacceptable it is to say that depression is “all in someone’s head.” Not only does saying this make the person feel weak but it disvalidates what they are going through; as this post explains depression “can change your nervous system to prevent you from simply being able to get over it.” Thank you for sharing!
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From your blog, I learned that the public tends to associate major depressive disorder with race, and I am shocked to know that MDD is perceived as a “white people disease.” Moreover, I learned about the relationship between MDD and the change in the brain. It enlights people to learn about MDD in an objective way rather than assuming it’s due to patients’ weak will.
In my personality psychology seminar class, our team conducted a study on the public stigma of psychological disorders and we found that MDD is associated with the highest level of negative emotionality and the lowest level of extraversion among the 7 psychological disorders we investigated. As a result, MDD is associated with the most socially undesirable traits.
I hope to learn more about ways to reduce people’s negative stereotypes of MDD. In our seminar class, we were thinking about designing some programs that can acknowledge more people about MDD to reduce the stigma of the disorder. However, we realized that just knowing about MDD might not work well in reducing the stereotypes, so we wonder if there are other ways we can use to achieve the goal.
I like the picture (the maze in the brain) you used in the blog because it vividly depict the mindset of a patient with MDD.
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I thought it was really interesting how you emphasized how it is not beneficial / in fact harmful to tell someone suffering with MDD to “get over it” because the consequences depression has on our nervous system. Since therapy isn’t 100% effective and neither is the current antidepressants on the market, I wonder if researchers are exploring depression treatments related to nervous system regulation. I know EMDR is used for trauma and anxiety; it would be interesting to see how patients with MDD respond to alternative treatments like this.
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Hi Lior, this is a great topic to expand on. We talked this spring about MDD and treatment-resistant therapy, so I can see where you came up with a number of your topics for this blog post. I particularly enjoyed the pictures as well as how you broke down the biological basis for depression and possible combinations of therapy. This will, no doubt, be a debated topic as we move forward into 2025 as the opioid crisis continues to spiral out of control. I would love to hear more of your thoughts on this topic at a later date.
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This is a very important topic and I admire the emphasis you placed on cross-cultural differences in acknowledging and experiencing depression. I think that while there may be resources available to help different people cope with depression, it is important to consider how cultural differences and peoples’ backgrounds influence the circumstances in which they are taught to cope or even how they view depression. I also liked the way you acknowledged the misconception that depression is all in your head.” I took an I&O psychology class which delved into how this sentiment can especially manifest in the workplace, and among leaders. We talked about how depression is often an “invisible disability” because those that suffer from it may be reluctant to disclose it or feel uncomfortable discussing it with their coworkers or supervisor, and how this can be problematic and impair innovation, interpersonal relationships with customers and coworkers, time management, and workplace safety and vigilance. In fact, there was research to support that overall psychological health is a moderate to strong correlate of work performance.
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Hi,
It is interesting to me because I have learned that depression could be associated with people’s races. But people’s misconceptions about “White People Disease” is surprising to be. Because according to what I have learned in previous courses, depression have a lot to do with people’s gene. Two takeaways from this blog are that, first, when I met someone who is diagnosed with MDD I should not just tell them “you can do it” or “is all in your head”. Instead, I should tell them to see the doctor if they are still feeling depressed and ask them to take their medicine in time. Another takeaway from this article is that sad is not equal to MDD. Even though I have learned this before but when people talk about that again and again I would just keep on thinking that when someone is sad he may have MDD. In the future, I can tell people this is not when they talk about sad equals to depression and eliminate their stereotype about MDD.
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