On Gratitude and Depression

With the past week’s celebrity suicides of Kate Spade and Anthony Bourdain, mental health is on the minds of many of us, which means that many of us are looking for solutions to the problems of depression and suicide. One solution that pops up a lot is that gratitude can effectively combat depression and prevent suicide. I’ve heard this in multiple places, and the link between gratitude and depression is brought up frequently. I don’t think this is wholly wrong; however, I also don’t think it’s wholly right. That gratitude cures depression only tells part of the truth, and that gap can be dangerous for some in the depths of depression.

The disagreement, I think, hangs on the concept of depression as a singular thing, but there are at least two kinds: situational and chronic. Situational depression is a normal reaction to trauma or negative events in life. When something in life has got you down, that’s when gratitude can really help bring you back up. But negative events aren’t the only cause of depression, and that’s where we get into dangerous territory.

The thought that gratitude prevents depression and suicide is a bit like the thought that swimming prevents drowning. It makes sense and is true in a lot of cases, but there are some other major factors to consider that tell the rest of the truth. Some of us were not expecting to be thrown into the water and are so weighed down by what we carry that no amount of swimming can keep us above water. Some of us have been trapped in a vast ocean with no land in sight and have been treading water for quite some time to no avail. Some of us got hurt, which impaired our ability to swim and made swimming even short distances very difficult or even impossible. To a normal person close to shore, swimming is the perfect solution, but the real problem cases are the ones that don’t meet that criteria.

Also implied in this idea is the notion that the people who live with depression for years or eventually resort to suicide simply didn’t try hard enough. That we’re weak and took the easy way out. Let me be clear: I don’t think the people making these claims mean to imply that. But that doesn’t mean that people don’t hear it. Understanding around serious depression is generally poor, so, without extra care given to clarity on this subject, it’s very easy for people to fill in the gaps with what they already believe. For those dealing with the recent loss of a loved one due to suicide, this idea does little more than heap guilt onto the survivors.

Chronic depression itself is often thought of as an emotional disorder, but it’s actually a physical disorder. When you do something that makes you happy, your brain releases chemicals to trigger that physical response in your body: dopamine, serotonin, and oxytocin. That warm feeling you get when you accomplish something? That’s dopamine. That feeling of joy that rushes through you when something really good happens? That’s serotonin. That feeling of connection you have when you cuddle with a loved one? That’s oxytocin. These are the reason we feel happy or contented. In fact, addictive drugs that bring about happy feelings simply trigger the release of these brain chemicals. That’s how powerful they are.

Research is still emerging on this (and I’m admittedly not an expert), but depression is thought to be brought about by inflammation localized in a few spots in the brain — a physical condition. When those parts of the brain are inflamed, it causes what’s called chronic depression. This means that the depression is not brought about by any stressor (an emotional response), meaning it’s there until the brain decides it shouldn’t be inflamed anymore.

So those two brain chemicals I mentioned earlier? Chronic depression inhibits the brain’s receptors to those chemicals. So with depression, when you accomplish something, less dopamine is absorbed and you don’t get that feeling of accomplishment; when something good happens, less serotonin is absorbed and you don’t get that feeling of happiness; when you spend quality time with a loved one, less oxytocin is absorbed and you don’t get that feeling of connection. This is the real pain of depression. It’s not that we forget or can’t find the reasons to be happy — it’s that our brains literally cannot process that, and things that used to make us happy now do very little or nothing for us.

Depression is a heavy burden when it hits, but it can be devastating when it goes on for months or even years. Deprivation from those brain chemicals has physical symptoms too, like fatigue, pain, and digestive issues. Think about drug addicts who go into withdrawal when they suddenly quit. That’s actually pretty similar to what depression feels like. And when that feeling goes on for months or years, it is soul-crushing.

Anyway, I need to bring this all back to the original research around gratitude and depression. As this article in Psychology Today states, gratitude can do great things for you, but it does it by triggering the release of those brain chemicals. It does nothing to improve the receptors in the brain. Gratitude is amazing at lifting your spirits when something in life has got you down (situational depression), and there’s lots of research to support that, but it’s far less effective when you’re depressed for physiological reasons with no root cause (chronic depression). So gratitude is, at best, a temporary reprieve from the chronic emptiness of depression, and at worst another reminder that nothing we can do will give us those feelings of joy until the episode passes.

Furthermore, most of us with depression are quite aware of the mood-lifting effects of gratitude — but we’re not all aware of its mixed results on people with chronic depression. If you hear that gratitude can make your depression better, but it’s not making your depression better, the thing you’re left with is that you’re simply not trying hard enough. This is why this idea is so dangerous. With depression, you can feel not only that nothing will ever get better, but also that you’re to blame for your mental condition, and this idea makes that way worse.

I’ll reiterate that people saying that gratitude will help depression are not trying to hurt anyone. In fact, they’re putting forth some effort to help people they care about. This is a case of people trying to help, but needing a little direction on how to help, and that’s what I’m hoping this article provides.

If you’re depressed and gratitude is not the magic cure you were looking for, that’s alright. It’s not your fault. Some cases of depression hit harder than most, and it’s very possible that you have one. If that’s you, I urge you to reach out to someone for help.