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The Anger Iceberg

SOURCE:  Kyle Benson/Gottman Institute

Have you ever wondered why we get angry? According to psychologist Daniel Goleman, “emotions are, in essence, impulses to act, the instant plans for handling life that evolution has instilled in us.”

In his book Emotional Intelligence, Goleman tells us that anger causes blood to flow to our hands, making it easier for us to strike an enemy or hold a weapon. Our heart rate speeds up and a rush of hormones – including adrenaline – create a surge of energy strong enough to take “vigorous action.” In this way, anger has been ingrained into our brain to protect us.

The purpose of anger

Think of anger like an iceberg, a large piece of ice found floating in the open ocean. Most of the iceberg is hidden below the surface of the water. Similarly, when we are angry, there are usually other emotions hidden beneath the surface. It’s easy to see a person’s anger but can be difficult to see the underlying feelings the anger is protecting.

For example, Dave believed he had an anger problem. When his wife would make a request of him, he would criticize her. He didn’t like his reactions, but he felt he couldn’t help it. As he worked on mindfulness and started noticing the space between his anger and his actions, he opened up the door into a profound realization.

He didn’t really have an anger problem. Instead, he felt like his wife was placing impossible demands on him. By seeking to understand and accept his anger, rather than fix or suppress it, he began to improve his marriage by recognizing his anger as a signal that he needed to set healthy boundaries for what he would and would not do.

Dave’s story points out an important concept. As Susan David, Ph.D., author of Emotional Agility says, “Our raw feelings can be the messengers we need to teach us things about ourselves and can prompt insights into important life directions.” Her point is there is something more below the surface of our anger.

Anger as a protector of raw feelings

Anger is often described as a “secondary emotion” because people tend to use it to protect their own raw, vulnerable, overwhelming feelings. Underneath Dave’s anger was pure exhaustion and feeling that he wasn’t good enough for his wife. So his anger was protecting him from deeply painful shame.

Learning to recognize anger as a protector of our raw feelings can be incredibly powerful. It can lead to healing conversations that allow couples as well as children and parents to understand each other better.

Below is what we call the Anger Iceberg because it shows the “primary emotions” lurking below the surface. Sometimes it’s embarrassment, loneliness, exhaustion, or fear.

anger-iceberg-1

3 tips for listening to anger

One of the most difficult things about listening to a child or lover’s anger, especially when it’s directed at us, is that we become defensive. We want to fight back as our own anger boils to the surface. If this happens, we get in a heated verbal battle which leaves both parties feeling misunderstood and hurt. Here are three powerful tips for listening to anger.

1. Don’t take it personally

Your partner or child’s anger is usually not about you. It’s about their underlying primary feelings. To not taking this personally takes a high level of emotional intelligence.

One of the ways I do this is by becoming curious of why they’re angry. It’s much easier for me to become defensive, but I’ve found thinking, “Wow, this person is angry, why is that?” leads me on a journey to seeing the raw emotions they are protecting and actually brings us closer together.

2. Don’t EVER tell your partner to “calm down”
When I work with couples and one of the partners get angry, I have witnessed the other partner say, “Calm down” or “You’re overreacting.” This tells the recipient that their feelings don’t matter and they are not acceptable.

The goal here is not to change or fix your partner’s emotions but rather to sit on their anger iceberg with them. Communicate that you understand and accept their feelings.

When you do this well, your partner’s anger will subside and the primary emotion will rise to the surface. Not to mention they will feel heard by you, which builds trust over time.

Maybe you grew up in a family where anger wasn’t allowed, so when your partner expresses it, it feels paralyzing and you freeze. Or maybe you try to solve their anger for them because their anger scares you. Open yourself up to experience you and your partner’s full spectrum of emotions.

3. Identify the obstacle
Anger is often caused by an obstacle blocking a goal. For example, if your partner’s goal is to feel special on their birthday and their family member missing their special day makes them angry, identifying the obstacle will give you insight into why they’re angry.

The bottom line is that people feel angry for a reason. It’s your job to understand and sit with them in it. By doing so, you will not only help them to understand their anger, but you will become closer to them in the process.

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What Research is Telling us About how Pornography is Impacting Long-Term Romantic Relationships

A few years ago, I was sitting in front of my class of graduate students in a therapy training program when one of the students was describing some difficulty he was having with a case diagnostically coded in the DSM-5 (basically the diagnostic bible for mental health), but with a relatively rare prevalence. It made treatment trickier than some of the more common presentations assigned to the rest of his cohort.

Trying to empathize, I said that I could remember almost three decades earlier when I was assigned the only pornography case in the clinic, which was also associated with other paraphilic behaviors identified in the DSM-III-R (the version of the DSM at that time—which has since been altered to exclude any reference to sexual addiction). I added that as an early 20-something female, I had a “why me,” attitude when the intake staff informed me that they specifically wanted me to take the case so the male would have a real-life experience with a female instead of objectifying females in images.

The disbelief in the room was palpable. It took me a minute to decipher the incredulous stares boring into me from around the table. Suddenly, it clicked, “Oh,” I recognized, “You’re all thinking I can’t be telling the truth because you can’t imagine a time when couples weren’t bringing compulsive pornography use in as a problem at least 50% of the time, right?” “Yeah,” one student confirmed, “What do you mean you had the ONLY case of compulsive porn use?”

I knew it was the only case back then because the intake staff had driven the point home, explaining why they wanted me to agree to take it. “Well,” I continued, “Who in here is aware that Gambling Disorder is in the DSM?” All the hands went up. “OK, now, who in here is treating a gambling disorder case right now?” No hands went up. “So, you know it exists as a clinical presentation, but no one in here has that type of case. Well, that’s what compulsive pornography use was like before the internet.”

As I said the words out loud, a wave of nostalgia flooded my system. After watching the proliferation of compulsive pornography use through the decades, I longed for a return to the 80’s. I had anecdotally seen a shift in how pornography was impacting marriages, in a way the larger mental health community refused to openly acknowledge because the research was lagging and qualitative processes are always difficult to measure. Besides that, pornography covers such a broad range of materials and behaviors that trying to conceptualize it to regulate it is problematic when it’s viewed as normative and acceptable in varying degrees by a large percentage of the population. Another problem diagnostic professionals face is where to draw the line when pathologizing a natural biological human drive (except the DSM has an entire section on eating disorders, including binge eating–so…….).

However, regardless of whether pornography use is mentioned in the DSM, or whether it is officially an “addiction,” or not, it is showing up in couples’ therapy sessions in record numbers, and NOT just in religious populations. I tire of conservative religions taking the heat for sexual problems when the broader cultural messages and displays of sexuality are at least as much or more complicit in contributing to constraining sexual scripts for both males and females, which exacerbate disconnection in couples. In fact, research is verifying a clear decrease in religious beliefs and behaviors in general, so any increases in couples’ sexual challenges don’t seem to be correlated with increased religiosity (not to mention the fact that research also shows that higher rates of religiosity are significantly correlated with lower rates of pornography consumption).

The fact is that most media presentations of sexuality are dramatized and dichotomized in a way that denies the more complex and incremental ranges that exist for most people.Authentic displays about the emotional processes inherent to sexual intimacy are mostly absent at the societal level. Healthy relationship models of sexuality are nearly non-existent.

In my clinical opinion, many of the problems that come up with porn use in marriage have less to do with religious imperatives and more to do with attachment processes in long-term monogamous relationships. Sexuality is an expected part of a long-term monogamous romantic attachment, and is generally laden with special meaning. An expectation of sexual fidelity is normative in marriage. While some people report that porn can be beneficial to creating an erotic climate, or increasing comfort with sex, there are many partners who view it as betrayal and it makes them question whether they are loved or not.

Even in instances of consensual polyamory, attachment processes come into play in often unanticipated ways. I once attended a training with marriage researcher Dr. John Gottman in which he was questioned about long-term research related to polyamory, and he replied that his institute had problems gaining longitudinal research on those couples because they weren’t stable enough; in other words, too many of them ended their relationships to provide enough reliable data, implying that the lifestyle isn’t necessarily tenable for long-term couple relationships. Whenever I have treated polyamorous couples in therapy (which is admittedly not a lot), it is also my experience that they might agree to the arrangement but then struggle with emotions that arise when attachment security and a sense of “specialness,” to their partners are questioned. They start worrying that their partners will start caring about someone else more, and it often creates emotional pain for which they are unprepared. When many engage in the process, they report that it wasn’t “just sex,” like they thought it would be–there was emotional meaning attached.

Religious or not, many couples are displaying clinical challenges related to increased pornography use. After seeing hundreds of couples as a clinician and as a supervisor to therapists, if I said otherwise, it would be a lie. There are some anecdotally discernible differences in couples now compared to three decades ago, directly related to pornography. Now, research is emerging verifying the clinical challenges I have witnessed for some time.

Here is a short summary of what some of the research indicates about pornography use and its impact on marriage and other long-term romantic relationships, and which I have also seen clinically.

  1. Male pornography use is correlated with lower sexual satisfaction for both the porn users and their partners(and sexual satisfaction is highly correlated with overall relationship satisfaction, so relationship happiness is likely collaterally impacted through this pathway).
  2. Some studies have shown that male porn use is associated with lower interest in relational sex, and lower satisfaction with sexual partners.
  3. In some studies, porn use was related to weakened commitment to romantic partners (as measured by both self-report and outward observation).
  4. Porn use is associated with higher rates of extra-relationship flirtation, considering alternative partners, and infidelity.
  5. Women whose spouses use porn report lower self-esteem and increased insecurity about physical appearance.
  6. Some studies show that higher porn use is related to higher divorce and infidelity.
  7. Some research shows an association between higher porn use and less global happiness.
  8. Recent longitudinal research (2017) shows that higher rates of porn use are associated with decreased marital quality OVER TIME (this matters, because most of the research is cross-sectional, so cause and effect can’t be determined).
  9. Females whose partners use porn report decreased attraction for their partners and more damaged senses of self.
  10. Increased porn use is sometimes associated with a negative impact on financial well-being and work productivity, which impacts relationships.

It’s important to note that men use pornography at a higher rate than females. The research has demonstrated some subtle differences among gender. It seems that female use doesn’t necessarily have the deleterious impact on marriage that male use has, which could be that females use porn more frequently in a relational context while men use it more individually, or that the fewer females users don’t provide enough statistical power to show significant associations.

Also, most porn research has been cross-sectional, self-report, which can be biased, and with limited sample sizes, so generalizability is limited. Longitudinal research that is finally emerging is demonstrated more causality between porn use and decreased relationship quality.

What have I seen clinically?

For what it’s worth, as a clinician, I have seen several changes in couples that I believe have arisen from increased porn use. I’m just one clinician, but in my conversations with other couples’ clinicians, they are verifying these shifts as well:

  1. More instances of low relationship sexual desire in porn-viewing males and females married to porn-viewing males. I was learning sex therapy back in 1989-1990, and fewer instances of low male desire in young adults appeared clinically than now.
  2. More instances of male erectile dysfunction. I used to see this presentation almost exclusively in older males or those with a health condition. Now, I see it in young men with no known medical conditions, but with high rates of porn use.
  3. More instances of lower sexual quality reported for males and females. 
  4. More instances of males blaming their inabilities to perform on their partners’ appearances.
  5. More instances of wives’ unwillingness to engage in sexual experiences, often because they don’t want to be compared to pornography. In general, sexual safety is diminished.
  6. More women reporting what looks like a type of porn betrayal trauma in which they can’t safely engage in sex because images of what their partners may have been viewing flash in their heads.
  7. More women reporting inability to engage sexually because of increased self-monitoring about their own bodies, after feeling compared to pornography.
  8. More women reporting feeling manipulated into sexual behaviors with which they are uncomfortable, reportedly introduced by pornography.
  9. Seeming lower relational sex frequency. Again, I don’t have research numbers on this–it’s just a clinical impression. It seems like couples are having less relational sex in part because porn users are having sex by themselves with porn.

In many ways, sex therapy was easier back in the early 1990’s. I actually had an easier time getting females to engage in sex therapy exercises because to them, collaboration didn’t feel like competing with supernormal images.

One of the biggest indicators that pornography is a problem appeared via an open letter on pornography posted by Dr. John Gottman, viewable here. He is a gold star researcher. Like many clinicians, he used to support couple porn use for upregulating desire and sexual quality. This letter explains how he has shifted his position because the supernormal images presented in porn have a negative impact, as well as increased portrayals of violence toward women.

Anyone who says pornography isn’t having a negative impact overall on long-term marriage is either lying, ignorant, or in denial.

Some of the studies including for this post are listed below, and the abstracts are easy to find online for anyone interested. There are many resources available for people who want to decrease porn use, or feel betrayed and injured by partners who use porn. Patrick Carnes and his daughter, Stefanie Carnes, have worked extensively in this area. I recommend both authors’ books to couples who want to deal with compulsive pornography use.

References:

A Love That Doesn’t Last: Pornography Consumption and Weakened Commitment to One’s Romantic Partner (2012) by Lambert, N. M., Negash, S., Stillman, T., Olmstead, S. B. & Fincham, F. D. in Journal of Social and Clinical Psychology, 31(4), 410-438.

Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data (2017), Perry, S. L. in Archives of Sexual Behavior, 46(2), 549-559.

Pornography and Marriage (2014) by Doran, K. & Price, J. in Journal of Family and Economic Issues, 35:489-498.

Pornography Use: Who Uses It and How It Is Associated with Couple Outcomes (2013), Poulsen, F. O., Busby, D. M. & Galovan, A. M. in Journal of Sex Research, 50(1), 72-83.

Photo credit: Copyright: georgemuresan / 123RF Stock Photo

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Is Pornography Considered Adultery?

SOURCE:  Leslie Vernick

Sadly, many men struggle with pornography and sexual addiction these days. Satan has a foothold into men’s hearts and homes, and the church hasn’t done a very good job at validating the devastating effects this habit has on one’s mind, body, spirit and marriage.

Perhaps some church leaders are reluctant to come down hard on this problem because they fear what might happen. According to surveys conducted by Barna Research, a sizable percentage of pastors also struggle with pornography problems.

Secular research and brain science are starting to speak about the damaging effects of watching pornography. Here is a link to an article and TED talk that is sobering to watch. Every adult and ministry leader should watch this.

Jesus takes this issue of pornography very seriously. He says, “You have heard the commandment that says, ‘You must not commit adultery.’ But I say anyone who even looks at a woman with lust has already committed adultery with her in his heart. So if your eye – even your good eye – causes you to lust, gouge it out and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell. And if your hand – even your stronger hand – causes you to sin, cut it off and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell.” Matthew 5:27-30

Jesus says don’t mess around with this. He tells people to take decisive action if they have this problem. Gouging out your eye or cutting off your hand will not keep you from lusting, but what Jesus meant was, DO what it takes to deal with this problem NOW. Sadly, many men don’t listen.

Instead, they play with fire thinking they won’t get burned. But they’re wrong. The Bible is full of warnings about sexual immorality and the consequences of unbridled lust.

For example, Paul writes, “there should be no sexual immorality among us and that such sins have no place among God’s people.” He goes on to say, “we should not be fooled by those who try to excuse these sins, for the anger of God will fall on all who disobey him.” And later he tells us to “expose the worthless deeds of evil and darkness.” (See Ephesians 5).

Does this mean porn is the same as adultery? Jesus says it is, as does Peter (2 Peter 2:14). And if it’s repeated and unrepentant, it may be Biblical grounds for divorce. The question that determines what happens next is what is a man’s response to his problem with pornography and lust?

Does he hate it? Is he repentant? Is he doing everything within his power to stop and eliminate this habit, even when it costs him? For example, is he willing to be without the Internet? Is he willing to put controls on his computer? Is he going for help with his thought life? Is he honest and open with others about his struggle and is he willing to be held accountable? And, is he grateful for a wife who holds him accountable for his behaviors so that he doesn’t burn himself and his entire family down to the ground with his own foolish fantasies?

If so, then a Christian wife’s response would be to be gracious and forgiving, coupled with an uncompromising stance against allowing such evil in her home and marriage. No woman in her right mind, Christian or otherwise, would allow her husband to bring another woman into their home to have sex.

In the same way, if he is not repentant or desiring to change, no woman should turn the other way or close her eyes to knowing her husband is ogling another woman or watching pornography. It degrades her, demeans him, and demeans the women he ogles.

It’s time women draw a line in the sand for the wellbeing of their marriage, family, and their spouse and say, “No more. If that’s what you want I can’t stop you, but I won’t live like this.”

This is a tough stance but Jesus and Scripture call for tough stances. If your husband won’t, you must. If you don’t your husband will continue to behave as if he can have his cake and eat it too. He can enjoy all the perks of home, marriage, and even family but still live treacherously and lustfully. Don’t let him.

Remember, this is not just his life it’s yours too. Your strong stand may be the one thing that will get his attention and hopefully motivate him to face his issue. If he refuses, then it’s time you quit enabling his habit to destroy you and your children.

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How to Avoid Codependency When You Help Someone in Need

Great article for sponsors!

SOURCE:  Dr. Henry Cloud

Challenge Codependency occurs when we don’t have an accurate awareness of our boundaries and behaviors, and we allow someone else’s needs to control and take over our lives.

Solution You may be inclined to jump in and “save the world.” But there are better things you can do for that individual that will improve their quality of life and spare you from the toxicity of a codependent relationship.

“I’ve been in an accident,” Bethany whimpered. Her voice was filled with pain-staking fear. “I’m ok, but can you come get me?”

I assumed she meant the hospital. She was sitting in jail.

My blurry, tired eyes adjusted to the harsh glow of my cell phone as I looked at the time. If I left within the next few minutes, I’d have a head start on morning rush hour.

As I pulled up outside the Metro Detention Center, I saw Bethany waiting on the sidewalk for me. She stood there looking down at the ground with a defeated look on her face, perhaps still hungover. Her arms were crossed over her torso, clinched tight around her frame.

My door locks clicked. She got in my car, never lifting her head. Her disheveled hair draped over her eyes as if to hide her embarrassment. I didn’t even make it to the first traffic light before her face fell into her hands. Bethany let out deep sobs with diaphragmatic breaths. I offered a napkin from my center console.

“I hit a pole,” she quivered. “No one else was involved, but I think I have a drinking problem, and I honestly have no idea what to do right now.”

When you watch a friend or loved one struggle with pain in their life, your first response may be to do whatever it takes to ensure they don’t have to endure any more than they have to.

Why?

Although you care for that person, what you’re witnessing is uncomfortable for you, so you may be inclined to jump in and be the hero. But there are better things you can do for that individual that will improve their quality of life and spare you from the toxicity of a codependent relationship.

1. Show empathy
Though I had never been in Bethany’s situation, I knew what it was like to experience sadness. I was all too familiar with hurt, and I understood what it meant to feel shame. Bethany didn’t need me to tell her what she had done wrong. She knew, and if I spent time telling her what I think she should have done, it would have closed the door to trust.

2. Set and maintain boundaries
Bethany was in need of emotional support, and the circle of people she trusted was small. She was having trouble processing her feelings and was having anxiety over the legal consequences she’d have to endure. She called frequently, all hours of the night, and while I was at work.

After a few days, I had to let her know I couldn’t always answer the phone, so I sent her a text. “Hey, Bethany. I’m sorry you’re experiencing this right now. I can’t talk at the moment but let’s set aside a time later this week, and I’d be glad to listen to you.” It may have hurt her feelings, but it saved my sanity.

3. Remember it’s not your battle to fight
Bethany had lost her car, her job and her dignity. She was facing more jail time, and it was becoming increasingly difficult to watch her struggle. Part of me wanted to help her make everything go away, but I couldn’t step in and offer to pay her attorney or her court costs.

I knew that what was happening in her life was part of her journey, and if I disrupted the course, I would be denying her the lesson she was meant to learn. If Bethany was going to change, she would have to endure the consequences of her actions.

4. Realize you can’t change someone
I helped Bethany find several local AA meetings to attend and put her in touch with an outpatient recovery program, but I couldn’t make her go. It had to be her decision. Sometimes she went; sometimes she didn’t, and I couldn’t force her into making the choice I wanted for her.

5. Your feelings matter, too
Helping someone in need can leave you feeling exhausted, resentful, angry, hurt, sad or frustrated. Not only is it ok to have these feelings, but you need to be able to express them to the person you’re helping. Sometimes I had to tell Bethany, “You know, what you’re going through is really tough, but I’m feeling overwhelmed with helping you right now.”

When you feel compelled to help someone with a serious problem, whether it’s out of love or as a favor to a friend, it could breed a codependent relationship if you continuously sacrifice your needs for the benefit of someone else. There are myriad reasons why you may find yourself in such situations, but by having an awareness of your own habits and behaviors, you can avoid a potentially dysfunctional relationship.

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How People With Depression Interact With The World Differently

SOURCE:  Lindsay Holmes

The condition has a huge impact on everyday life.

Nothing about depression is easy. But the way it affects a person’s daily life is arguably the most difficult part of the disorder.

Approximately 300 million people globally are affected by depression, according to the World Health Organization. Not only does it create emotional health issues, like excessive rumination and lack of motivation, but it also causes physical health problems, like headaches and trouble eating. It can also cause fatigue, irritability and difficulty concentrating.

The reality is that these symptoms all have a significant effect on routines, from running errands to social situations to even just going to sleep. As with any medical issue, the more knowledge you’re armed with, the better. That’s why we rounded up just some of the ways depression influences a person’s day-to-day life.

Below are a few ways people with the disorder interact differently with the world compared to their peers:

People with depression often ignore routine appointments.

For most, haircuts or dermatologist visits are expected blips on the calendar. However, depression can make these events feel like monumental tasks.

A case in point is a heartbreaking account from Kate Langman, a Wisconsin-based hairstylist. Her Facebook post  went viral after she shared the story of a client with depression who came into the salon.

“She couldn’t get out of her bed for 6 months. Which meant she didn’t wash her hair or brush it,” Langman wrote.

Going to a simple, menial appointment is often one of the biggest victories.

They might snooze more than most.

Depression often leads to increased fatigue and irregular sleep patterns. This means that those living with the disorder may sleep more than usual or even experience insomnia.

This might not sound so bad in theory: Naps are awesome, right? But as writer Cory Steig put it in a Refinery29 post, napping when dealing with depression is more draining than anything:

[Y]ou know you’re probably not going to wake up refreshed and energized enough to take on the task you’re supposed to be doing instead of taking a nap.

They might leave work to-do lists unfinished.

The mental health disorder can take a toll on a person’s work performance. Symptoms like a lack of motivation or energy can prevent an individual with the condition from accomplishing tasks.

Or, the illness can keep people out of the office altogether: Employees with the condition miss approximately four workdays every three months due to its effects, according to data from the U.S. Centers for Disease Control and Prevention. Serious mental illness costs the country more than $190 billion in lost earnings every year.

People living with depression may avoid fun activities.

Depression can cause a lack of interest in thing people once found pleasurable. That could mean going to parties, participating in sports or even engaging in sex is no longer the norm.

“Depression makes your life dramatically different,” Dr. John Greden, executive director of the University of Michigan Comprehensive Depression Center, previously told HuffPost.

Depression makes them see things through a glass half empty.

The condition often makes the person living with it see everything from a pessimistic perspective.

“Depression is a negative view of self, of the world and of the future,” Greden said. “Everything is sort of being seen through dark-colored glasses … It’s pretty common, when people are depressed, for them to think that no one understands them ― and that’s a really tough place to be.”

People with depression have brains that are more prone to stress.

While some cases of depression can be acute and circumstantial (i.e. getting laid off of a job or going through a trauma), others can be more biological in nature. Research suggests depression can be influenced by environmental and genetic factors. A 2014 study even found that depression might make that person’s brain more susceptible to psychological stress.

In other words, the condition isn’t just something they “made up” or can “get over” so quickly. It’s a physiological issue that requires care.

Depression makes them want to push others away.

A common side effect of depression is changes to relationships. People living with the disorder may start to withdraw from their friends and family, and the mood symptoms may cause them to become irritable or angry.

That being said, a little encouragement can go a long way. Reader Avarie Downs, who identifies as having high-functioning depression, points out that even just an affectionate gesture can make a huge difference:

I wish he knew how overwhelming being sad during a depressive state is … sometimes it would be really nice to get a hug, instead of just the cold shoulder and being ignored because it is difficult to understand. Support is worth more than words could ever say.

Experts also recommend letting people with depression know that they’re not alone. Offering to listen to them talk about their experience or accompanying them to therapy can also help.

People with depression may need to see doctors more regularly.

Depression not only needs to be treated by a professional, but it also could put the person at a greater risk for other illnesses. So seeing doctors, between primary care physicians or mental health workers, on a more regular basis is so key when it comes to managing the condition.

“Depression is a common problem,” Ken Duckworth, medical director of the National Alliance on Mental Illness, previously told HuffPost. “There shouldn’t be shame in seeking help for that. People wouldn’t feel shamed if they got help for a broken arm. Depression is much like that. It’s treatable and you should tend to it.”

Ultimately, depression ― just like any other medical illness ― alters a person’s daily existence. And the more people keep that in mind, the less stigma and more understanding there will be about what it means to live with the disorder.