If you feel unwell, talking to your doctor or other health professional is an important first step. But if you're diagnosed with depression (or major depressive disorder, the medical term for depression), you may end up with more questions than answers. You might wonder why this has happened to you and how a diagnosis will affect your life. Receiving a diagnosis can be a difficult experience, but it's important to remember that you are not your diagnosis—you are a person that happens to be living with depression.
The medical system may not be the only way to deal with depression. You don't have to adopt a strictly medical point of view—some people find it helpful, but others don't. But you will likely have to work with people in the medical system, such as doctors and mental health professionals, to access treatments and other forms of support.
When you're diagnosed with a health problem, particularly a long-term health problem, it's normal to feel many different things. Depression is no different. Even if you've suspected depression for some time, hearing the diagnosis from a doctor can still be troubling. The way your health professional investigated your problem and explained the diagnosis to you can also have a big impact on how you feel about it. Many people feel some combination of:
Relief—My problem has a name, and now I know why I'm not feeling well.
Hope—I can find a treatment that works. Now I can figure out how to cope with depression.
Shock/Denial—This can't be happening. Not me.
Shame—This is a reflection on who I am as a person. I feel flawed.
Confusion—I don't understand what all of this means. I don't think my diagnosis matches how I see the problem.
Anger—Why did this happen to me?
Guilt—How did this happen? It's my fault.
Grief—My life will never be the same. I feel like I've lost myself.
Loss of control—I feel powerless. I don't know what to do.
You might have difficult thoughts around the diagnosis. On top of that, you may also be dealing with the negative feelings like guilt and self-blame that are part of depression itself. You may also worry how others will react.
With time, you will become an expert on your own mental health. But early on, all of the information can be confusing or even conflicting. All you need to know is that it’s okay to feel like you aren't sure how depression fits with your life, and that it's okay to take time to figure everything out. Most importantly, you are not alone.
It's easy to wonder if you caused your depression. Close family members may also blame themselves. No one is immune from depression. It isn't a moral weakness or a flaw in your character. Just like other health conditions, it's very rarely due to one specific thing.
"During the past two years my mental health has been challenged, and it's only recently that I've been properly diagnosed. Knowing that I needed medical attention for what was occurring was not something I was pleased about, given my independent nature. However, deep down I knew treatment was necessary ... If it were not for my [family doctor] and associate and staff, I don't know where I'd be today." —Kate (pseudonym)
It can take a long time to diagnose depression. It may have taken some time for you to realize something was wrong and find help. Next, your mental health professional must carefully look for clues based on your information. They may not give you a diagnosis until they understand how you feel. Your doctor may also have to see if any other problems may be adding to your mental health problems. Depression symptoms usually have to affect you for a period of time or follow a pattern, which can add to the length of time it takes to receive a diagnosis. Finally, your mental health professional will consider what's going on in your life before they make a diagnosis.
You are diagnosed with more than one mental illness—It's common for people to have more than one mental illness at the same time. Substance use disorders and many mental illnesses often go along with depression. Depression and anxiety disorders go together particularly often—half of people diagnosed with depression also experience with an anxiety disorder.
Your diagnosis changes—A diagnosis can change over time or when there's new information. Your mental health professional may uncover symptoms that point to a different diagnosis. You may also by diagnosed by someone with less experience recognizing your particular group of symptoms or someone who didn't spend a lot of time asking you questions.
Some people feel like their diagnosis doesn't fit with the way they see their problem. For some, it may be that the diagnosis was inaccurate. But others still feel like it doesn't fit, even after everyone has worked hard to find an accurate diagnosis.
During the early stages of any mental illness, people find a way to understand their symptoms. You may have thought that you were just more tired than usual in the early stages of depression. People around you may also reinforce that understanding. If your diagnosis changes, you may feel like your understanding makes more sense. Figuring out how any diagnosis fits with your life is a process that takes time. With a new diagnosis, you may have to start the same process over again. Feelings or assumptions like shame or fear can also make it hard to agree with a diagnosis.
Access to specialized health care programs or services is often based on a diagnosis. Even if you don't fully agree with it or understand the decision right now, a diagnosis can be a useful way to try different treatments and access health care providers.
Depression and bipolar disorder share some symptoms, but they are different illnesses that require different treatments. Bipolar disorder includes episodes of depression as well as episodes of mania. Mania can be harder to see, so bipolar disorder may be diagnosed as depression. Depression can be more troubling than mania, so many people seek help for depression first.
Common signs of mania include:
Feeling like you need less sleep
Feeling like your thoughts are racing
Taking on many tasks or making big plans that you can’t realistically complete
Taking big risks you wouldn’t normally consider, like going on expensive shopping sprees
Some people interpret mania as periods when they're simply "very creative" or "very productive," but mania can have a lot of negative consequences. It's important to see if mania is part of the picture so you get the right treatment and support. For more on mania and bipolar disorder, find bipolar disorder info sheets at www.heretohelp.bc.ca/bipolar-disorder.
A diagnosis is only a starting point. Even if you suspect that you've been living with depression for a long time, you likely need more information to help you on your recovery journey. This information will help you figure out what you need to do to rebuild and maintain well-being.
You might already know the basics of depression, like what the symptoms look like. If you don't know the basics, you need to ask questions from professionals and groups you trust. At some point, you'll need to go beyond the basics, like:
How depression may affect your life and what you can do about it
What treatments and supports are available
What you should expect in treatment and recovery
You can learn about depression from your health care provider, support group, community organizations, or on your own through books or websites. For more on finding quality information on mental health topics, see our fact sheet Evaluating Mental Health and Substance Use Information at www.heretohelp.bc.ca.
Once you've received your diagnosis, you may wonder if you should tell others in your networks. There may benefits and risks of disclosure in different areas of your life. For example, telling your workplace or school that you have a disability may allow you to make changes that help you work or study more effectively, but it can also open you to stigma and discrimination. You will have to think about the risks and benefits of disclosure as they apply to your own situation. For more on disclosing a disability (including a mental illness) at work, find Disclosing Your Disability: A Legal Guide for People with Disabilities in BC from Disability Alliance BC at disabilityalliancebc.org/disclosureguide/.
It may take time to find the exact combination of treatments and support for you, but you can expect to feel better. With treatment, at least 80% of people recover.
Most people talk about recovery in terms of controlling symptoms so they can live well without letting depression get in the way. Everyone's recovery journey looks different. Some parts may take a long time, while others will pass quickly. You may even take a few steps back from time to time. What matters is being kind to yourself, working on your health in a way that makes sense to you, and seeking extra support when you need it.
Working through it: Thinking about your diagnosis
Writing your thoughts, concerns, questions and goals down can be very helpful tool to help you make sense of your diagnosis and next steps. Working it out by writing can also help you describe what you’re going through to loved ones or health professionals. Also, if you need to access different services and supports, various professionals may start to ask you about your diagnosis including who provided the diagnosis and when it happened. Writing things down can help you remember what you’ve been told. If you add your thoughts and concerns too, writing can help you see your own progress over time in your recovery journey.
How to start
Before you can be expected to deal with your diagnosis, you need to be able to put your diagnosis into words. Answer the following questions in your journal:
What diagnosis were you given?
Who provided you with the diagnosis?
When was it given to you (date)?
Did anyone else confirm this diagnosis? When?
What investigations were done to arrive at the diagnosis?
In lay words, what does this diagnosis mean? What does it involve?
What questions did you ask after you were given the confirmed diagnosis? If you can remember, what answers were you given for your questions?
How much did you already know about depression? Little? Some? A lot?
What attitudes and assumptions did you have about people with depression before this?
How much do you accept this diagnosis? Fully, Unsure, Don’t accept it?
How much does it make sense with what you were experiencing?
Do you plan to share your diagnosis with loved ones? If so, what will you say? to whom? when?
It’s important to be kind to yourself during times of stress. What things are you doing—or what are you going to start doing now—for yourself as a result of this diagnosis?
Now that you have identified the diagnosis, you’re ready to think about how you’re handling it. Answer the following questions in your journal:
How well do I handle questions from my loved ones about my condition?
How well do I relate to the professionals involved in my care?
How comfortable would I feel in contacting a mental health organization or support group for help?
How much hope do I have for the future? How realistic is it?
How much support do I feel from my loved ones in handling the reality of my diagnosis?
What hardships or roadblocks do I foresee in getting the best care for myself?
Once you have assessed how you’re handling your diagnosis, you’re ready to develop a plan of action for yourself. Write this plan of action in your journal:
My Plan of Action to Handle my Diagnosis
The diagnosis I have is:
My next appointment with my health professional is:
I will get answers to the following questions about the diagnosis:
I will seek to become fully aware of the full details of the diagnosis and long-term outlook by (date):
I will get answers to the following questions I have about treatment:
I will perform the following tasks to help myself:
I will connect with (person, people, groups) to get support when I need it:
I will look after my health by doing my best to:
I will reassess these goals every (period of time). My first review date will be (date):
If this exercise doesn’t help
If you continue to have a hard time coping with a diagnosis, it’s a good idea to reach out for help. You could talk to a mental health professional like a counsellor, a support group for people with depression, or a trusted friend or family member.
This journal exercise has been adapted from a resource developed by psychologists James J. Messina, PhD and Constance M. Messina, PhD.
If you're having a hard time coping with your diagnosis, you may want to consider outside help. Here are some places to look:
Your family doctor
A mental health organization like the Mood Disorders Association of BC or the Canadian Mental Health Association
A trusted friend or family member
An online support group
A private psychotherapist or counsellor
Your local mental health clinic or centre (you may need a doctor's referral)
Your doctor or mental health professional can recommend resources in your community. In addition to professional resources, you may find non-professional support helpful. Here are some other places to look for help:
BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for more info sheets on depression and mood disorders, self-tests and personal stories. You can also find fact sheets on working with your health care provider and preventing relapse from depression.
Support groups are an important way to find support and information. They may help you feel less alone and more connected, even if you haven’t told many others about your diagnosis. You can find support groups in your community through the Mood Disorders Association of BC online at www.mdabc.net or by phone at 604-873-0103. You can also find support groups online. For more on choosing the right support group for you, see the fact sheet Choosing the Support Group that's Right for You.
About the author
The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.