Someone recently asked me to write on what I wish people knew about depression, in light of Robin William’s suicide. Here’s my response.

I wish people knew that depression is complex, that it is a physiological condition with psychological and spiritual components, and therefore can’t be forced into any neat and tidy box, that healing needs to come from lots of kinds of sources and that every person’s recovery is different.

I wish people knew the depression doesn’t happen in a vacuum and is part of a intricate web of biological systems (nervous, digestive, endocrine, respiratory), that depression is about the gut as well as the brain, the thyroid and the nerves, that we would have better health in this country if we approached depression with a holistic view.

I wish people understood that untreated depression can increase the risk of developing other illnesses, that a 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses (such as pneumonia and influenza), and conditions of the nervous system (like Parkinson’s disease and multiple sclerosis).

I wish people would offer those who struggle with depression the same compassion they offer to friends with rheumatoid arthritis, lupus, breast cancer, or any other socially acceptable illness, that they’d question those discriminations and judgments reserved for disorders that fall under the umbrella of “mental illness.”

I wish people knew that depression wasn’t something that can be cured by participating in a 21-day meditation series with Deepak Chopra or Eckhart Tolle on Oprah.com, and that although mindfulness efforts can certainly help, it’s possible to have consistent, chronic death thoughts even after years of developing a meditation practice.

I wish people knew you could be grateful and depressed at the same time, that gratitude can coexist with a mood disorder.

I wish people knew that, despite impressive research on neuroplasticity and our brain’s capability of changing, it is unfair to expect a person to undo depression by merely thinking happy thoughts, that the science is new and while a person can be mindful of forming new neural passageways, he can’t change a lamp into an elephant overnight, just as he can’t unthink a tumor from happening.

I wish people knew that medications don’t provide all the answers. They can begin the healing process and allow the other hard work to be done, but aren’t capable of fixing everything.

I wish people knew that millions of people don’t respond to medications, and that, while brain stimulation technologies offer hope for treatment-resistant depression, these persons are dealing with a different kind of beast altogether and should not be blamed for their chronic illness.

I wish people knew that a depressed person is capable of fake laughing for two hours through a dinner only to go home and Google “easiest ways to get cancer,” that most depressed persons deserve Academy Awards for outstanding acting, and that it can be practically impossible to pick up on the desperation and sadness in a person who wants so badly to die because chances are she is the one cracking jokes in a crowd.

I wish people knew that depression isn’t caused by constipated energy in the crown (or seventh) chakra or by the possession of demons in the soul, that neither reiki nor an exorcism is likely to cure it.

I wish people knew that the endorphins from exercise are as close as a depressive will get to an anesthesia for pain but that it’s possible to swim 5,000 yards a day or run seven miles a day and still be suicidal, that a sad swimmer can fill up her goggles with tears.

I wish people knew that while yoga is helpful for some, a person can walk out of the studio just as depressed as she was before Namaste.

I wish people knew how essential diet was to treating depression, but that you can eliminate gluten, dairy, caffeine, alcohol, and sugar from your diet — you can exist on green smoothies — and still be depressed, that fish oil, vitamin B 12, and a good probiotic could very well improve your mood, but that they aren’t magical elements.

I wish people knew that the worst part about depression is the sheer loneliness, the inability to express the anguish that rages within, and that the smiley-face culture we live in worsens that loneliness because depressed persons are so scared to tell the truth.

I wish people knew that persons who struggle with depression aren’t lazy, uncommitted, and weak, that they are not trying to get attention.

I wish people knew that depressed brains looked different on high resolution x-rays, that when experts scanned the brains of depressed people, they discovered that the front lobes of the brain displayed lower activity levels than those in non-depressed patients, that there are breakdowns in normal patterns of emotional processing, that depression can be associated with the loss of volume in parts of the brain and can inhibit the birth of new brain cells, which is why renowned psychiatrist Peter Kramer believes it is the “most devastating disease known to mankind.”

I wish people knew that taking one’s life can feel like sneezing to a severely depressed person, that it can be a mere reaction to the body’s strong message, that after fighting a sneeze for years and years, some people simply can’t not sneeze anymore, that they should not be condemned or demonized for sneezing.

I wish people knew that the hardest thing some persons will ever do in this lifetime is to stay alive, that just because staying alive comes easily to some, it doesn’t mean arriving at a natural death is any less of a triumph for those who have to work so very hard to keep breathing.

I wish people knew that the best thing you can do for a person who suffers from depression is to believe her.

I wish people knew that sometimes depression is triggered by something and sometimes it’s not, that sometimes one small thing is needed to pull a person out of darkness, and sometimes everything is unable to, that sometimes the only thing you can do is to wait for symptoms to subside.

I wish people knew that depression comes and it goes, and in its ebb and flow are found pockets of peace that can sustain a person for the journey.

I wish people knew, more than anything else, that there is hope.

Beyond medication and meditation.

Beyond fish oil and vitamin D.

Beyond acupuncture and yoga.

Beyond mindfulness and biofeedback.

Beyond cognitive behavioral therapy and brain stimulation technology.

Beyond every action imaginable, there is hope for depression.

In reaching beyond the self to others who understand the instinct to sneeze.

In sharing the familiar yet unique story of one’s illness.

In finding a purpose to live for.

In attaching every piece of the heart and soul to some meaning in this world.

In gently turning the pain and the bitterness to love and service.

Originally posted on Sanity Break at Everyday Health.

What I Wish People Knew about Depression