When 'Just Think Positive' Does More Bad Than Good for People With Major Depressive Disorder

There is a lot of advice out there about thinking positive thoughts, including what to say to yourself and how to say it. Write daily affirmations in a journal. Write positive things about yourself on Post-its and put them on your bedroom walls. Look in the mirror, force your mouth into a smile, tell yourself, “I love you, you’re great, you’re strong.”

In and of themselves, these are affirming statements and actions. There is research about how smiling leads to a better mood compared to frowning, how your brain chemicals respond to the positivity and negativity of words, and the beneficial effects of practicing positive habits. Many people engage in positive thinking and feel that it has a positive impact on their lives. Positive thinking practices are a part of CBT and often suggested early in the therapeutic process to combat various forms of depression, anxiety, and other mood disorders. But it doesn’t always work. And, it can actually harm those of us with major depressive disorder. At times, trying to pull the positivity out of us can make us feel more worthless and exacerbate our symptoms.

Depression has come in waves throughout most of my life. I was 16 when I first remember experiencing the symptoms of depression without being able to pinpoint a reason or cause, and feeling confused, ashamed, and worthless. I’m now 40 with a diagnosis of major depressive disorder (MDD). As I think about the more severe episodes I’ve had, I have recognized that others would often suggest various forms of “think positive” or “do positive.” When I absorbed these comments, my depression would get worse. For example:

“You’ll get past this. Just have faith!”
“Smile more! You never know the power of a simple smile.”
“Come on, laugh with me. It will feel good!”
“Have you tried _______ (yoga, exercise, eating cashews, meditating, talking about it, fill in the blank with just about any behavior)?”

And of course, “just think positive!” In my non-depressed state, these sound like good ideas. At least, they sound like they can’t hurt. But my depressed brain does something entirely different with these suggestions. My depressed brain twists them into blame, putting the responsibility of recovery solely onto me. It says:

“Do something for God’s sake, it’s not like you’re physically incapable. Your arms and legs work. Go get some exercise! Get out in the sun! Don’t let laziness take over.”

My depressed brain goes even further when I realize that I can’t be/do positive, or I try and I don’t feel any better.

“You’re letting your negativity take over. You’re so weak. Look at all the blessings you have! You can’t even be grateful. You should probably stop talking to people because you’re just burdening them with your negativity.”

Then things get dangerous. After some time of isolation, my depressed brain tells me that my very existence is bothersome to those around me, that they’re better off without me, and that I should kill myself or at least run away and disappear. My depressed brain says they’ll get over my absence, but my constant presence will ruin their lives. My depressed brain does not hear, “Maybe _____ could help?” but rather, “Do something – after all, this is your fault.”

There is another way that “just think/do positive” does harm for me as a person with MDD. I know in my rational mind that people are trying to help with their advice. But I also know that part of the reason for offering “help” is that my depression makes them really, really uncomfortable. In the midst of an episode, my mood, defeatedness, and lack of motivation can make others feel helpless, awkward, and anxious. It is human nature to avoid discomfort. Having an “out” by giving advice is a lot more palatable than sitting in the darkness alongside me, feeling weird and not knowing what to say or do. When people take the “out,” it allows my depressed brain to tell me that no one really wants to help but merely relieve themselves of the burden I am, and that I’m at the point of annoying everyone around me with my weakness and laziness.

In my experience of MDD, my depressed brain is more powerful than “just think positive.” It is irrational, unpredictable, and unreasonable. It both tells me that I can will myself better if I just tried harder or was stronger, and that I am a failure for not being able to will myself better. My desire for control of my mind butts up against my fear of being out of control, and the cycle begins of simultaneously trying and failing, fueling shame and hopelessness, continuously feeding the depression. In essence, the positivity advice asks me to take control of something that is outside of my power. When stuck in major depression, my brain needs the external resources of medication and therapy before I can use my internal resources towards recovery. The illness of MDD debilitates me when I’m on my own. That’s how it is for me.

So what does help? Hearing that I am loved, I am strong, that I mean a lot to others, that my presence is welcomed… these are helpful as long as there are no strings attached. I find that when I am deep in a severe episode, it might be a friend’s or my spouse’s comment that I am loved that saves me that day. It comes without condition. It is merely a statement. An, “I love you,” or, “You are a great friend,” or even more direct, “I love you the same, depressed or not.” When I hear these types of statements, the voice of depression that tells me I’m worthless, useless, and a burden to everyone quiets. Sometimes it quiets enough to get me out of bed that day, sometimes enough to stop me from self-harming. The impact is powerful. These statements don’t seek to change me. They don’t ask me to do something. They don’t suggest that only if I behave in a palatable way, do I deserve the company of others. What they do is validate me with my illness. They tell me I am accepted as I am.

I know that those who love me mean well. I know they are trying to help me and don’t want me to suffer. I know they are human, with strengths and beauty and also challenges, just as I am. It’s just that… it would be nice if my depressed brain had less food to chew on. And if others could sit with their own discomfort alongside me in the dark, for a short while, as I sit with mine 24/7 without choice. If they understood that I actually need more than my own will and actions to recover, and that in the depths of my depression I am incapable of thinking and doing positive because that is one of the symptoms of the illness. It would be nice if others could realize that for some of us with MDD, actively loving us just as we are is far more powerful in nurturing positivity than is simply telling us to “just think positive.”