Why I Can Have Depression and Be Happy at the Same Time

I have struggled with depression my entire life, in part due to a genetic mutation passed down to me from my parents that affects the way my body metabolizes specific chemicals my brain needs to moderate my moods. I regularly go through horrendous downward spirals where I feel completely broken and worthless — where life feels utterly hopeless. I struggle with long periods of numbness where I have difficulty functioning or even finding the motivation to get out of bed. On bad days, I will cry until my face is sore and my voice is hoarse, and it is unlikely I will be able to accomplish much more than basic self-care. I am battling an illness that warps my very perceptions of life and continuously exhausts and pains me both physically and mentally.

But I am happy.

I have an amazing fiancé, who is very supportive of me and my diagnosis. I have healthy, kind, smart and all-around wonderful children who have grown into incredible adults. My fiancé’s children are both amazing, as well. Together, we have formed a beautiful, blended family that I love with all my heart and I am proud to call my own. I have a team of doctors who actually listen to me and a treatment plan that is slowly but surely helping improve my quality of life. And I have a blossoming writing career that has given me a true sense of purpose and an ability to help others in need. I have many wonderful blessings in my life to be grateful for, many reasons to be happy.

Yet, I have been diagnosed with depression.

That is because a mental illness like depression has nothing to do with happiness. Depression is not caused by being in the wrong frame of mind or just not trying hard enough to be happy. Having a depression diagnosis has nothing to do with feeling sad, a little blue or under the weather. People with depression aren’t being “Negative Nancys” or “Debbie Downers” who just need to learn to lighten up and look on the bright side. My diagnosis wouldn’t just disappear if I just tried to smile a little harder or maintained a more positive outlook on life. My depression has nothing to do with whether or not I am happy.

I have trained myself to find reasons to smile every day. I am usually the first to look for something positive, in even the roughest of situations. No matter how hard my own day might feel, I always try to show compassion and kindness to others. If nothing else, I am grateful each day I wake up and thankful for all the loving and supportive people in my life and share that sentiment regularly. I am hopeful for the possibilities the future may have in store for me, as well. Some of my friends lovingly joke that I am the happiest, most positive little depressed person they know.

Yet I continue to struggle with my depression diagnosis.

My brain does not care whether or not I am happy or grateful, or whether I am hopeful, compassionate or kind. My mental illness is caused by my brain not working properly, much like any other illness. I have no more control over having a mental illness than someone else having diabetes, heart disease or another medical condition they may have been passed genetically. Yes, events in my life may have further exasperated my mental illness, much like having excessive sugar might worsen a person’s diabetes or having foods high in cholesterol might affect the severity of heart disease, but my condition preceded many of the traumas and abuses I have endured over the years. I have even sought treatment to help resolve those issues to the best of my ability, yet my depression has remained.

Because depression is an illness — a medical diagnosis with both mental and physical causations.

It is not all in my head.

It is not a state of mind or emotion.

Depression isn’t about being sad.

The cure for depression is not happiness.

Like any other illness, depression needs ongoing medical treatment. Doctors need to not only diagnose the condition but also to isolate and treat both the mental and physical reasons for the illness, as well. Though doctors often utilize psychological treatments like therapy, meditation and mindfulness, they usually also include psychiatric methods and medications to help treat the physical causation. That is because doctors recognize mental illnesses such as depression as a verifiable disability that deserves a comprehensive, multi-pronged treatment.

In cases like mine, where my depression has a genetic causation, my diagnosis is permanent. I was born with it, so please don’t blame me for the fact I was born with organs that malfunctioned. The only difference in my case is the organs affected. No matter how happy I am or how positive my outlook is on life, my liver will never be able to metabolize the substances my brain needs in order to function properly. I will have this medical diagnosis and need ongoing treatment until the day I die.

If I confide in you that I am struggling with depression, please don’t try to encourage me to try to be happier and more positive, or point out all the blessings I have in my life. I am happy and grateful already. You do not need to remind me to be hopeful for the future because I already am. Please don’t blame me for my diagnosis either, insinuating that I wouldn’t be ill if I just tried a little harder. I did not ask for this diagnosis, nor did I cause it. What I need from you is the same compassion, understanding and support you would give anyone else with any other medical diagnosis.

Because, though I am already happy, knowing you were doing your best to be supportive and treat me with the same respect you would someone struggling with other illnesses would make me even happier.

A version of this article originally appeared on Unlovable.