Is Depression a Choice?

Concerned young woman talks with friend in coffee shop
hsyncoban / Getty Images

If you struggle with depression, you may have encountered a friend or family member who insists that you'd feel better if you just got out of your room more often and tried to change your life. These notions are not only untrue for many people with depression, but they can be harmful.

Many misconceptions surround depression, but suggesting that it is a choice is particularly damaging. It's very important for you to realize that depression is not your fault.

In a 2017 viral Twitter thread, comedian Andy Richter discussed his experiences with depression and criticized the notion that people can "overcome depression if you just try hard enough." His comments struck a chord: Many people commented that depression, just like other physical illnesses, is not a choice and cannot be cured by "staying positive."

Depression Causes and Risk Factors

Depression is a complex disorder, and researchers are still learning about its causes. Among these are:

  • Brain chemistry. Your brain relies on a delicate interplay of neurotransmitters—chemicals that help regulate mood—to function well. In some people, these chemicals are out of balance.
  • Genetics: Depression often runs in families.
  • Environment. Negative experiences such as abuse, neglect, and violence can increase the likelihood of depression. So can attitudes, behaviors, and coping mechanisms learned in childhood.
  • Other diseases. People who have serious or chronic diseases often develop secondary depression.
  • Temperament. Low self-esteem, limited stress tolerance, and pessimistic attitudes can contribute to a tendency toward depression.

One or more of these factors can combine to produce major depression. For example, if you have a family history of depression, a particular occurrence or situation could trigger the disorder.


Although you might be aware of lifestyle changes you can make to support your mental health, actually undertaking them can be difficult if you are depressed. For example, exercising every day can be nearly impossible when you barely have the energy to get out of bed. People sometimes mistake this inaction for laziness or ignorance, but it's important to remember that it is not your fault. It's a symptom of a disease.

When to Seek Outside Help

If you experience persistent feelings of sadness and futility and lose interest in activities you usually enjoy, contact a professional if this continues for more than two weeks.

Here are a few other symptoms of depression to watch for:

  • Changes in weight or appetite
  • Problems with sleep
  • Tiredness or lack of energy
  • Feelings of guilt or worthlessness
  • Problems with thinking or concentration
  • Thoughts of death or suicide

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Treatment for Depression

One of the ways a mental health professional can help you is by prescribing antidepressants. Antidepressants can alleviate depression by raising the levels of various neurotransmitters—such as serotonin, norepinephrine, and dopamine—available in the brain for use. Different antidepressants affect neurotransmitters in different ways, so certain antidepressants may be more effective than others for any given individual.

Another popular treatment option, either on its own or in combination with antidepressant medications, is psychotherapy. Psychotherapy, also known as talk therapy, can be useful in helping depression because it teaches people to recognize how their thoughts and behaviors may be contributing to their depression. When combined with medications, this may be the most effective approach to prevent a recurrence of depression.

How to Cope

Depression is not your fault, and it is certainly not a choice. Evidence-based treatment options including medications and psychotherapy can be helpful in reducing symptoms of depression. You also can make lifestyle modifications that can help you cope and provide some relief. Doing these things won't cure your depression, but they can complement other treatments and make it easier to manage your symptoms.

  • Eat a healthy diet. Research has hinted at a connection between nutritional deficiencies and depression, although it is not clear if one causes the other. Try to get the daily recommended amounts of amino acids, minerals, fatty acids, and complex carbohydrates.
  • Try to get enough rest. Depression can lead to sleep disturbances, either sleeping too little or too much. Focus on establishing good sleep habits, such as going to bed at the same time each night, not using electronic devices before bed, and creating a relaxing bedtime routine.
  • Try to exercise. Finding the motivation to exercise when you are depressed is difficult, but even just a bit can have an impact. Research has shown that regular moderate exercise can not only help prevent depression, it can also be an effective treatment. One study found that as little as one hour of exercise per week could help stave off symptoms of depression.

Of course, this research does not suggest that you could have prevented your depression. Remember: This is a complex condition that involves many variables and risk factors.

Self-Help for Depression

If you have mild or situational depression, you might be able to snap yourself out of it by simply getting out more or making some easy changes in your lives. Research has found that lifestyle modifications such as exercise, diet changes, relaxation, sleep, and increased social interaction can have both protective and alleviating effects on symptoms of depression.

Making lifestyle changes might help, but they aren't a cure-all. There is no single approach that is right for everyone.

What to Say to Someone With Depression

If you have a friend or loved one who is depressed, offer support without blaming or shaming the individual for their condition.

  • Acknowledge their pain. Don't be dismissive of the symptoms of depression. Let them know that you recognize that what they are going through is very real and very hard, and then let them know that you are there to offer support.
  • Ask what you can do. Depression can make it hard to accomplish even basic daily tasks. Household duties like making dinner or doing the laundry can seem almost impossible. Even small things like bringing them dinner or picking up the dry cleaning can be helpful.
  • Don't offer cures or solutions. It might seem helpful to recommend solutions but in many cases, those "have you tried this" statements come off as non-empathetic at best or judgmental at worst.
  • Let them know that you care. Tell the person directly that they are important to you and that you value them. Depression can make people feel worthless, so finding social support is critical.

A Word From Verywell

The feelings of guilt and worthlessness that go along with depression can make blaming yourself very easy—especially if friends and family are blaming you already. But this doesn't mean that it's your fault. Depression is a real illness, just like any other, and there are effective treatments. You don't have to suffer in silence or feel guilty that you aren't trying hard enough to get well. Sometimes, just making it through the day is the best that you can do—and that's OK.

Was this page helpful?
10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pringle A, McCabe C, Cowen PJ, Harmer CJ. Antidepressant treatment and emotional processing: can we dissociate the roles of serotonin and noradrenaline? J Psychopharmacol. 2013;27(8):719-31. doi:10.1177/0269881112474523

  2. Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: Review and meta-analysisAJP. 2000;157(10):1552-1562. doi:10.1176/appi.ajp.157.10.1552

  3. Simon GE. Treating depression in patients with chronic diseaseWest J Med. 2001;175(5):292-293. doi:10.1136/ewjm.175.5.292

  4. American Psychiatric Association. Let’s Talk Facts About Depression. 2005.

  5. Fakra E, Azorin JM, Adida M, Da Fonseca D, Kaladjian A, Pringuey D. Troubles affectifs et antidépresseurs : innovations thérapeutiques [Affective disorders and antidepressant drugs: Therapeutic innovations]. Encephale. 2010;36 Suppl 6:S183–S187. doi:10.1016/S0013-7006(10)70055-5

  6. Ribeiro Â, Ribeiro JP, von Doellinger O. Depression and psychodynamic psychotherapyBraz J Psychiatry. 2018;40(1):105–109. doi:10.1590/1516-4446-2016-2107

  7. Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnessesIndian J Psychiatry. 2008;50(2):77–82. doi:10.4103/0019-5545.42391

  8. Mammen G, Faulkner G. Physical activity and the prevention of depression: A systematic review of prospective studies. American Journal of Preventative Medicine. 2013;45(5):649-657. doi:10.1016/j.amepre.2013.08.001

  9. Harvey SB, Øverland S, Hatch SL, Wessely S, Mykletun A, Hotopf M. Exercise and the prevention of depression: Results of the HUNT Cohort Study. Am J Psychiatry. 2018;175(1):28-36. doi:10.1176/appi.ajp.2017.16111223

  10. Sarris J, O'Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC Psychiatry. 2014;14:107. doi:10.1186/1471-244X-14-107

Additional Reading