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Caregiving Chronicles


Caregiving Chronicles will present news and analysis on caregiving topics in MetroWest and around the world, in-depth Q&As with experts in fields related to caregiving and updates and announcements about caregiving resources available in MetroWest from Program Director Douglas Flynn.

3-part Series: If Depression could talk, what would it say? Part I: What does depression look like?
By DebraMcDonagh / March 11, 2019

If Depression could talk, what would it say?

The Caregiving Chronicles has put together a series of articles that focus on the stigma of depression and why individuals with this diagnosis often hide how they feel rather than openly discuss it or seek help.  In this three-part series we will identify:

Part  1: What does depression look like? 

Told through an open dialog with a 60+ year old diagnosed with depression.

Part 2: What are the key signs and symptoms of Depression?

Q&A with Michelle Birdwell, Triage Coordinator, Elder Community Care Program

Part 3: How you can support someone with depression.

Q&A with Michelle Birdwell, Triage Coordinator, Elder Community Care Program

Part I: What does depression look like?

Depression sometimes hides behind a smile

Historically, when someone had seemed to be continually lethargic or sad for no tangible reason, or if they showed little interest in daily activities, it was not viewed as an illness. It was not uncommon for that person to be treated as if they are feeling sorry for them self or even told they should just "snap out of it."

Even today, mental illness still carries that stigma and makes many people with depression suffer in silence, placing a smile on their face and forcing an outward appearance of interest, happiness, or even joy. To someone with depression, this makes you feel even worse inside; it makes you ask yourself things like, “What is wrong with me? Why can’t I be like a ‘normal’ person and just have a good time?”

For someone who has never had on-going depression, it is hard to comprehend having an ever-present feeling of dread, continually dealing with a feeling that you’re bad, in trouble or generally “less-than” other people. Therefore, those suffering from a chronic depressive disorder have become masters at presenting themselves as if they are not emotionally suffering so that they don’t worry people who care for them or get asked “what’s wrong” 10 times a day. They learn to do what they are supposed to do while acting with perceived normal behavior for each situation. 

During an open discussion with someone over 60, who suffers from persistent major depression, she shared with the Caregiving Chronicles editor [listed as CGMW in this article] that, “It becomes second nature just to paste a smile on my face and force myself to push through my daily routine. Sometimes, I do not even realize I am doing it. My family worries about me, so I pretend to be happy. It’s just easier. I go to therapy, I am on medication, and I speak with my prescriber regularly, and some days I actually do feel a glimmer of true hope or excitement. But it doesn’t usually last. Most days I just push myself to do just enough to seem like a mentally healthy, motivated participant in my own life. Some days it is a chore not to go back to bed and stay there.”

When I asked her how her therapist or prescriber helps her through the harder times, she went on to say, “I don’t usually tell them, I cancel appointments and just ride it out. They will just change my medication and, I have no confidence that it will work and will have to go through more side effects. I have never NOT felt this way, so it’s easier just to keep pretending that I am o.k.”

CGMW then sat with Michelle Birdwell, BayPath’s Triage Coordinator for Elder Community Care (ECC), which is a partnership program between BayPath Elder Services, United Way of Tri-County and Advocates, Inc. that is made up of trained social workers and mental health clinicians that work specifically with people over the age of 60.

Michelle confirmed that a vast majority of people with depression feel hopeless and helpless and that this is a very prevalent problem with people over the age of 60 due to decreasing health, loss of independence, and loss of their peers, friends and/or partners. According to the National Institutes of Health, of the 35 million Americans aged 65 years or older, about two million of them have depression.

When left untreated, depression can deepen. It is essential to learn the signs and symptoms of depression, especially when in a caregiving role. 

Next week, look for Part II of this series: “Signs and Symptoms of Depression.”

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BayPath Elder Services, Inc

The BayPath Family Caregiver Support Program and has been made possible by funding from the Older Americans Act as granted by Executive Office of Elder Affairs. Participants may make a voluntary donation toward the cost of this federally funded service. Click here for more information. was originally made possible, in part, by generous grants from the MetroWest Health Foundation. Additional funding support was graciously donated by Avidia Bank from 2018 – 2021.

Thank you, MetroWest Health Foundation and Avidia Bank, for enabling BayPath Elder Services to provide support and resources to family caregivers.