Can You Be Happy and Depressed?

Deborah's Story

Deborah has a wonderful life, but she still lives with depression every day. Find out how major depression affects some people who appear to be happy.

By Diana Rodriguez

Medically reviewed by Pat F. Bass III, MD, MS, MPH

Deborah Serani, PhD, 54, of Smithtown, N.Y., is cheerful and quick to laugh because she has much to be happy about. She’s a successful psychologist and is happily married with a grown daughter. From the outside, her life seems perfect. But Serani has to stay on guard againstdepression, an illness she’s battled for decades.

Serani struggled with dysthymia, a chronic, typically milder form of depression, throughout her childhood. Then, when she was 19 years old, she tried to kill herself. “I was very isolated,” she says.

Her parents were shocked after her suicide attempt because no one suspected she was in such despair. “I wasn’t the kind of kid who was shouting that I was in pain,” Serani says. “I was dangerously quiet. From the outside everything looked great. I always had a smile on my face even though I was really struggling.”

Serani was able to control her depression with talk therapy for more than a decade. Because she credited psychotherapy with saving her life, she decided to pursue psychology as a career. “It was a natural fit for me,” she says. “Living with depression has certainly given me a unique perspective on working with others.”

When Depression Comes Back

At age 33, Serani gave birth to a baby girl. She had everything she wanted, but her depression came back with a vengeance.

Serani suffered an episode of postpartum depression, a subtype of major depressive disorder. She started feeling empty, and the suicidal thoughts crept back into her head. “I knew it was happening, but I couldn’t do anything about it. It’s like seeing a car crash — I couldn’t steer myself away,” she says.

She alerted her family that she was feeling depressed, but some of them brushed it off, wondering what she could possibly be depressed about. Luckily, Serani knew better: She understood that her history of depression increased her risk for postpartum depression and that she needed help.

Understanding Depression

“Depression isn’t caused by not having something you want,” says Lateefah Watford, MD, a psychiatrist with Kaiser Permanente in Georgia. “Depression is a disease that involves inappropriate levels of neurotransmitters in the brain, and it impacts both mood and cognitive functioning.”

Some of the main causes of depression are genetics (having a family history of depression), levels of reproductive hormones in women, and abnormalities in the neurotransmitters, especially serotonin, which is responsible for boosting mood.

“When you get to the point that you believe you’re depressed, it’s important to acknowledge how you’re feeling and understand that it’s not an indicator of weakness, but rather of the illness,” Dr. Watford says.

Long-Term Treatment and Lifestyle Changes for Depression

For the first time, Serani started taking medication for depression, and it opened a whole new world for her. Serani views her depression just as she would diabetes or any other chronic illness that requires medication to control it.

She knows that she’ll always need medication and that living with depression also means taking good care of herself in general, including eating healthy, getting good sleep, exercising regularly, and getting enough sunlight. She still has days when it’s hard to get out of bed, but she takes that first step to get up and into the shower, and each step after that is a little easier.

Serani, who’s the author of two books on depression, has faced scrutiny from friends and family members who simply don’t understand her depression. She tries to use these conversations to teach others about depression and that sometimes it’s okay to just feel sad.

“I tell them that the range of human emotions includes being sad and depressed sometimes, even if you appear to have it all,” she says. “So I tell others to let me cry, let me be sad, and let me have the emotional moment.”

Serani’s professional expertise has been helpful for accepting and managing her own depression. “I know the science behind the mind and the research that’s out there,” she says. “Being a mental health professional helps take the sting out of the stigma in my personal battle, too.”