Depression is a mental health disorder that leaves those who suffer from it feeling empty, hopeless, even worthless. It can lead to feelings of complete isolation even when surrounded by people who love them. Sometimes it can be hard to understand depression, even those who suffer from it may not know why they feel the way they do. So to help, here are eight things patients with depression wish everyone knew and could understand:

1. Physical health often gets put on the backburner

Depression can make it hard to concentrate on your physical health and make you undervalue the importance your physical health plays in your life. Even if you’re feeling physically unwell, you may still have trouble getting the help that you need. It can be hard to care for your body (i.e., eating, showering, etc.) when you’re depressed and feeling like it doesn’t matter.

2. Pretending to be happy can seem very fake and hard when you’re depressed

You may want to pretend to be happy for the sake of others, but it can be hard actually to do so when you’re depressed. Faking the happiness that you want can not only be a very difficult thing to do but it can also leave you feeling even more alone in your sadness.

3. Thoughts of self harm don’t seem abnormal when you’re depressed

Thoughts of self-harm may not seem like a bad decision when you’re dealing with severe depression. In fact, they can feel like they’re the only thing that can grant patients some form of self control when they feel completely out of control of everything else in their life. However, if you are experiencing thoughts of self harm, it’s important to talk to a loved one and a qualified mental health professional who can help.

4. Sadness, the blues, and depression aren’t the same

Being sad is a normal reaction to life’s circumstances, but depression is different. Sadness may be short-lived—it is a temporary reaction to an unpleasant experience. Depression is a long-term mental health condition that causes feelings of hopelessness and apathy. People who suffer from depression don’t feel relief from their sadness for extended periods of time, and without proper care, and possibly medication, those feelings often come back.

5. You can’t just get over depression

Depression is a cycle of feelings that can be triggered by grief, trauma, or the loss of a loved one. A person with depression often feels that there is no way out, leading to them not reaching out for the help they need.

6. Sometimes it’s hard to talk about

Depression is a serious mental illness that can leave people feeling overwhelmed and ashamed to admit that they’re having problems. It’s sometimes difficult to talk about depression or reach out for help leaving people with depression feeling even more isolated and alone.

7. Leaving the house can seem impossible

Depressed patients can experience overwhelming feelings, which make leaving the house difficult. This can leave you feeling isolated and stuck indoors. Even if you want to go out and socialize, the thought of getting ready to go out or having to see people can be completely overwhelming.

8. It’s hard to remember that others care

Depression can make it difficult to see that there are people around you who can support you. You may blame yourself for feeling the way you do and have ongoing trouble believing that you’re all alone. But people who suffer from depression should remember that even if there doesn’t seem like anyone who loves them now doesn’t mean there isn’t, or that there never will be someone who does.