Here’s the kicker: Nearly 60 percent of those suffering from depression do not receive treatment of any kind. Barriers include lack of insurance, financial concerns and a nationwide shortage of mental health providers, but guilt and shame are also to blame, says Alicia Clark, PsyD, a licensed psychologist in Washington, D.C.

 “A stigma endures about mental illness,” Clark says. “People still feel guilty about being depressed, like it’s their fault. They’re embarrassed to admit to anyone that they’re suffering, and they think others will judge them, so they’re reluctant to seek help.” Plus, she adds, depression can cause lethargy, so a depressed person often doesn’t have the energy to take action.

For example, Christine, who grew up in Chicago, didn’t get the help she needed when she was a teen, and she partially blames the stigma that persisted in the 1970s.

 “I first realized there was something wrong when I was 15,” she says. “I was having bouts of crying and anxiety, and I couldn’t concentrate in school. I asked my mom if I could go to a therapist, and she said ‘No, we solve problems on our own.’ I went to the county mental health service and saw one anyway, but they told my mom and that was the end of that.”

Leaving depression untreated is dangerous, Occhipinti warns. “Ongoing depression can worsen, leading to lost work and income, strained relationships and a loss of your support network—and thus a higher risk of addiction, serious physical illness and suicidal thoughts or actions.”

Christine can attest to those dangers. “I didn’t see a therapist again until I was in my 30s, and by then it had progressed to the point where the pain was unbearable. I didn’t even want to get out of bed most days, and I attempted suicide a few times.” Today, 20 years later, she’s functioning much better, thanks to a new therapist and a highly effective medication that she says saved her life.