Depression Symptoms: Guilt and Shame

by Anne Windermere Patient Advocate

When you have depression it is possible to experience a wide variety of symptoms. I have found that in talking to other people who suffer from depression, that how one experiences any of these symptoms is unique to the individual. For example, the depression symptom of a great change in appetite may mean one person may gain weight rapidly and for another it may mean a disinterest in food resulting in weight loss. Although we have these diagnostic checklists for diagnosing depression, the symptoms we feel and live with day to day can be vastly different from person to person. My goal here is to explore both the commonalities and the differences in how we perceive and experience depressive symptoms.

In previous posts we have talked about the following symptoms of depression:

Feeling Numb

Feeling Trapped


If you have missed reading any of these articles please feel free to go back and comment about your personal experience with these symptoms. In this post we will be exploring the depression symptoms of feeling guilt and shame.

What is guilt and shame?

Guilt is usually defined as the human emotion of feeling regret or remorse over violating one’s internal values. Shame is thought to result from the feeling of being externally judged and applying that judgment to oneself. Guilt is feeling bad for some action or actions you did or did not do. Shame is the overall feeling that you deserve self contempt. These feelings can be normal in some circumstances and may prevent us from straying from our own internal values as well as those from society. But when it comes to depression, these feelings can become magnified and distorted due to a faulty thought system. In many cases depressive guilt and shame can become toxic and threaten our mental health and well being.

How does toxic guilt and shame manifest during depression?

• You may find yourself constantly apologizing even for things which are not your fault.

• You may blame yourself when anything goes wrong, even for those things not under your control.

• Your mantra is “Everything is my fault.”

• You may sabotage your happiness because you feel you don’t deserve it.

• You may have feelings that you are inferior, unworthy, dirty, untouchable, but not know why.

• We may feel guilt and shame for being depressed because we feel we are letting others down or that we are becoming a burden.

Where does toxic shame and guilt come from?

In my personal experience and in talking with others who suffer from depression, many times these feelings can go back to childhood and especially childhood traumas. Children who have been physically, emotionally, and especially children who have been sexually abused, quite often bear the scars of their abuse in these feelings of guilt and shame. A child does not understand why these things happen and the human response is to put the blame on oneself. There may be an underlying feeling that, “These bad things happened because I am bad.”

These feelings can be very tenacious and last well through adulthood. It takes a lot of therapy to finally come to the rightful conclusion that the abuse was not your fault. And in fact, the shame belongs to the perpetrators, people who were supposed to love and care for you.

In addition to life experiences, depressive guilt and shame also has a biological basis. According to a 2008 study reported in the journal Cerebral Cortex researchers found that: “The brain region we have identified to be associated with proneness to guilt has been shown to be abnormally active in patients with severe depression in several previous studies, but until now its involvement in guilt had been unknown.” So if you feel like you are a guilt magnet during a bout of depression, there may be a scientific explanation for experiencing this symptom.

What can be done to decrease feelings of toxic shame and guilt?

• This particular symptom is a good match for treatment with cognitive behavioral therapy. These feelings are directly tied into a thought process which is not logical. When you begin to pull at the threads of assumption backing up these feelings, they fall away.

• Overall, if you treat your depression, you are going to also lessen the hold these feelings of guilt and shame have over you. When one is depressed, there is more of a likelihood that the negative thoughts and feelings will gain strength and become entrenched. In other words, whatever treatment for depression which works for you such as therapy, medication, or a combination approach, will also take care of the individual symptoms such as ruminating in guilt.

• Write down your thoughts associated with feeling guilty and challenge the logic behind them. Can it really be true that “everything is your fault?” Can you separate your personal responsibility from things you have no control over?

• If you did suffer from any type of trauma or abuse as a child or as an adult you will need some help in dealing with the emotional aftershocks. A good therapist will help guide you through the recovery process.

• Know that depression is not your fault. Depression is not a character flaw or weakness. Depression can happen to anybody and it is nothing to be ashamed about. You are worthy and good despite your depression. Become an empowered patient by being knowledgeable about this disorder. That way you can refute any bias, prejudice, and misinformation about depression with facts.

We are very interested in hearing about your experience. Have you ever felt excessively guilty or have you experienced feelings of shame in relation to your depression? How does this particular symptom manifest for you? Is there anything which helps to ease these feelings? Telling us your story is a way to not only share but a way to connect with others who are going through the same thing. We would love to hear from you.

Anne Windermere
Meet Our Writer
Anne Windermere

These articles were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Merely Me."