Podcast Summary: "The Big Mistake We Make About Depression" Alive with Steve Burns – March 18, 2026 (Lemonada Media)

Episode Overview

In this episode, Steve Burns sits down with Dr. Jesse Gold, Chief Wellness Officer of the University of Tennessee system and Associate Professor of Psychiatry, to unravel the misunderstandings around depression. The conversation delves into the nuanced difference between sadness and clinical depression, the constellation of symptoms that define depression, the importance of destigmatizing mental health conversations, and the societal and biological factors at play. Burns and Gold explore why depression is often mischaracterized, discuss vulnerability and masking in high-functioning individuals, the impact of social media, and practical advice for those seeking help.

Key Discussion Points and Insights

1. Distinguishing Depression from Sadness

[06:26; 07:11; 12:10]

• Clinical Depression vs. Sadness: Dr. Gold emphasizes that depression is clinically distinct from situational sadness. "When you're depressed, it's a mood, it's sad. But when we're talking about depression, it's much more than sadness." [07:11]

• Diagnostic Criteria: Depression requires at least two weeks of either persistent low mood or anhedonia (lack of interest in things you used to enjoy). There's a range of associated symptoms: changes in sleep and appetite, fatigue, guilt, poor concentration, psychomotor slowing, and thoughts of death or suicide.

  • Steve jokes: “Anne Hedonia. Sounds like someone I went to school with.” [08:18]
  • Dr. Gold: “She. Every time I asked her to do something, she just ignored me.” [08:30]

• Duration and Impact: Burns reflects, “Sadness...comes and it goes. It’s neither reliable nor permanent. Depression is different in my life. I always called it the gray hum...like an air conditioner in the back of my life.” [18:56]

2. The Hidden Symptoms and High Functioning Depression

[18:12; 19:38; 24:02]

• Physical Symptoms Dominate: Depression often manifests as physical symptoms rather than just mood. Gold explains: “It’s change in sleep...change in energy...change in concentration...appetite changes,” showing how intertwined physical health and mental health are. [08:30 - 12:10]
• High Achieving, Still Depressed: Both Steve and Dr. Gold discuss how individuals, especially in Western work culture, are conditioned to show up and perform—masking depressive symptoms. Gold: “You can put on a face about it, you can go through the motions...our culture feeds into it.” [19:38]
• Burns recounts filming Blue’s Clues: “I went to work every day...I felt enormously frustrated and unqualified...what I did was work harder...when I got back to my apartment until the next day, it was almost like I wasn’t there.” [22:45 - 25:54]

3. Suicidal Thoughts: A Common but Taboo Symptom

[12:10 - 15:06]

• Normalizing Suicidal Ideation: Steve admits, “I was having these thoughts and I thought I must be completely insane...it was a comfort to me to know that it’s actually pretty common that the brain goes there.” [13:15]
• Dr. Gold: “All the evidence says, like, asking folks about it is safer than not. There’s a spectrum...there’s also passing thoughts...it’s a warning sign that we need to be thinking more about it and talking more about it and helping them.” [13:37]

4. Masking, Identity, and Internalization

[24:02 - 29:45]

• Work Persona vs. Authentic Self: Steve explores his experience with masking, noting the split between his public persona ("TV Steve") and private self: “I leaned in to my depression as a way of proving to the world that I was not him...that just became this negative feedback loop.” [26:44 - 29:45]
• Adopting Sadness as Identity: Burns reflects, "I began to identify with [the dark feelings] and almost wear them as a badge…It was a way of not dealing." Dr. Gold notes that apprehension about treatment sometimes stems from fearing it will change one’s personality: “This thing that we’ve become known for, even if it’s not a thing that we really like about ourselves..." [28:30]

5. Nature, Nurture, and the Depression Equation

[31:05 - 32:56]

• Genetics and Environment: “There’s definitely a genetic component...But it’s not exclusively genetics...as much as your brain and the biology part might be coming in some percentage from genetics, the fact that you grow up in a house with somebody who is living this way...contributes just as much,” Dr. Gold explains. [31:05]
• Biopsychosocial Model: She describes the holistic lens: biology (neurochemistry, heredity), psycho (processing, learned coping), and social (relationships, environment) all interact to shape mental health.

6. Social Media: Double-Edged Sword for Mental Health

[38:16 - 45:58]

• Designed for Comparison: Steve observes, “It seems brilliantly designed for misery...comparing snapshots, curated snapshots of people’s fake life against your real life.”
• Dr. Gold: “Social media...does affect their self-esteem. It does affect body image for sure...We do see increased depression rates and anxiety...we’re backtracking on social media. Like, it happened and we didn’t react...now we’re like, oh, no, no, we need to talk about phones in schools...” [39:35 - 42:56]
• Healthy Use and Education: Dr. Gold recommends teaching kids digital resilience and critical thinking, not simply prohibiting access. She encourages leveraging social media for positive mental health narratives but warns that online self-diagnosis should be followed up with professionals.

7. The Brain, Chemistry, and Evolving Treatments

[45:58 - 51:07]

• Serotonin, Dopamine, Norepinephrine: Dr. Gold dispels the myth that depression is solely a serotonin deficit issue. “It’s still a definite work in progress in terms of what we see in like, scans and what we do to treat it.”
• Medication and Therapy: "Sometimes you need help replenishing some of that because either your brain doesn't have enough...or isn't making enough...The brain isn't cool, uncharted territory." [46:19 - 48:51]
• Playful banter: “Why do so many of these terms sound like girls you might have gone to high school with?... Serotonin, she was great...Norepinephrine...I remember her.” [50:39 - 51:18]

8. Where the Mental Health Conversation Stands Today

[51:21 - 53:06]

• Burns seeks Dr. Gold’s opinion: “How do you feel about the current conversation around mental health?”
• Gold replies: “Awareness is a step...Talking about it should be boring...it shouldn’t be headline news...But I’m hopeful it’s getting there.” [52:04]

9. Steps to Seeking Help

[53:06 – 57:49]

• Finding Help: Start with friends, family, or professionals. Use insurance directories, Psychology Today, or apps. “If you read someone’s paragraph just like a dating app, and you’re like, this person would be terrible, do not spend time with them...the data on therapy says fit is everything.” [53:16; 57:16]
• Crisis Resources: 988 is always available; hotlines, warm lines, group support exist for diverse needs.
• Re-evaluation and Fit: Steve shares, “The most important thing was taking a first step...your therapist has to be the right therapist for you.” [56:06]
• Dr. Gold notes, “If you don’t feel safe, if you feel like you’re putting on a show...all the data on therapy says fit is everything.” [57:16]

Notable Quotes & Memorable Moments

• On anhedonia:
  “Anne Hedonia. Sounds like someone I went to school with…God, she was so boring.” — Steve Burns [08:18]
  “She, every time I asked her to do something, she just ignored me.” — Dr. Jesse Gold [08:30]

• On masking depression:
  “When I was first, what I now know was clinically depressed...I didn’t know that that’s what was going on because it didn’t feel like what I thought depression was. … What I did was work harder.” — Steve Burns [22:45]

• On suicidal ideation:
  “I was having these thoughts, and I thought I must be completely insane...it was a comfort to me to know it’s actually pretty common.” — Steve Burns [13:15]

• On identity and depression:
  “I began to identify with [the dark feelings] and almost wear them as a badge…It was a way of not dealing.” — Steve Burns [27:42]

• On therapy fit:
  “If you don’t feel safe, if you feel like you’re putting on a show...all the data on therapy says fit is everything, and I feel like I didn’t understand that until I had a really good therapist.” — Dr. Jesse Gold [57:16]

• On stigma and progress:
  “Talking about it should be boring...it shouldn’t be headline news...but I’m hopeful it’s getting there.” — Dr. Jesse Gold [52:04]

Timestamps for Important Segments

• [06:26 – 12:10]: Clinical vs. colloquial depression – “constellation” of symptoms
• [13:15 – 15:06]: Suicidal ideation and destigmatization
• [18:12 – 19:38]: Physical symptoms and duration in depression; masking and societal expectations
• [22:45 – 25:54]: Steve’s personal story: masking depression at work, identity split
• [31:05 – 32:56]: Genetics, upbringing, and the biopsychosocial model
• [38:16 – 45:58]: Social media’s impact on mental health, education, and digital hygiene
• [45:58 – 51:07]: Neurochemistry, evolution of medication, and the unknowns of the brain
• [53:06 – 57:49]: Practical steps for seeking help and the importance of a therapeutic match

Episode Tone

The conversation is intimate, sincere, lightly humorous, and deeply empathetic. Dr. Gold balances clinical insight with warmth, while Steve shares honestly from his own life, using wit and candor to break down walls around mental health topics.

For Listeners

This episode is essential for anyone wanting to understand depression beyond stereotypes, recognize it in themselves or loved ones, or seeking encouragement for starting a conversation about it. Both Burns and Gold model compassionate dialogue and validate the lived experience of depression while offering practical advice for seeking support.

“The struggle is not optional. Doesn’t matter who you are—you’re going to feel some of it in some way.” — Steve Burns [52:04]