When you've accidentally done something wrong, like break a plate or forgot a prior engagement, you feel bad about it. Guilt is the word we attribute that to, which is something temporary and specific to a situation. It's healthy in that it helps us to stop making the same mistake, to learn from it. With severe depression however that negative feeling occurs either when something triggers it or even just out of nowhere. It's called shame, unjustified usually, which is where you feel that you're a bad person even if you've done nothing wrong. Your mind tries to come up with 'reasons' why you feel this way, stories you tell yourself so that there seems to be a feeling of control.
When someone's ill, it's normal for them to stay home from work or school, perhaps also visit the doctor. With severe depression however, being ill is chronic and you tend to still engage in normal responsibilities, no matter how difficult it is to cope, because it doesn't appear to be a physical ailment. Unfortunately today, the general public not only doesn't accommodate for the condition but they also dismiss its legitimacy as a disease. No matter how many times you explain it, even provide documented resources, efforts seem futile. This ignorance, misperception, makes performing day to day responsibilities even more difficult, and saying, "It's frustrating!" is an understatement.
These events tend to be frequent and over time can be detrimental to one's self-esteem and personality. Anxious. Over cautious. Feeling less-than, belittled. Whereas most people attribute the bad feelings to external causes, (reasons) severe depression makes you feel like shame is inevitable because you're "somehow just a bad person," despite any your actions/reactions.
While it's no easy thing to live with, the one thing that would make it less painful is for others to understand and be, if not somewhat sensitive, at least respectful. There will always be stubborn people who stay ignorant, making every excuse as to why only old ideas are valid and new ideas are nonsense, however if the general consensus brings themselves to take mental health issues seriously then the treatment and overall wellbeing for those who suffer would be much better.
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