Get over it. Pull your socks up. Cheer up. This is a common attitude toward depressed people. I hold those who express such opinions in the same category as those who tell fat people they need to lose weight: Insensitive, ignorant, unhelpful and intolerant of other people’s weakness.
Depression is a debilitating condition that undermines you physically, emotionally and intellectually. It is not just a case of having the blues, of feeling a little low because you are tired or stressed or because you have had a setback. Though being “depressed” has become an every day word to describe someone who is feeling sad or dejected, clinical depression is on an altogether different level.
Tuesday was World Mental Health Day. Mental illness is often devastating, misunderstood and stigmatized. It is also common. Depression, in particular, affects millions across the planet, 121 million according to the World Health Organization.
Unlike illnesses like heart disease or diabetes, depression cannot be identified cleanly by a blood test or a scan. It is a disease that is both visible and invisible. Visible because it affects your every day functioning in a way in which many more “concrete” illnesses might not. If a colleague or a friend is clinically depressed you will notice the changes in both physique and behavior. And yet, standard medical tests will not pick up any changes in the body.
There used to be a theory popular in the 1950s that depressed people have a chemical imbalance in the brain. In fact I often hear depressed people speaking about having something wrong with their brain wiring. I don’t much understand the scientific theory behind it but suffice it to say that there is widespread disagreement among psychiatrists and psychologists about whether such an imbalance exists. Or to put it more simply, there is debate about the causal link. Do depressed people have an imbalance that makes them depressed? Or does psychiatric medication cause the imbalance?
To some extent, I don’t think it matters. Or rather it does not matter to me. Depression is obviously complex and its causes are likely to be an intricate mix of social factors, personality factors, genetic factors and physiological factors. Clearly anti-depressants can help deal with the symptoms of depression. And as one friend once put it, “why spend hours and hours talking about your misery when you can take a magic little pill?” But I have yet to meet anyone who believes that anti-depressants cure depression.
The problem of course is that it is big business. The pharmaceutical industry thrives on illnesses like depression where people can be put on daily pills for extended periods: Months, years even. And it is an easy fix. A five-minute appointment with a doctor, a quick diagnosis, a little prescription and a couple of months later the patient feels fine. Except that it does not often work this way.
Depression is a fight. It is the black cloud that can come back at any moment and strike you down. This week we heard Alistair Campbell — Tony Blair’s former right hand man — speak candidly of his experience of depression. His words made clear the extent of the struggle as well as the phenomenal power of this illness when it strikes. Even something as simple as brushing your teeth can become beyond you.
Pain and sadness are part of life but we are becoming less and less equipped to deal with them. First there is the constant pressure to be happy — the “have a nice day” culture as I call it. When we witness something tragic or when we experience something hard, we are expected to be affected by it only briefly. We are quickly urged to move on and regain a “normal” state of being, one which is positive and at least moderately cheerful. Nobody wants to spend time with someone sad and grumpy, do they?
Just consider how we react when a friend confides in us that they are struggling. What do we do? We try to pull them up. We rarely let them vent the full depth of their despair — though truly empathic people know how to do this — instead we try to counter what they say, to tell them it’s not quite as bad as they think.
I once heard a lecturer posit that depressed people were realists. What they cannot do is pull the wool over their eyes. They see the world as it really is and they feel assailed by the misery that exists. Perhaps he had a point. If it is the case, it is a hard way to live.
Psychological treatments for depression vary. The most common is cognitive behavioral therapy or CBT. In essence this a method which aims to teach you to identify and correct patterns of negative thinking which underpin depression. It can be highly effective but it is not for everyone. I have heard more than one psychologist object to the principle of altering the way people think.
So how do we deal with depression? First we need to recognize it as a serious condition and treat those who suffer from it with more understanding and respect. We also need to give it its due. It is not something which should be fobbed off with a few pills and good wishes. I am not advocating that we should not take anti-depressants, simply that we should question why so many people are taking them and perhaps consider taking a more intelligent approach, one that may or may not include drugs that change the way your brain functions.
And the more intelligent approach? One which is holistic in the true sense of the word. Since depression affects people on so many different levels, its treatment should also be multifaceted. It should encompass social conditions as well as the physiological and the deeply personal. More than anything, it should find ways to give depressed people the resources they need — be they social, emotional, intellectual or physical — to enable them to help themselves back to wellness.
