Things have changed hugely, but I am still loathe to accept that depression is being treated like a ‘real’ illness. Even today I still hear comments such as ‘but what does she have to be depressed about’ referring to a seemingly privileged teenager who was displaying signs of depression. ‘But the problem with depression is that it makes the sufferer SO selfish, doesn’t it?’ in response to a family member who had been signed off from work for several months suffering with severe depression and anxiety. Or ’Suicide is such an angry act, isn’t it’.
Herein lies the problem. Society generally views physical illness as out of the sufferer’s hands and mental illness as a choice. Almost as if the depression-sufferer could simply ‘get over it’ if he or she just bucked their ideas up a bit and were a bit more grateful for their lot. I honestly believe that until this view of mental health changes, then we aren’t going to move forward in our understanding.
Maybe we have been categorising depression all wrong? Because when we attribute suffering to our moods, then it automatically seems like it is something transient and fleeting. How can you compare depression to something as awful as cancer when cancer is permanent, out of our control and potentially deadly, when, with depression you could wake up tomorrow and feel fine?
What people who have never suffered with depression can’t or don’t understand is that depression is physical. It seeps into every part of your being. Yes, it may be a mental illness that distorts your feelings, the way that you see and view every part of the world and your place in it, but it is so much more. It suffocates you, it changes the way you identify with your body. It changes your reactions and your movements, it confuses messages from brain to body and it makes you feel like you are swimming through treacle when you are simply trying to put one foot in front of the other. It’s a dark, heavy presence that permeates your brain with harmful thoughts that takes every ounce of positivity and vitality away from you. It sucks the life out of you and makes everything feel impossible. The quicksand of depression can strike at any time. You can be going through the happiest time of your life. Content, fulfilled, happy and then all of a sudden it hits. It comes from nowhere, but you feel it. You feel the shift, the kaleidoscope stops turning into focus and often there is nothing you can do. Depressives will describe this experience using different words and likening it to different experiences, but one thing that I would wager they all have in common is that it feels physical. Your whole being is affected and you need to retreat, hide, sleep, and repair until it passes. Often there is no sign, it simply strikes and knocks the wind from out of your sails. The only positive (if you can call it that) is that the chronic sufferer generally knows that it will pass. It has to. It always has before. Because if it doesn’t, then what is the alternative? What would you do if you knew it never would? What would you do if this was it? If you were permanently walking around with the chains of depression weighing you down.
There are therapies available to depression sufferers, these range from medication and talking and lifestyle therapies. They all have the potential for work depending on who you are, on what your depression feels like and looks like. How it manifests, how it affects you. But there is never a fast solution. It isn’t easy. And very often you can never be ‘cured’ because whichever therapy you choose (if indeed you choose any at all) it is always lurking, around the corner, after the next happy day out or good night’s sleep. Even when it isn’t there. It is.
A big misconception is that depressives are always sad or unhappy people. I don’t think this is true. You can, of course, have feelings of sadness and unhappiness, so can anyone. But to label it as feeling sad or low is simply an injustice. This is where I think the confusion lies and the reason that so many people cannot understand it. When non-depressives try to imagine what depression feels like, they remember a time when they felt sad. When they suffered a loss - death, accident, a break-up. I am not saying that depression can’t be triggered by one of these episodes, but that isn’t the whole story. If you suffer a trauma then a natural reaction is to be low, sad even depressed. But being depressed in reaction to a traumatic event is not always the same as having depression. I am in no way minimising the depression and anxiety that can be brought on by suffering a trauma, but often that is clearer to understand. For the sufferer and those around him or her. It makes sense. They get dispensation if you like. What is far harder for people to understand is that people suffering from depression don’t seem to have gone through a trauma in order to slide into a depressive episode. Absolutely there may be grief and trauma from the past that plays a part in the current downturn. But not always. It isn’t that simple.
If you know someone who suffers from depression (and we all know someone, even if we don’t know we know) then they generally don’t sit around being sad with a big sign above their heads flashing ‘depression’ they can be some of the happiest, most attractive, engaging people you know. They can be loud and gregarious, they can also be quiet and reserved. They can be tall or short, fat or thin, rich or poor. In truth they can be anyone. And just as it is pretty much impossible to pick out ‘baddies’ and goodies’ in real life. It can be the same with depressives. Having depression is just one part of them. I have often found depression sufferers to be some of the most energetic, happy and life-loving people I know. My theory for this is that they know how shit things can get. So while they aren’t in the midst of a depressive period, trying desperately to keep afloat, they relish the respite. The light happy feeling that comes with being in remission for as long as possible. The calm before the anxiety and churning feeling of fear seeps in. The feeling that signals another downturn could be on the way.
Think about the recent well known people who have committed suicide. You read the same comments over and over. Alluding to their fame, success, attractiveness, talent, sparkle and that…..something. Their deaths are referred to as tragic, a waste. We didn’t see it coming, why couldn’t they be saved? How could they want to die when they had so much to live for? The truth is that they probably didn’t want to die. They just couldn’t find a way to live that wasn’t agony. They may have physically brought about their own deaths, but I would imagine that they had no more choice in the matter than someone who had been knocked over by a speeding car. Suicide is not the considered act of someone who has choice. It is the desperate action of someone who has run out of options. An inner turmoil that, thankfully, many of us will never be able to contemplate.
You see, that’s the problem with calling something a ‘mental' illness. It suggests thought and choice. It gives the impression that the sufferer can simply snap out of it. Whereas a physical illness is something that is forced upon the sufferer through little fault of their own. Simply an unfortunate genetic flaw or life circumstance. If mental and physical illnesses are forever seen as different then a mental illness will forever be the misunderstood poor relation. Our language needs to change, our understanding needs to be better. We need to see something as an illness, rather than dividing it into different compartments. Sufferers require empathy but they also require understanding. Someone who has never suffered with cancer or a mental health illness will, I truly believe, be much more able to put themselves in the shoes of the cancer patient than the depression sufferer. Why? Because we seem to be able to visualise ourselves when our bodies are breaking rather than our minds. Cancer is one of the cruellest, most insidious, complex diseases I have witnessed. It seems different for each and every sufferer and I find it so hard to comprehend how someone with it must be feeling. And yet, everyone seems to understand. Especially when someone is going through the treatment phase. Losing weight, losing hair, in pain, suffering. But generally what we see is the effect of the treatment and not the cancer itself. The cancer can sometimes be as invisible to the onlooker as the dark shadow of depression is. But still, it somehow remains unreal, a state of mind that can be shaken off rather than a disease that terrifies and kills.
But they both kill. They both destroy. They wipe out people, decimate families, bring grief and pain.
The reason that we need to understand depression better is because it’s everywhere. We no longer lock it away and refuse to speak its name. It walks next to us all. it can strike at any time and it destroys.
Let’s put this into perspective. In the UK the leading direct cause of death among new mums within the first year after their child is born is suicide, the leading cause of death in men aged between 20 - 49 in the UK is suicide. Why wait until someone has died to then understand the pain and despair that they were suffering? We need to know the signs, learn the language, keep people close. Listen. Even if they don’t have the words, we need to help them to find them. To let them know that what they are suffering with won't simply be dismissed as low mood or feeling a bit down.
Would you be too busy to listen to someone who had heart disease, or had been given 12 months to live?
Let's stop separating mental and physical illnesses and pitting them against each other, or believing that one is more serious than the other. Illness is illness and those suffering should be listened to, understood and helped.