Okay, what do you say we do our bit in the battle against stigma. What battle, you say? Well, the last time you were depressed (yes, that would be most of you at some point), did you admit it to anyone? Maybe you felt it would seem like an admission of weakness; or some kind of ‘brain chemistry’ you were born with (doomed!). Thanks, Big Pharma!*
It enrages me that – thanks in large measure to pharmaceutical marketing – depression is too often seen as a “mental illness”. Absurd. It’s something that happens to almost everyone at some point. But we reinforce the stigma problem by not talking about it – by letting the pharmaceutical industry do all the talking.
The medicalization of it has made us come to see it as a physical/biological phenomenon, caused by ‘chemical imbalances’, treatable with ‘anti-depressants’. In my view, pills may be okay briefly, but the primary focus should be getting at the root, the actual cause, through some form of psychological therapy.
Depression is an everyday reality that we need to stop denying, and remaining ignorant about. But it takes guts to brave the potential reactions, and speak openly. Especially in a critical-judgmental culture whose media generally lead them by the nose.
Jan Wong’s book, Out of the Blue, is a fascinating contribution to the conversation. And this internet era of ‘social networking’ and blogging are helping, though it’s hard to compete with sophisticated marketing.
It seems Jan Wong descended from a ‘stoic’ culture — in a different language, from the other side of the world – similar in some ways to my own “Scottish-Presbyterian settler” roots. It’s easy to find lots of explanations for each of our experiences with depression, in our heritage – without adding traumatizing events. And here we are today both in Toronto, both having dealt with similar psychological, or emotional issues. Both of our experiences with depression have been impacted by stigma and ignorance. So it’s up to us to contribute to a ‘public chat’.
I’m old enough to remember when it wasn’t that big a deal to say, perhaps over coffee, “Gee I’m depressed.” Though I acknowledge that from age 19 to 35, I lived in Montreal, a more open, expressive, culture. Toronto culture – English culture in general — has traditionally been more emotionally closed. So the pressure here is to keep things to yourself. Emotional distress is too often seen as an abnormal problem that makes people uncomfortable to hear about. Despite the likelihood they’ve been through it themselves – or perhaps because of it?
Jan’s depression happened decades later than mine, and here in Toronto. So her experience was affected more by a lack of communication about it than mine was. And a lot more medicine. Luckily for her, she eventually had one of those rare psychiatrists who did do at least some ‘talk therapy’.
My era meant mostly talk therapy — and a range of “modern humanistic” talk therapies, encounter groups, a self-help group, endless reading of theories, ‘learning tools’, and so on.** I remember anti-depressants that made me ‘dopey’, and put my creativity and imagination to sleep as well as my body. I was no longer depressed – I was neutralized!
After decades of this, my experiences and learning came together in a two-sided epiphany: one side about the need to take action (even just getting angry) as an antidote to depression; the other side, realizing that one could practice positive feelings, a little like strengthening a muscle.
Choices! What a concept. Just realizing that was empowering. After learning how to ‘practise contentment’ for example, I came to see chronic depression as often a habit – and one that could be changed. (Some people prefer ‘conditioned response’ or ‘habitual response’ rather than habit.)
About ‘taking action’: depression is so often a kind of conditioned powerlessness (‘repressed anger’ for example, in a family that disapproves of anger). So an idea that I once could have found depressing, I might now choose to intellectually analyze, minus the feelings (which also takes practice), and perhaps then take action. Join a group. Write a letter to the editor. In other words, empower myself.
One ‘practice’ for example: refusing to let my mind go into negative thinking; part of my mind gives a stern No! command to the part that’s sliding. It is simple, but does take persistence.
In this long learning process, the icing on the cake was giving myself permission to express anger despite my upbringing. Learning how to express healthy anger in a controlled, creative way is empowering, energizing and sometimes even delicious.
So getting in touch with whatever makes us feel unable to impact events in our lives, is a step toward eliminating or reducing depression. Actually, what I’m doing right now – blogging – is one example of action and empowerment. And I have come to believe that a little occasional depression is a healthy signal in our lives – something needs to change. Time to be mindful, figure out what’s happening, take action.
Maybe even get angry. (Sometimes anger is just a bad habit, and sometimes it is justified). Imagine if Jan Wong had not needed to block on her perfectly natural feelings – hurt, sadness, anxiety, anger. In the end, she did turn it all into something positive. But imagine if she could have – right at the start – talked openly to someone about her feelings.
Some of us who have shared our experiences have felt enriched in many ways. Every person I’ve spoken to about this, has volunteered their own similar experiences, some very severe. And they are among the most interesting, deep and ‘high functioning’ people I’ve known. Come to think of it, what if emotional struggles are a prerequisite to wisdom? Good lord! Well as the late gestalt psychologist Fritz Perls said, “You have to suffer to grow.”
Helping to erase stigma through ‘coming out’ is about creating a society more transparent, more real, more mutually supportive, and more self-confident. It’s about replacing ignorance or disdain with respect and consideration, among increasingly knowledgeable family, friends and neighbours.
When everyone finally ‘gets it’, our culture will be a much more healing, nourishing, inclusive one; people will be helped instead of hindered when going through emotional distress. And that part is up to all of us. Let’s all help end stigma? Come out, come out, wherever you are!
* http://www.madinamerica.com/2011/11/anatomy-of-an-epidemic and http://healthland.time.com/2013/05/07/as-psychiatry-introduces-dsm-5-research-abandons-it/
** http://en.wikipedia.org/wiki/Neuro-linguistic_programming (I think NLP was one of the most effective approaches for me).