Thursday 29 September 2016

Let's grab the chance to face the stigma and talk openly

Whether you believe it or not, serious clinical depression is very real – and it can happen to anyone

Published 20/04/2014 | 02:30

‘We still don't acknowledge the fact that men can be as vulnerable to depression as women’
‘We still don't acknowledge the fact that men can be as vulnerable to depression as women’

It was Gloria Steinem who said it best. "Depression," she noted, "is when nothing matters, and sadness is when everything matters."

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It's a distinction that many people still fail to make. Far, far more than we would suspect. And while I make no claim to interpret the comments made by John Waters in this newspaper last week – "I don't believe in depression. There's no such thing. It's bullshit. It's a cop out" – I note that many of the more understanding reactions to his words came from people who have admitted to suffering from the very illness he says is non-existent.

Why is that? Well, first of all I think that people who have suffered from the trauma and stigma of mental illness understand the currency of kindness. Judge not, and all that. No one knows what is going on in another person's life or how they may really be feeling – and we have no right to speculate.

Secondly, I think perhaps because we know the difference between what GP Harry Barry called depression with a small "d" and depression with a capital "D". ("The difference is crucial," Dr Barry says. "Because many people in the worlds of media and therapy blur this distinction. This has led to widespread uncertainty among those most affected.") We know because we have experienced it ourselves, but we can understand that to those who haven't, the very concept of such a debilitating illness of the mind – one which can prevent you from washing, eating, talking or even getting out of bed in the morning – is beyond imagination.

We also understand the stigma associated with "coming out", as it were, as a person who has or is suffering from a mental disorder. In Ireland, a recent report found that 87.4 per cent of people believe that there is "a stigma in Ireland about discussing mental health problems". This discussion is made even more difficult for our men, who are still all too often judged as weak or somehow inadequate if they admit to emotional or mental health issues. We still don't acknowledge the fact that men can be as vulnerable to depression as women.

Regular readers will know that I have written often of my own experiences of depression. It is an experience very unlike that caused by grief, sadness or loss. From what I know of my own experience, real, clinical depression occurs when all types of emotions, good, bad or indifferent, are replaced with an inability to feel anything but total despair – as Steinem said, when nothing matters – and everything is replaced with a desperate need to end this existential suffering by whatever means possible.

But there is also the suggestion that, in some cases, Western medicine is "medicalising sadness"; that in our increasingly secular world of immediate gratification and synthetic pleasures, unpleasant emotions can be dispensed with – all we need to do is pop some Prozac and we'll be all right Jack. Thankfully, this isn't true. In the same way as the misuse of alcohol – the traditional means of avoiding unwanted emotions in Ireland – will not cure a broken heart or an emotional trauma, the use of anti-depressives or "happy pills" will not erase what Thomas

a Kempis called "the proper sorrows of the soul". Pain is part of living. In the same way as your body should feel pain if hurt, you should suffer emotionally when a tragedy or crisis hits you; if you don't then you are ill indeed.

Yet all too often people moan to me that they feel "depressed" as they experience minor mishaps. Perhaps, they suggest, they should get along to their doctor and insist that he or she prescribe them some Prozac or such like. In very many of these cases, the person talking to me is not depressed at all however – they're just sad, or angry or frustrated or, well, "depressed" with a small "d". What they're suffering from is a surfeit of emotion, not a deadly, dark lack of it. What they most probably would benefit from is talk therapy, good friends and kindness.

Sometimes however, for whatever reason, depression with a small "d" can change into depression with a capital "D" – a major depressive disorder – or, even more frighteningly, clinical depression can just occur out of the blue. And in order to get to a place where healing can begin, medication or hospital- isation is sometimes needed.

Serious, clinical depression is not rational – that's why it is an illness. So no amount of "good news" will shift it – not a win on the Euromillions or a marriage proposal from Brad Pitt.

Serious, clinical depression can also happen to anyone. And like science, this is true whether we believe in it or not. And so, instead of pointing fingers and criticising others for their perceived lack of empathy, we should really take the chance, as Sinead O'Connor wrote in her blog last week, "to turn this into the urgently required discussion of Irish men and depression/ suicide and [ask] how do we get men talking and asking for help, as well as [ask] how do we stop the stigma which makes all sufferers have to hide or hurt".

Aware: 1890 303302; Samaritans: 6710071.


Sunday Independent

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