Even though clinical depression affects about 10% of the population, it amazes me to see the lingering stigmas associated with it. I suppose I should be glad that there are people who just don’t get it – that means they’ve never had to, and I hope they never do. These are ideas I run into time and again, and if you’ll notice, they tend to be variations on the theme of “people with depression should just get over themselves.”
You can probably guess that my knee-jerk response to that involves a lot of curse words. In the interest of fostering understanding on the subject, however, here are some more…thought-out responses.
1. Depression is something you can “snap out of.”
I’ve heard this one about a thousand times, and never from someone who has actually had depression. If you can “snap out of it” by “thinking positive,” then you may have been depressed, but you didn’t have depression. There is a difference, though it’s really more of a continuum than a dividing line.
Everyone gets depressed. Sadness and even despair are part of the human condition. But there are people who, for whatever reason, are unable to emerge from that sadness for long periods of time, or who go into a spiral without any outside stimuli. Their brains are wired up all funky and they don’t maintain a balance of chemicals like seratonin and dopamine. Their transmissions get stuck in park. Healthy levels of emotion become distorted, and despair slowly consumes everything else.
For a lot of people there are underlying emotional issues that feed into that imbalance, and addressing those issues can help stop the depression from recurring and can help other therapies work better and faster. But when it gets to the point that you can’t get out of bed, there is no snapping out of it. All the New-Agey affirmations in the world aren’t enough, sometimes – sometimes you have to call out the big guns.
Ideally no one would ever get to that point. Ideally we’d live in a world where emotional problems were dealt with at onset and no one felt the need to bottle up their problems until they become toxic. But guess what? This is a messed up world and we are a messed up people.
The efficacy of talking therapy is actually subject to debate. Not everyone benefits from sharing their innermost problems with a paid professional. A great many people do. A lot of people benefit from both therapy and drugs. Emotional problems are never simple, and a single approach, whether pharmaceutical or otherwise, is rarely enough. You have to be willing to come at it from all sides and find the combination of therapies that works for you.
2. If you take antidepressants it’s because you can’t or won’t deal with your own problems.
I take antidepressants because I want to function. I want to get out of bed. I want to hold down a job. I want to engage with my friends and family and I want to have the energy and desire to leave my house.
I have what is known as treatment-resistant depression, so it’s possible that I’ll never be able to do those things without help. Once I got over the notion that this meant I was somehow more, or less, broken than the average person, I was able to look at it as a manageable health condition rather than a judgment about my character. I’ve been on some form of antidepressant for about 80% of the last 13 years, and truthfully I probably should have been before that. Some people have depression for six months or a year, are treated, work through it, and never have to deal with it again; for some it recurs; for others it never goes away, and is always lurking in the corner.
I come from a pharmaceutical family, so I have long understood that drugs, like every other kind of medical intervention, are powerful and important tools. They don’t substitute for healthy living – a triple bypass doesn’t just undo 40 years of cheeseburgers – but they have their place and have saved countless lives. Are Americans over-reliant on prescription medications, thanks in large part to the pharmaceutical industry itself? Hell yes. But that doesn’t mean that everyone who takes antidepressants is some kind of weak, self-indulgent yuppie.
Depression is a mental health condition. Like any health condition it requires treatment, and left untreated can cause all manner of consequences up to and including death. You wouldn’t expect someone to just suck it up and deal with cancer, would you? Then why should an emotional cancer be treated the way “female hysteria” used to be? Just because something is “all in your head” doesn’t make it any less debilitating.
3. Antidepressants turn you into a zombie.
They can, if you’re on the wrong one. People often don’t realize just how many antidepressants there are out there, and more importantly how different everyone’s brain is. The main class of drugs, SSRIs, comprises a dozen or more drugs, and each one works differently for each person. The first one you take might not work, or it might work but not very well. You may need to adjust your dosage or change drugs completely. You may have the common side effects or some wild and crazy new ones. One size does not fit all. You’re looking for a key that will fit in your particular lock.
4. Antidepressants can “fix” you.
Antidepressants are powerful drugs that can alter your entire way of existing in the world; they can nudge you out of a downward spiral that could very well take your life. They can help restore the color to life and help you feel strong enough to take a deeper look at what’s going on beneath the inertia.
But they can’t fix it. They can’t make the bad things in your life go away, or make you love yourself, or make your relationships healthy. They are not a magic wand, and they don’t work for everyone. And while I’m a big believer in their judicious use, I don’t think they’re something to just jump into without a bit of research and a long conversation with your doctor.
I think that’s where a lot of people get tripped up; they think that antidepressants can make your problems go poof and suddenly unicorns and rainbows shoot out of your every orifice. The only thing I know of that can do that is LSD, and it’s really not something I’d recommend for everyday use.
5. You shouldn’t medicate depression because it’s trying to tell you something–it’s good for you! It makes you more creative! All you really need to do is go vegan/do yoga/meditate/pray.
With all due respect, kiss my asana.
I believe that all life experiences have the potential to teach us, and that we can gain a lot of positives from even the worst negative, but this goes back to Myth #2, and it infuriates me. Sentiments like these tend to come from, as I said, people who’ve never dealt with depression themselves; or people who found a therapy that worked for them and are now evangelizing it.
No, we shouldn’t medicate every negative emotion; and by and large people in America don’t know how to feel in the first place. We tend to stuff and suppress everything by buying into consumer culture thinking that more food, more possessions, and more money are a substitute for genuine experience. But while emotions are what make us human, screwed up brain chemistry is not the same thing – clinical depression means that your emotions are not in accord with your circumstances. You could be having the best year of your life and it would barely register; in fact chances are you’d feel guilty on top of everything else for not having that “attitude of gratitude” that spirituality bloggers love to talk about.
In fact that tends to happen with lifestyle-related depression “fixes;” you try them, can’t maintain the change because of your depression, and are left feeling worse, because now not only are you depressed, you’re a failure. This is why I say that there’s no single healing modality that banished depression. If you want to recover from it, you need to take a more holistic approach. It may be that you need to start with drugs, which lift the clouds enough that you feel able to take the next step, whatever that step is for you.
My observation is that the best overall treatment for depression is a combination of healthy diet, exercise, meditation, some kind of emotional expression (which may be talking therapy, writing, art, et cetera), and learning your symptoms well enough to know when things are getting bad, hopefully enabling you to nip recurrences in the bud. This is easier said than done, of course – I haven’t quite managed it yet. But like all healing, it’s a process, and takes a lot of baby steps, some of which end up going backward. The trick is not to judge yourself for needing help. It’s true that our society is toxic, and that societal factors play a huge role in the upswing of mental and physical illness (just look at how many things we declare “war” on in the news every day – cancer, obesity, drugs, depression, you name it). But take it from me: you can’t change the world if you can’t get out of bed. Healing, as with regime change, begins at home.