The Stigma of Depression
“It’s all in your head”. Yes, unfortunately it is in my head. And my gastro-intestinal system. And muscles. And my checking account. And the hole that once resided a social life. Manic depression – specifically, and mental health issues in general – takes no prisoners and often solicits little understanding. We beat ourselves up. We are tougher on ourselves, punish ourselves more than anyone on the outside could possibly do. And, unfortunately, depression is usually accompanied by an additional partner or two in misery – anxiety, alcoholism, substance abuse, chronic pain. “Take a walk”. “Everyone has problems”. “Be a Man!”. “Toughen Up!” Etc. Some of the pearls of wisdom and encouragement those of us with depression hear. The well-intentioned, but still often cynical and critical, sentiments of “oh, you look like you’re feeling good today” (translation: you are obviously fine and, finally, over your little “illness” and can resume your normal life … and stop moping) do not usually help. The stigma of depression.
Is stigmatizing others, the perceived weakness or inferiority of others, natural? Is it a part of human nature, the human condition? Or is it learned or developed? Whether we want to admit it or not, we are all guilty of stigmatizing someone at some point – whether it was said or thought, we have all made comments or had thoughts, even in jest, about someone who is different from us (it could male/female, age-related, racial, sexual-orientation, mental or physical disabilities or a host of others). Anything about someone who cannot help the shape, form, or condition they exist in. With depression and other mental health issues, it boils down to do you believe someone? Depression cannot be measured like white blood cell levels or heart rate. Yes, everyone “feels down”. And yes, there are those out there who say that they suffer from depression – or any other condition – for their own reason (to scam Social Security or an insurance company, to get out of work or other obligations, to solicit attention or sympathy). Still, it is best to take people at their word until you know different, treat them respectfully and do not belittle them with your own cures and superiority – trust me, we already feel bad enough.
We beat ourselves up. I beat myself up, always dwelling on the past and the bad decisions or plain, old bad luck that have sabotaged this or that. It is extremely unhealthy but it is what we do. And we often turn to drugs and alcohol to cure the pain. Work can become impossible, especially when you are in a stressful situation and/or work for a very demanding and overly critical boss. Most have no idea the amount of guilt that manifests when we call in sick to work or miss an appointment because we are feeling so poorly. “Get up and tough it out”, you tell yourself over and over as you fitfully try to sleep it off. Most have no idea how badly we feel as we constantly make up excuses to not go out and socialize, to spend time with our friends and family (the people in our lives who make us feel best but even then, we want nothing more than to lay in bed and ignore the world). Finally, as I did, you come clean to those who you love and who love you (and even the world in general) and tell them, “Hey, I suffer from manic depression (or whatever it is you suffer from) and …”. Veins are opened, words pour out of your mouth or into the text or e-mail and the relief felt is wonderful. And most will understand, if not immediately, in time. And if not, it is time to do an assessment to check if they really deserve your time, love, and energy. It is our responsibility to eliminate as many negative forces in our lives.
Depeche Mode once sang “Words like violence, break the silence … painful to me, pierce right through me. Words are meaningless and forgettable …”. “Enjoy the Silence” is the song. “Words are meaningless” … and yet so meaningful. They do hurt and we do carry them with us and dwell on them, like bad memories. Words are forgettable? Sorry, no. We can say they do not affect us , that we do not care what others say or think about us but we do. In those dark corners of the mind, where it is just you and you, they lurk under the bed and in closets, ready to pounce and remind you of how bad you feel. “Enjoy the silence?”? You usually never allow yourself to enjoy it. Lord Byron once said, “It is in solitude that we are least alone”. Those who do not suffer from mental health issues must know that we are our own worst enemies, inside our conflicted minds, and we do not really have a need for more misery. Thank you.
In popular culture, depression has been a frequent topic, and that is a good thing. David Chase created our generations alpha male, Tony Soprano, and the late James Gandolfini played him perfectly – strong, full of rage, and manic depressive. Early in the first season, Soprano is driving with his “nephew” and Family heir, Christopher, and, after just being told by the woman who would become his therapist throughout the series about what he suffers from, he asks Christopher if he ever feels depressed. Christopher replies, “Me? I’m no mental midget.” and dismisses the entire subject with a look of irritated disdain. It is a look we know well. Several episodes later, Tony opens up to his crew about his condition, explaining that he sees a therapist and is on medications and the camera pans to Christopher, who has the perfect expression of embarrassment and regret, obviously looking out of the corner of his eye for the closest hole to bury himself in. Chase and Gandolfini did us a great service with their brilliant work but much work remains.
On March 16, 2015, Anna McDonald of ESPN.com wrote an article on former top prospect, pitcher Ian Ferguson. Out of Colorado, Ferguson was a top prospect in the Kansas City Royals system and was poised to make an appearance with the big league club in 2003, but he suffered from debilitating anxiety and his career derailed to the point where he was soon out of baseball. However, he was able to come to terms with his condition and move with a positive life – he is now married and works for the city of Denver’s Parks and Recreation department. I do not want to spend a lot of time re-hashing his story so please check it out on the link below – it is definitely worth reading. If nothing else, the article highlights that mental health issues can affect anyone, at any time and completely destroy everything in its path – careers, relationships, lives.
Depression, anxiety, and the other, various forms of “major depressive disorders” reportedly affect up to 7-8% of the population, with women approximately 70% more likely to experience these symptoms than men. Of course, it could easily be that many men do not actively or officially report their symptoms, their “disorder” to a medical professional due to the on-going stigma in this country. They may fear admitting this “weakness”, for “not feeling like a man”. It is widely believed that in many of these cases and situations, many will self-medicate to help fight the demons, rather than spend time with a therapist or psychiatrist. Alcohol or illegal drugs are a common substitute for antidepressants. It should be noted, though, that many – if not all – antidepressants have side effects, many serious, and the first (or second … or third) medication prescribed and taken may not work. If often times takes some time to find the proper medication, and course of action including psychotherapy. And, like me, you may easily find that no medications truly work.
According to the National Institute of Mental Health (nimh.nih.gov), “Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.
People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.
Signs and symptoms include:
• Persistent sad, anxious, or “empty” feelings
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable, including sex
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping
• Overeating, or appetite loss
• Thoughts of suicide, suicide attempts
• Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
Depression is an awful thing. Checked, you are on medication or seeing a therapist or psychiatrist, or both, and do your best to understand it and cope. Unchecked, it is largely ignored and misunderstood – although it is misunderstood no matter – and manifests through bouts of self-medication and self-loathing, volcanic fits of rage or silence and just not feeling well. Once you understand what you are suffering from, once you can accept it, the rage or silence and “un-wellness” of it all will likely continue but accepting it, confronting it, and seeking help in fighting it are so vital to living better. Living better is always the goal, the key for everyone in life. We are not weird, we are not devoid of love or feelings. We love our husbands and wives, boyfriends and girlfriends, family and friends as much as anyone and we can be just as successful as anyone in our fields. We just need some understanding … from you and from ourselves. Be nice, please. And we will always do our best. And then we can realize that what others think, their stigma’s, really do not matter.
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I am a 43 year-old writer, having self-published my first novel last summer, graduate student in Urban and Regional Studies (government, basically) and manic depressive. Having worked for years in mortgage lending, I was laid-off for the third time a couple of years ago – while on medical leave for my depression – and moved in with my parents, which is not ideal at my age but has been nice considering my mental health issues. I hope to soon be back on my own, feeling well, and beginning a new career. I live in the Twin Cities, Minnesota.
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