Day Eighty-Seven: De-Stigmatizing Depression

I was talking with a friend the other day and she seemed a bit down. She confided in me that she was battling depression and was not having a very easy time of it. After a few questions, she said something that really startled me. She said that she hoped that the parents of her children's school friends wouldn't find out about her problem, because she was afraid that they wouldn't allow their kids to come over anymore. I was really shocked. She was clearly upset about this possibility. I had to admit that there are people I actually know that would think this way; think that there is something so wrong with her that she could not be trusted with their children. Yet, I had not stopped to think about it in these terms. I rarely do. I simply assumed that most educated people would be enlightened, sensitive and caring. This is just not always so.

I had been toying with the idea of writing about my own struggles with depression in this blog. Something kept stopping me. I felt it viscerally. I have been struggling with writing these past few months because I have been having issues with both depression and hormones. I have been agitated, withdrawn and moody. I couldn't write because I was depressed. Upon a bit of self examination, I had to admit that the reason I hadn't written about it is because I was fearful of the reaction of others. I didn't want to open this door to the scrutiny of those who may think less of me because of my condition. Really, this reaction is not too far off from that of my friend. As I was mulling this over, I came across a relevant article in (where else?!) Oprah's O Magazine.

In "O", there is a monthly column entitled "Aha Moment." Notable people are invited to share the "aha moment" in their life in the hope that it will shed some light into our own lives. In her "Aha Moment" piece, Glenn Close talked about her commitment to change the perception and fear surrounding those suffering from mental illnesses. "My aha moment hit me several years ago, when I realized that three deeply frightening words had power over me: schizophrenia, depression and bipolar. There is mental illness in my family. And I knew if I really wanted to help, I would have to learn to say these words fearlessly, out loud. That's the beginning." (The Oprah Magazine, January 2010, Volume 11, No. 1) Talk about the universe giving you what you need... This article hit me like a truck.

I have been very open about my diagnosis of depression. I talk about it with my family, my friends and even my acquaintances. I didn't really give any thought to any fear about discussing my depression until I thought about sending it out over the web for all to see and all to judge. There are some very real vestiges of the middle ages lurking in our collective consciousness. The idea of the "mad woman" or the "lunatic" who needs to be shut away in an institution as to not inflict harm on innocent bystanders is still viable. More common is the notion that someone with depression is just a wimp who needs to pull it together; the "stop being weak and pull yourself up by your bootstraps" mentality abounds. Worse still are those that think that popping a pill is some magic bullet. Just take the right "meds" in the correct dosage and things will be rosy from then on. The reality is far more complex than any of these misconceptions.

I suffer from chronic depression. There are seven categories of depression and they range from the mild to the truly debilitating. There is Major, Chronic, Atypical, Postpartum, Bipolar, Seasonal and Psychotic Depression. These are real, serious medical conditions. These are not manifestations of a temporary situation nor are they a product of a personal weakness. These conditions are biochemically based and stem from an imbalance in the brain and the spinal cord. Specifically, people with depression have a smaller hippocampus which, in turn, means that there are fewer serotonin receptors in the brain. Serotonin is a neurotransmitter or a chemical which allows for communication between the nerves in the brain. The photo of the markedly less active brain above shows how stark the difference between a brain with firing neurotransmitters and one which is not working as well. This results in the myriad of emotional and physical symptoms of depression; loss of appetite, inability to sleep, feeling lethargic, disinterested in one's surroundings and activities, feeling useless, listless and worthless. Not fun. No way. No how.

Somehow, when we talk about a chronic illness that has nothing to do with the brain or with emotions, we do not carry the same fears into the conversation. We don't expect a cancer patient to "pull themselves up by their boot straps." We don't think that someone with heart disease should just "suck it up" without taking any medication. We don't expect someone with high blood pressure to wean themselves off medication. Why then do so many of us think this when it comes to depression? I think it is absolutely ridiculous to be ashamed about taking medication for a documented medical condition when that medication aids in the alleviation of symptoms. Sadly, there are millions of people who do not agree. Because of that, millions of people needlessly suffer.

It is estimated that 121 million people world wide suffer from some form of depression. Women are two times more likely to suffer from depression than men. Although the "depression" gene has not yet been found, it is clear that heredity plays an important role in whether or not you are likely to suffer from depression. It is estimated that 30% of substance abusers are suffering from depression, thus, they are using drugs and alcohol to "self-medicate." Over 50% of people with chronic illnesses suffer from depression. Once the depression is addressed, it is proven that the underlying chronic illness better responds to treatment.

In looking back, I have suffered from chronic depression from the onset of puberty. I did not have my depression formally diagnosed or treated until I was 29 years old. I clearly remember when the medication first began working. It was like a veil had been lifted off my brain. My perception was clearer, was "happier" for lack of a better explanation. I thought of all the years of suffering with crippling self doubt, self loathing, confusion, sadness, anger and longing and of how much time I wasted trying to "just deal with it." I do not regret my path in life, but it is hard not to acknowledge that many years would have been much easier had I known I had a real and treatable illness. I was not just moody, I was not just a bitch, I did not just have a low-self esteem. I had chronic depression. I doubt that anyone around me thought that a bright, young, successful high school student was clinically depressed. My pediatrician didn't catch it. My parent's didn't know. It wasn't something people talked about or often contemplated 25 years ago.

I know that depression has made things harder for me. It was harder to concentrate in school- high school, college, law school- during times of normal, emotional upheaval. It can be harder to parent when I'm not feeling very good about myself. It is harder to bounce back from normal trials; not getting that job, owing at tax time, gaining an extra few pounds. From the profound to the silly, things loom larger than they should when suffering from depression. Medication is a great help, although it needs to be adjusted from time to time; weight gain, pregnancy, aging, all play a factor. Talking is also a great help. Talking to my doctor, to a therapist, my husband, my friends and family, with people who understand, with people who don't, with anyone with a sympathetic or knowledgeable ear is very therapeutic. Despite this need, I find this not the stuff of "polite" or "acceptable" conversation. Often this isn't a topic people want to talk about freely.

I am. I am talking about depression and my experience with it freely. I am talking "fearlessly and out loud". People suffer from depression. Good people, bad people, educated people, ignorant people, men, women, teenagers, black, white, Asian, Christian, Jewish, Muslim, atheist, physically fit, obese, funny, boring, obnoxious, ANYONE. It is not a personal failing. It is medically treatable biochemical condition. I have found that the more I talk to people about it, the more likely it is that they too have someone in their family with some form of depression. It is clear to me that the more we talk about it, understand it, and look at it square in the eye, the more people will seek help and find understanding. More people will see that their loved ones, friends or neighbors are not someone to be pitied, ignored or shunned, but regular people with just another medical condition. The more we talk, the less frightening the words schizophrenia, depression and bipolar become.

Thank you Glenn Close. Thanks also to Me. I feel tons lighter for this one sided conversation. I hope it helps you or someone you love too.