Depression is a Disease

I don’t know why I’ve felt so compelled to write about mental health issues lately.  Perhaps it’s because I’ve been feeling a little bit better, and with more energy and clearer thoughts, I am more able to speak out or advocate for those who I fear have less  of a voice.  But for whatever reason, I do feel compelled.

I’m pretty much a talk radio junkie.  I spend hours in the car a day, so this makes my life a bit more enjoyable.  This morning I was listening to an interview with an author who wrote a book about prayer in people’s lives.  It sounded interesting, so I started listening.

This woman was speaking about how she experienced extreme clinical depression for years in her twenties.  That sounds like something I could relate to.  And then she talked about how after years of not believing in God and on the brink of suicide, she fell to her knees and began to pray.  Her story is a pretty remarkable one with her feeling led on a train, into Manhattan and finally finding herself in front of a cathedral where she reunited with her faith and her depression lifted and her life regained meaning.

Awesome for her!  You go girl!

It would have been a heartwarming story.  But then she opened her mouth again, and out came the notion that people don’t need all those years of therapy and all of those medications (both said in a tone seeming to mock the ridiculousness of such treatments.)  All people need is God.

Hmmm.

I believe in God.  I pray a lot.  I go to church.  I am still depressed.   I must be doing it wrong.  In addition to living wrong and thinking wrong and feeling wrong, I must also be praying and believing in God wrong.  This depression  must be my fault.

No, those weren’t the thoughts that went through my head, but I can tell you with certainty at one point they would have.  Her thoughts would have given me further ammunition to attack my own character and further verification that my illness was my fault.

Our culture has a weird relationship to mental illness.  Even when we don’t or even when we don’t want to, we put it in a different category than other illness.

There’s cancer and diabetes and heart disease and arthritis and gum disease.  And then there’s mental illness.  Over there in the corner.  With those other ideas that we want to give equal weight to but that we are often really secretly judging, thinking we could never fall prey to such an illness.  We are stronger than it.

And I think part of it is because of the symptoms that are indicative of mental illness — behavioral changes, emotional changes, cognitive changes.  As a society (and perhaps as a species,) we like to think we are in ultimate control of these things.  We often define ourselves and our lives based upon these very same things.  People who do a,b, and c are living life right.  People who do x, y, and z are doing it wrong.  I’m in the first group, and so I am good and right and just and healthy.  People who are unhealthy, people in the second set are just weak.  People who worry too much just don’t focus on the right things.  People get depressed because they are not able to see things in the positive light that I am.  They allow themselves to succumb to pessimism.  They aren’t as strong as I am.

If we are to fully see mental illness as a disease, I think it would require us to acknowledge that the healthy parts of our lives are at least in part due to factors like good biochemistry, a temperament conducive to moderation, and a lack of overwhelming life situations.  After all, if mental illness isn’t completely a choice, then mental health isn’t either.

And I think another aspect is just the way we view our own circumstances.  How frequently do we hear people saying they are so depressed because a television show was cancelled or saying they are so OCD about cleaning their counters or they are so ADD when it comes to reading?

We take our quirks and passions and equate them with the real struggles of other people.  Can you get depressed about a show being cancelled?  Sure.  Is it on the same scale as someone suffering from clinical depression?  Probably not.  (And I speak as someone who was completely heartbroken when All My Children was cancelled… twice.)

And putting the symptoms aside for a bit, that leads me to the comments people make about the solutions.

“I started running and my depression lifted.”

“I started eating healthier, and I was no longer anxious.”

“I started praying and my mind cleared.”

“I took this supplement and started meditation, and everything got better.”

Are these statements true?  Absolutely.  These things help people with mental illness.  There are as many treatments as there are depressed people.  If these worked for these people, that is remarkable and I thank God they were able to find treatments.

Do those work for everyone?  No.

Part of what people who haven’t had problems with depression don’t understand is that our behavior is oftentimes dictated by the disease.  Do we know deep inside that going outside and taking a walk will help?  Yes.  Can we do it?  No.  Do we know that eating regular, healthy meals will help stabilize us a bit?  Yes.  Can we do it?  Not always.

The very nature of depression (particularly moderate to severe depression) makes many of these activities impossible.  It’s the nature of the beast.  The treatments can be almost impossible to carry out.

And because of that, I think we start to moralize the disease — either outright saying (as the woman above) or strongly implying that people are depressed because they are deficient in certain areas that we hold dear.

Which brings me to antidepressants and therapy.  Oftentimes people who are against one are against the other.  With these people, I can’t help but think they question the very existence of the disease itself.

It seems to almost be a badge of honor in our culture to be against medical treatments for mental health issues.  “I would never medicate my child,” or “I would never put those drugs into my body.”  And what statements like these do is shame those who choose them or who want to choose them.

I’ve been on antidepressants for the better part of the past ten years.  But every time I go back on them, I start the whole cycle of shame all over again.  Should I go on them?  Am I being weak?  And of course the decision is severely complicated by my cognitive and emotional processing which is severely subpar when I am in the thick of things.

And that’s why these issues are so important to me.  It’s why I seethed the whole way home after hearing this segment on the radio.  When people make blanket statements about what will help depression and scoff at other treatments, they are causing serious damage to the mental health community.  And they are making very personal decisions much harder.

I am so happy for that woman that prayer helped her.  That bringing God into her life helped her.  But to say that this is all people need to overcome clinical depression is both shaming the depressed person because of their illness and shaming them away from possible solutions.

People die from depression just like they die from cancer or AIDS.  Different treatments are best for different people.  To shame people away from certain treatments based solely upon your own personal experiences all the while ignoring all of the scientific evidence is what is shameful in my opinion.  And it’s more than shameful; it’s extraordinarily dangerous.

Depression is a disease.  Pure and simple.  It’s not some magical state different from other illnesses.  It’s not a weakness.  It’s not a moral or a character deficiency.  It’s not a choice.  It’s a disease.  It’s a multifaceted disease caused by a myriad of factors and treated according to the individual in question.

It’s a disease.  Pure and simple.