An Image Problem

One of the biggest challenges facing those of us who struggle with depression is a complete lack of understanding from our friends, family, and the public at large. Depression is not seen as an illness, it’s seen as a mood. We try to explain, we cite facts and figures, but most people just don’t get it. When all is said and done, they assume we could snap out of it if we would just try a little harder or look at a rainbow.

A big part of the problem is the name: depression. In addition to being the name of a clinical diagnosis, it’s the name of an emotional state (as well as a dent, a weather phenomenon, and an economic issue). Most dictionaries list the emotional definition ahead of the medical one.

Even when depression is seen as a clinical diagnosis, often it is still tied to an emotional state: a condition triggered by a major event. This incorrectly makes it seem temporary, like a mourning period, and something that will go away as soon as the sufferer moves on or cheers up. While this is true in some circumstances, it’s not the standard.

Depression has an image problem. Imagine the reaction you’d get if you told someone you needed medication to regulate Non-binding Seratonin? Or that you were just diagnosed with Neurogenesis Deficiency Syndrome? That sounds like a disease anyone could get behind without passing judgment.

Another problem is the treatment.

The primary treatment for depression is therapy. Yes, medication can be involved, but it is almost always recommended along with therapy. Therapy carries all kinds of negative implications and social stigma. (This stigma is probably worse for men. We expect women to be a little crazy—“hysterical” even—but men are supposed to be tougher than that.) It’s open-ended. There is no cure, no finish line. Rarely is a patient considered done with therapy. Visits may become less frequent or even suspended, but it’s expected that visits could resume at any time. Progress is difficult to measure, and it’s nearly impossible to compare results between patients or providers.

It would be great if medication or surgery could provide a definite solution, or if depression could be quantified easily and tracked. We could tell our families that our checkup went well, and our blood depression level was down to 8.4%. Instead, we come home from therapy, shrug and say, “It was OK today. The new dosage seems to maybe be a little better. It’ll be hard to say for another couple of months.”

Depression is vague and fuzzy. Despite treatment, it can still come and go quickly. Our ability to discuss it with friends and family is limited by their understanding and our ability to articulate ourselves. Yet we must discuss it, or we run the risk of isolating ourselves even further. It’s a problem.

One thought on “An Image Problem”

  1. I have been sad ALL OF MY LIFE but only recently (56 years old) decided to do something about it (because it was getting worse suddenly). Now I have a diagnosis (double depression), a medication (Bupropion), and a therapist (worthwhile so far). But my wife, to whom I’ve been married nearly 35 years, never knew. I guess she could tell I was moody and grumpy, but she never really knew I was eternally sad (and sometimes much, much worse). So when I sprung it on her and told her I needed to do something about it, she was unprepared. Among other things, she said that she could never trust me again since I’d never told her how sad I was all along. She also used the word “insane” once to describe me.

    I realize most of that came from shock and a lack of vocabulary for this condition. Also, it’s dawning on her that she is mostly powerless to help. But all of that came from the person who loves me the most in the world. I dare not tell anyone at work. They really do prey on weakness there. I haven’t told any friends. Certainly not my family who would tell me to snap out of it and ask what I could possibly have to be sad about. (That’s one of the big ironies: I have just about everything in good shape in my life, and I am sad/depressed nonetheless.) I hide my condition.

    Depression creates loneliness. Loneliness feeds depression. Yay!

    I’m reading The Noonday Demon by Andrew Solomon now. If you’re a reader, I really recommend it. A kindred spirit who writes in terms that non-medical people can understand.

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