October 8, 2014
First published: Evening Herald 07-Oct-2014
Depression is a devastating and sometimes fatal illness. But now that we actually talk about it, it's important that we do so with accuracy.
After Robin Williams died by suicide in August, after the shock, during the upset, people who knew him and people who didn't expressed their grief and issued a common call for people suffering from depression to reach out, to stop suffering in silence, not to feel alone.
It felt appropriate because the Robin Williams most of us thought we knew was the slightly manic and very hairy comic who had been in some of the biggest films of our lives, from Dead Poets Society to Mrs Doubtfire via Good Morning Vietnam and the Night at the Museum films.
Sure wasn't he hilarious? What emerged after his death, however, was that his suicide was not completely unfathomable, his friends knew that he had had depression for many years, he was under a lot of stress and he also had early onset Parkinson's.
There had been drugs and alcohol, marriage breakdown, loss and despair. Like any good cliche, the clown's tears behind the laughter are based in truth.
Last month a new campaign aimed at young people with depression, Love From Future You, went live.
It encourages anyone fighting bad feelings to reach out, to speak, to know that it is not uncommon to feel lost, worthless, pointless but that it can be be beaten and it will pass.
Depression in some form or other affects the vast majority of people at some point in their lives.
Whether we experience it as grief or stress or long-lived flatness or a rabid aching despair, whether it's for a reason we can pinpoint or for no cause we can find, whether it is one episode or many, a bad patch or a life long endurance course, most of us experience depression.
But experiences vary greatly and in this, as in everything, we judge others from the perspective of our own experiences.
So if we went through a bad patch but got up and got on with things sometimes we just can't understand why someone else can't.
If we we were floored by a depression that made even the simplest things in life into conundrums we could not understand and didn't care about anyway, we might think that anyone who wasn't similarly crushed didn't suffer as badly, if at all.
The taboo around depression has lifted a lot in recent decades, largely thanks to people like Marian Keyes, Bressie, Owen Wilson and Catherine Zeta Jones discussing their own battles with the Black Dog.
Of course it hasn't completely lifted, there are still people who feel shame, or who are made to feel shame, mental illness carries a stigma I will never quite understand.
I'm not a fan of shame, it's a nasty unproductive emotion, but humanity does have an attachment to it and it is very much a part and parcel of depression.
However, being a bully or a drunk driver or a thief or doing any consciously-decided activity that causes pain is probably a reasonable cause of shame.
Having a mental illness or emotional disorder you didn't choose, that's really not a reason to feel ashamed.
Anyone who feels mental illness is a weakness should be more concerned about the idiocy behind that feeling than the illness itself.
If you want to keep quiet about it, knock yourself out, but acute privacy and
shame are close relatives on occasion.
Public perceptions aside, there are also distinct personal illness styles.
In all matters of sickness there is a definite hierarchy of suffering amongst certain types of people.
A friend who was treated for cancer said she had started to avoid some people during chemotherapy because they competed to see who was sicker.
Because she was beautiful she was intriguing and because she was young there was a good chance she would have a more grievous kind so she attracted the competitive invalid.
Unwillingly familiar with chemo usage and dosage, she knew when people were simply lying to make their illness seem more serious.
On the other end of the spectrum there are people who feel it is more admirable to suffer in silence, to endure quietly, to understate or keep secret.
Some people have to let you know their every little ailment, others would fail to mention if their legs fell off.
I have had my run ins with the Black Dog since I was a teenager. At a point in my 20s I thought I had gone completely mad, it was like I had lost control of my mind and would never get it back.
That incapacity passed and became a Living Dead kind of thing, then I had episodes and oh, just years of crap.
It's only in recent years that I feel I might have finally got rid of the dog. It was a broad range of depressions for a broad range of reasons and I tried a broad range of treatments.
And through it all I always worked. I have always been freelance so no work means no pay and that was not an option.
I think that on most occasions having to work did me good, too much time with my thoughts would have ruined me completely.
At times though it was excruciating and I know not everyone has the same coping mechanisms, or it must be said, the same supports.
I know that but I still judge. For instance I know of someone who has a long history of depression but she is a civil servant and has had all the time off she wanted to recover.
Which is good. Except she has not really recovered. And not only has she not recovered, in part because she does not change the behaviours that exacerbate her illness, but she books days off when there are things she thinks might have her feeling depressed.
And these things include stuff like some dodgy bloke not phoning, again.
She has heard rumblings in work that it is occasionally suspected that she is taking the proverbial, but no-one has dared broach this with her because depression is a mental illness and mental illness is moving from being shameful to being a sacred cow.
To some extent there is always hyper correction when we swing from one extreme to another but the middle ground is where we need to aim for.
Putting depression or any illness on a pedestal where no-one is allowed call bullshit is counter-productive.
Not only is there nothing to be gained by not telling someone the truth, there is also danger in it.
There can be no question that my feelings about the woman above and her use of her sick leave is tainted by an element of dog in the manger, I would have loved a bit of sick pay on occasion.
There is an important issue around realistic discussion of depression and mental illness.
It is important that people do not milk it, that people who are diagnosed with depression know that it is an illness, it is not part of them, that they do not become defined by it.
Depression evolves too. You change and your life changes and that bloody Black Dog hangs on, sometimes with its fangs in your neck, other times dragging out of you, sometimes as a shadow waiting to pounce.
They keep changing the definitions too, there's no such thing as a nervous breakdown any more and what used to be (the much misunderstood) manic depression is at least three different kinds of bi-polar now.
We love a nice label and a nice label is what helps us get help. It is also reassuring to know that the dreadful feelings that haunt you are recognised, real, common, it helps to alleviate some of the isolation to know that you're not bad, or broken, just ill.
However not all depression needs medical treatment. Sometimes depression is a totally normal and expected response to an event.
Sometimes it is just a matter of waiting it out, of talking it out, of time off work, of relearning mind habits or improving physical habits.
If we recognise and explore the different kinds of depression we can discover what treatment works best. That can only be achieved by openness and discussion but part of that openness has to be a freedom to say that not everything is an illness or a syndrome.
The truth is that sometimes people really do need to get their heads out of their bums and make changes.
That is not in any way to diminish the gravity of depression, on the contrary, it is to highlight how serious it can be.
Depression is sometimes chemical, sometimes reactive and sometimes a way of thinking.
Sometimes we all feel bad, it is vital to be able to work out when that feeling is normal or when it has strayed into something else because when depression is severe, it is a life-altering and life-threatening illness.
One of the most remarkable responses to Robin Williams' suicide was a blog post by English TV presenter Annabel Giles.
Her incredibly vivid description of what it's like to have the Living Dead kind of depression includes the line: "My depression is such that I want to die, but I don't want to kill myself."
It's really useful reading for anyone with depression, or anyone close to a person with depression.