I don’t need to tell you that, I know. I also don’t need to give you the statistics; they are published regularly elsewhere. They are sound, we know a lot about depression because it is so common, so debilitating, and so costly. And it’s on the increase. Depression is one of the most widely studies phenomena of human existence, it is also responds well to effective treatment in the majority of cases.
Come to think of it, I don’t know why I’m bothering. Misinformation and misunderstanding have such an effective grip on attitudes towards depression that there’s little point. Anyone who says the sort of things I do meets with quizzical stares and the sort of tolerant dismissal reserved for the stupidest kid in class who says they are going to make them something of themselves. Or doubt, or even scorn. It’s enough to make me depressed!
By the way, before you slither off to the side of the doubters (or the knee-jerk critics who say I’m making fun of depressed people), I’d like to tell you about a kid who was dismissed as stupid at school. A kid who was probably depressed from the age of 13 or thereabouts, a kid from a good home with loving parents, but who nevertheless felt isolated and alone. A kid who could become morose, withdrawn and helpless to function well or lift himself out of it, and who missed much of his schooling as a result. A kid who, when he grew up and married would be dogged by bouts of depression and, for his family at least, was not much fun to be with. The story gets worse, and I don’t want to upset you, but the story does have a happy ending, because in his late 30s the young man finally escaped his depression.
You know what comes next; I was that young man. That’s the key to drama, even the surprises are predictable. When I talk about depression in a dismissive or disrespectful tone, it is because we need to dismiss the ideas that are getting in the way of helping people who suffer from depression. We need to become thoroughly disrespectful of depression and laugh in its face. And while we are are at it, we need to challenge our stupid compliance with systems and beliefs that condemn sufferers to feeling worse, not feeling better.
We know what to do
We’ve had good guidelines on the treatment of depression for over 20 years. The USA, the UK and the WHO (World Health Organisation), all have recommended pathways for the treatment of depression, I guess other countries are the same. We know the treatments of choice for depression, what types of treatment are effective, the course of treatment and and roughly how long it takes to become symptom-free.
We know that medication has its place, that it should be used judiciously and, for mild to moderate depressions, always in conjunction with talking therapy. We know how to review treatment and at what point to stop prescribing. We know a lot, but we act as if we don’t know anything beyond the party-line that depression is a medical condition brought about by a chemical imbalance.
One of the problems is that when you put forward ideas like these you are seen as uncaring or not understanding. But I do care, that’s why I’m ranting, and I understand. I understand, partly because I’ve been there, but mainly because I have been trained to help people leave their depression behind, and I’ve been doing that successfully for 20-odd years.
Every case of depression is a personal tragedy. We all need to care enough to start thinking for ourselves, challenging and changing our expectations about depression and its treatment.
Understanding Depression, an interview with Dr Michael Yapko.