Oddly enough, one of the symptoms of both unipolar depression and all phases of bipolar disorder is the idea we aren’t sick.
In depressed phase, it is associated with lowered self-esteem. Together with all other negative thoughts comes the idea that we are just lazy, and we’re just pretending, and we don’t have depression at all. (This is greatly aided by having relatives or friends who provide us with helpful phrases along the lines of “why don’t you just pull yourself by the bootstraps” and “you know, you could just try not to be depressed”.) And so we find ourselves on the floor, curled into fetal position, thinking we’re just imagining all this and in fact don’t have any reason to feel bad, so why don’t we get up and do something. Then we don’t get up and we don’t do something, because depression won’t let us move.
This is a guest post by Rob Robinson. Used by permission.
Since I know that a number of my closest friends on here live with clinical depression and the attendant illnesses that derive from it, I thought it might be appropriate to post some thoughts on the matter, both for sufferers and non-sufferers. These are based on personal experience and also experience of working as a mental health lecturer, so they’re a mixture of life and theory.
What clinical depression IS – and what it isn’t….
Depression is not a lifestyle choice. It’s the most debilitating of illnesses and nobody chooses to suffer with it. The actual cause (as ever the medical profession is obsessed with finding a concrete, biological cause, and preferably one that can be treated with medication…) isn’t proven, though certain chemical imbalances in the brain are thought to occur in the sufferer. As with all mental illnesses, it engenders a great panic in medics because it can’t be ‘seen’ – it is diagnosed through observation, not scans or biopsies – and because it is a disorder of perception and thinking, both functions of the mind, and the mind happens to be contained within the brain, focus of research tends to treat it as a brain malfunction. The evidence for this is actually alarming sparse. Once the two clear physical conditions that might affect the brain – that is, organic disease such as Alzheimer’s, and trauma – where the organ has actually been damaged, as in taking a huge blow – are ruled out, then it all gets into a bit of a mushy grey soup as far as the most severe mental illnesses are concerned. Ironic, given that the brain might be described as mushy grey soup itself….
I often speak to people who don’t understand the nature of depression at all. They are convinced they’ve been depressed — “once after a break-up I cried for three days and listened to Nick Cave a lot, but I just pulled myself together and stopped being depressed”, which kinda suggests you’re just too weak or lazy to un-depress yourself. All it takes is pulling yourself up by the bootstraps, they suggest. Why don’t you stop being depressed? It’s easy!
Except, of course, it isn’t, and they have no clue what they are talking about. Bipolar depression is a chemical imbalance in the brain. (Apparently latest studies suggest it is a sort of inflammation.) You can’t stop being depressed any more than you could stop having cancer. There are ways to improve your mood, but when you’re in the darkest pits, those ways aren’t likely to work. For instance, physical exercise helps, but knowing that doesn’t help much when you can barely get dressed without assistance and taking a shower seems to be the same level of difficulty as climbing Mount Everest without oxygen tanks.
Andreas Lubitz’ name started appearing in my Google Alert a few days ago with speculations on whether he was depressed, or, in fact, bipolar. But a confirmation showed up yesterday:
A friend has told me he met a really fantastic girl. She’s everything he dreamed of. They’ve been dating non-committally for a few months, and now he asked her to be his girlfriend. Her response? “I can’t be anybody’s girlfriend,” she said. “I have bipolar disorder, and it’s a terrible illness. I’m just not fit to have a relationship, any relationship at all.” He asked me how he could convince her. “You’ve got bipolar,” he said, “and you’re in a relationship. It’s possible to have a relationship while having bipolar, right?”
Of course it is. But then the problem with bipolar disorder is that it doesn’t actually make anything impossible. You can be a respected professor of psychiatry like Kay Redfield Jamison. You can be a super-popular actor and TV personality like Stephen Fry. You can be a chart-topping singer like Robbie Williams. You can be married, have kids, a good job. It’s just that for us it’s harder than for “normies”, and some of us overestimate the difficulty level based on what we heard and read about ourselves. And this is where internalised stigma comes in.