The Stigmas of Depression
by Dave Ward

"Why don't you get some exercise, I heard exercise helps depression." 

 "I was depressed once and you know what really helped me, I went out, got my hair cut and bought a new outfit. Sounds silly, but it really helps."  

"Everybody gets sad! You just need to take a deep breath and pull yourself together." Although these may sound like words of encouragement, they can be quite damaging to a person who is suffering from depression.

While 10 per cent of the world's population suffers from depression at some point in their lives, it is not a commonly understood medical condition. Some think everybody gets depressed and those who cannot overcome it are weak. Others quote Aldous Huxley's "Brave New World", advocating that anti-depressants simply mask a normal and natural sadness. Many people don't realize that sadness and depression are two distinctly different things. The stigmas and misconceptions surrounding the subject can often make it more difficult for a person and the family to deal with depression.                          

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"One friend always thought I was a hypochondriac while another friend thought my behavior was just an excuse to avoid the responsibility I had to take in my life. It's just because I look healthy and cheery on the outside," says Jade Brandon, a 23-year-old from Brooklyn.

"My bout with depression gave me more resentment, anger, and loneliness than I had before. I almost believed I was feeble-minded and mentally underdeveloped because someone told me I didn't have enough discipline," she says.

People who want to help their friend or family member sometimes feel that they are damned if they do and damned if they don't. Depression can be a delicate thing to deal with. Often a depressed person feels their peers have simply dismissed their condition or, in other cases, think their family members are over-reacting and treating them like a child.

"I think the most difficult thing for them is when they notice or I tell them that I am feeling down. They tend to over-react and think I will kill myself. It's like I'm not allowed to feel sad like others who don't have depression," says Dana Wigton, a mental health social worker from Jackson, Michigan. 

"My fiancé wants to 'fix me' when I get depressed. He thinks if he can get me out of bed or get me a new job I will get better. If I tell my parents that I am feeling down, they call every day to ask me if I took my medication. This just makes me feel worse because I am not a child, nor am I helpless," she says. 

The reaction of others almost always plays a major role in how well a person deals with depression. However, one's own attitudes about depression can cause a person to go without medicated for years, even for a lifetime. Many depressed people attribute their sadness directly to their life situation and think nothing more of it.

"People often don't see it as an illness," says Dr. Miron Baron, a psychologist at Columbia University in New York. "I think sadness is a part of life," he says. "Depression is completely different. There are distinct symptoms."

The symptoms of depression can vary depending on the person's personality and past experience however, there are common symptoms to look for. Social isolation is probably the most common symptom for depression. Other symptoms are lack of motivation, insomnia, loss of appetite, irritability and anxiety. Another thing to look for is changes in personality. The person stops doing activities they normally enjoy. They may sleep for hours every day, miss appointments, be late for work, or feel tired all the time.

Those who want to help might ask the person how they are feeling and perhaps point out that they haven't been themselves lately. Often the person is aware that they are depressed and may even want someone to confront them about it.

"With normal sadness, you don't expect the same difficulty functioning in areas such as concentration, eating, and sleeping," says Dr. Michelle Clarke, a practicing psychiatrist in Toronto. "Some people think that depression is just an extreme form of being sad. It is qualitatively different from that in a sense that not everyone suffering from depression would describe their mood as sad; it does vary. Sadness does not just come and stay for most of the day, every day for two weeks. The kind of longevity and consistency of the mood is part of what makes the diagnosis and what makes it different," she says.

Even though family members usually have the best of intentions, if they do not accept the fact that depression is a chemical imbalance, their words of comfort may cause a depressed person to feel isolated and guilty. For example, one might say, "you just need to look on the bright side of life" or "you're just going through a rough time right now".

Statements like this may cause the person to think they are weak because they can't cope with the stresses of life. Someone who is concerned for a loved-one who is depressed should first try to get them to seek professional help. Although battling depression does involve a combination of medication and social interaction, the person may need medication to help motivate them to help themselves.

Dresden Wilks is a 21-year-old college student from Philadelphia who has suffered from depression since she was eight years old. She explains that the reactions of people around you heavily influence your perception and self-image. "Misunderstanding about depression can give a depressed person even more of a focus for self hate," she says. "When people I know tell me to cheer up or to just snap out of it, I start to blame myself for the way I feel, and it has taken me many years to trust myself enough to know that it is not my fault and that I deserve happiness."

Helping someone with depression can be challenging because it requires a person to be compassionate without overreacting. The important thing is to offer encouragement while, at the same time, acknowledge that they are dealing with an illness.

Men and Women

"There is no question that depression, in a way that incapacitates you or affects your functioning, is much more common in women. There is a clear preponderance in women," says Dr. Alexander Glassman, a psychologist at Columbia University.

Some psychologists say that cultural roles, stigmas, and pressures cause depression to be more common in women while others think that biological gender differences make women more susceptible.

Dr. Glassman says if more people were aware of the facts about depression, many people could be treated, and then return to a normal healthy lifestyle. "As high as 17 per cent of all people have trouble with depression but they may have only one episode, and so over their lifetime it's not a big deal. With about half of them, depression reoccurs. In about10 per cent of the cases the person may have significant difficulty with depression which again, occurs more often in women than men," he says.

Paul Fedy, a student from Waterloo, Ontario says that he found it difficult to talk to people about his depression because he didn't want to make them feel sorry for him. "There have been many times where I would have liked to talk to someone about how I felt but then I kept it inside because I didn't want their pity. I guess a lot of the time I worry about putting my problems on other people. I don't want to cause them any stress," he says.

Dana Wigton, a social worker who has also suffered from depression, points out that just because statistics show higher rates of depression in women does not necessarily mean men experience depression less. "Women tend to get diagnosed more often with depression, but I think that puts men at risk because they are socially trained not to show emotion from an early age," she says.

"Women tend to get depressed and anxious, men tend to abuse substances and commit crimes," says Dr. Michelle Clark. Perhaps depression is equal among men and women, only it manifests in the two genders differently.                           

Getting Help

Regardless of gender, many people don't recognize the symptoms of depression or they don't consider it to be a clinical illness. "When you look at statistics, what you see is that people don't go to treatment. They don't recognize that there is anything wrong with them that needs treatment, or that there is any treatment that works," says Dr. Glassman.

It can be quite hard to help someone who does not recognize that there is something medically wrong with them.

"One sure sign of trouble is that the person is becoming socially isolated. That's something that needs to be nipped in the bud as quickly as possible because people start to be more and more avoidant the more they get isolated," says Dr. Michelle Clark. "A sign of when they're starting to get in trouble is when their sleeping is off," she says.

It is important to confront the person who is showing symptoms of depression and to try to get them to talk to a psychiatrist so that they can get prompt and appropriate treatment. One of the biggest misconceptions about depression is that anti-depressants only mask what is really a normal and natural sadness. Sure, a person who is depressed may need to make changes in their lifestyle, but once they are in a state of clinical depression, they are often incapable of motivating themselves to make those changes.

Anti-depressants can help people who are depressed, or even suicidal, to gain the motivation they need to make changes in their social behavior and lifestyle.

Jade Brandon, 23, explains that although there are side effects, anti-depressants can indeed save lives. "It's better to have a contaminated body than no body at all. If one notices that the drug helps them, chances are they have a chemical imbalance. Also, if someone feels that their life is not what they want it to be, they should seek changes in their lifestyles," she says.

Every case of depression is unique and the appropriate treatment depends on the circum- stances of the individual. A common problem with recognizing and treating depression is that many people who suffer from depression use drugs or drink alcohol. Someone who smokes marijuana, for example, may not be able to tell the difference between being unmotivated because of being stoned or because they are depressed. The problem is that many people self-medicate their unhappiness with drugs and/or alcohol, which can either mask symptoms or make them worse.

"I don't know that any anti-depressant is really going to be able to work as long as they're using mood altering substances," says Dr. Clark. There are many factors involved in diagnosing and treating a person for depression. Anti-depressants can help stabilize a person's brain chemistry, and they can also help the person find the motivation she needs to help herself.

Helping someone with depression can sometimes be difficult, however a little bit of education on the subject can make a world of difference. Treatment can involve things such as exercise, antidepressants, social therapy, proper diet, lifestyle changes, or a combination. The important thing in treating depression is, not only recognizing the symptoms but also to recognize that depression is distinctly different from sadness.

Once people begin to treat depression they can get on with their lives. Dana Wigton still works as a mental health worker in Jackson Michigan while she continues her battle with recurrent depression. She also continues to wrestle with the stigmas sur- rounding the subject of depression." "There is a huge misconception that people who have depression are weak and will fall apart at the drop of a hat," she says.

"We just have to fight harder for what we have and are much stronger than what people give us credit for. Depression can be managed effectively. Depression does not have to be a life sentence and this diagnosis doesn't mean that people who experience it will never achieve their goals and dreams."

David J. Ward earned a Bachelor of Arts degree at the University of Waterloo in Ontario, Canada. He is currently doing a post-graduate degree in Journalism at Humber College in Toronto. The 23-year-old writer is also working on a cross-Canada film documentary to be completed in 2002. Ward has published various articles in health and travel magazines and hopes to own his own travel magazine in the future.