Today is another day on which a celebrity reminds us all that depression is a genuinely life-threatening disease. Robin Williams’ apparent suicide has shocked the world. Of course it has, just as any premature death ought to. But as with many deaths from suicide or related to addiction or general psychological issues, particularly with celebrities, there’s a minority of people who don’t quite understand. “What did he have to be depressed about?” people ask. “He had money, fame, respect… what’s not to love about life if you’re Robin Williams?”
It always bears repeating: depression is not a selective illness. There are compounding factors, of course: poverty, childhood trauma etc. But depression can come from anywhere and attack anyone. It’s important that people understand this, if the ongoing stigma is to subside.
It’s why articles like James Rhodes’ for The Telegraph today are important, and why people like Stephen Fry (who tweeted kind words about the article) continue to be crucial figures in the fight against mental health stigma.
Still, both Rhodes’ column and Fry’s comments regarding it left me a little uncomfortable. It’s not that the core message is troublesome. Far from it. The more times we can stand on a podium and remind people to talk about depression, to learn about it, to educate themselves and support those who are suffering from it, the better. In its introduction, though, Rhodes’ piece quite explicitly draws a distinction between severe and mild forms of depression, and his use of language carries a nasty undertone of sneering at those whose problems aren’t “real”.
Let’s be absolutely clear about something: nobody’s problems are trivial. Ever. If problems become trivial, they’re not problems; they’re minor inconveniences. It’s the reason I always found it baffling to see some people with self-harm problems berate others for “only doing it as a cry for help.” (Have you actually stopped to consider that phrase? “A cry for help”? A cry for help – as if someone crying for help is somehow worthy of sneers and derision, instead of – y’know – help.) It’s the reason that “well, some people are starving in Africa” is never an appropriate response to anything, and why the “first world problems” meme continues to irk me. And, placed in the context of a real, life-destroying illness, this attitude takes on a particularly scary face.
It’s scary because depression grows. If left unchecked, it bubbles and simmers inside you, barely noticeable at first, then a little more noticeable, before eventually you realise it’s taken over everything. You realise that the thing you loved doing a year ago now seems miserable to you, and you half-recall finding it mildly tedious six months back. You note that the constant reminders to yourself, that it will seem better after a good night’s sleep, aren’t something you can cling onto all that well when they never turn out to be true. Slowly, but at the same time very suddenly, you realise it’s sucked the life out of you.
Temporary illnesses are only ever temporary once they’ve stopped. Until then they’re constant, and it can’t always be easy to predict which way things will go. Indeed, depression itself can be temporary. Generally speaking, a period of two weeks of symptoms that match, with no obvious or typical trigger, is enough for it to be considered an episode of depression. For some people, that two weeks is the only time they’ll ever struggle with it. For others, it will be years, perhaps decades, of continual pain and suffering. For many of us it’s somewhere in the middle: a series of shorter episodes, a few days or weeks at a time, thankfully broken up by happier times. For those of us in the latter position, it’s something we learn to live with, and to not let consume us, but make no mistake: while we thank our lucky stars our situation isn’t worse, we still consider it a very “real” thing to live with.
Well-intentioned or not, I struggle to not be offended by Rhodes’ use of language. It “seems” that a lot of people are depressed, but “of course” they’re not. They’re just “claiming” to be depressed. They’re doing so for a variety of ludicrous reasons, such as being bought the “wrong-coloured iThing” – and the misuse of the term is diluting the perceived seriousness of “real” depression. We know that our use of language, to an extent, colours the way people around us see the world, so it’s an important topic to consider. But in raising this argument, Rhodes himself falls prey to temptation toward hyperbolic language, and leaves a gaping hole wide open in a genuinely problematic way.
The fact is that, like most illnesses, depression has different severities and, like most mental illnesses, is really a convenient catch-all term that describes a spectrum of psychological conditions. Practitioners will diagnose anything from “mild” to “severe” or “clinical” depression, and they use a complex (though not flawless) system to make these diagnoses, based on points accumulated from a survey of symptoms and the length of time those symptoms have been experienced. James Rhodes, meanwhile, asserts that depression should be considered separately from a case of “temporary low mood” that can be treated with talking therapy, citalopram and patience.
This is an odd thing to assert. What Rhodes is saying here is that psychological issues that require fairly significant treatment still aren’t proper depression unless… well, unless what? Unless you feel suicidal? Unless you self-injure? What are the criteria upon which Rhodes feels one should be allowed to “claim to be depressed”?
In his very own introduction, Rhodes loses sight of what becomes the very admirable point of his article: that it is important to listen to those with depression, to understand the condition they live with, and to talk openly and in confidence about an illness that has long been stigmatised. When you have, within the opening three paragraphs, already alienated a range of people with that very condition, there’s a problem. It’s counter to everything he goes onto argue.
The truth is, while it might be important to differentiate between severe and mild depression in terms of treatment, it’s not even slightly relevant to the wider discussion of the topic. People who catch their malignant mole before it starts to spread don’t steal the attention away from those with Stage IV lung cancer. People having a moan about the cold they caught aren’t damaging the world’s attempts to quell the Ebola outbreak. Selecting our language carefully is important, but there is a huge distinction between trivialising a word and using it in a way that feels appropriate to a given situation.
Do you feel like you’re depressed? Use the word. Go nuts. Shout it from the rooftops and help people to understand. People should be able to feel more comfortable talking about the illnesses they live with; in the world of mental health, it’s vital that we move in this direction. Of course it’s not cool to commandeer this sort of language to talk about a minor snafu you’ve had to deal with, just as it’s problematic to talk about how the price of your Sainsbury’s shop “raped” your wallet or whatever. But please, don’t be put off talking about your life because other people’s problems are perceived as worse than yours. These things can grow, and you’d be damn well better off acknowledging them early, before they start to spread.
For what I consider to be the most exceptional description of depression, one I still struggle to read but which I think is vitally important to do so, check out Allie Brosh’s ‘Adventures in Depression’.