Today, 10th October, is World Mental Health Day, a concept instituted 20 years ago “for global mental health education, awareness and advocacy”. This year’s theme is specifically on depression, which, according to the World Health Organization, was ranked as the third leading cause of the global burden of disease in 2004 and will move into the first place by 2030.
So this would be a particularly good time to reveal something which only a few very good friends know about me: I’ve been fighting depression for all of my adult life.
Depression takes two general forms. In the less common type, “bipolar affective disorder”, sufferers have wild mood swings, from deepest depression to crazed mania. Stephen Fry is well-known for being affected by this form of the disease. But more often, there is no manic phase, just recurrent episodes of depression, which can vary in severity. It can be referred to as “unipolar” or “episodic” to distinguish from the bipolar syndrome.
I’ve found that non-sufferers (or let’s call them “normal people”) just don’t understand depression. They’ve been very sad in their lives themselves, or experienced grief, and imagine that depression must be a bit like that. It isn’t at all.
I’m only speaking from my own experience, but depression seems to me to be more like a mental paralysis than any kind of sadness or just feeling low. Doing the simplest things requires a huge effort. A common other symptom is having very low self-esteem, and perhaps feelings of worthlessness, but I’ve never had that. I have two alternate explanations for this difference. One, I wholeheartedly accept that depression is an organic disease, and nothing to do with my self-worth (just as I wouldn’t feel it was my fault if I caught tuberculosis). Or second, maybe I just love myself too much.
The episodic nature of the disease means that I have good times and bad times. During the more severe spells, I cope by cutting down activities and socializing to a minimum. Today, I’m fortunate not to have to get up and go to work every day, but when I did have to do that, I mostly got by, and only rarely invented a physical sickness to cover a day or so off.
So my depression is definitely not the most severe category, because I can continue to function, albeit with some impairment. But some people are hit much harder by it, and practically “shut down” and withdraw from every aspect of normal life. A small percentage decide that they just want it all to stop, and take their own lives.
Friends and relatives can help a lot, but it’s not easy, because depressives are in a state where they interact badly with others. If your friend is depressed, it can help to be gently persistent. They’ll turn down a social event, for example, but might concede after a little encouragement. Or not. Don’t be offended by a refusal, and if you care about someone, don’t give up on them.