When I attended weekly Cognitive Behavioural Therapy sessions, I was more than happy for my colleagues to think I was having treatment for mysterious lady problems, rather than tell them I was going to a psychiatric hospital to get my head sorted. At the same time, I found that frustrating. I wanted to share what I was doing. There were so many people I thought therapy could help (and that‘s not sarcasm). I wanted to talk about it. I just … couldn’t.
I don‘t know why we all stopped talking about depression. The ancient Greeks clearly talked about it. They called it melancholy, or black bile, and they believed it made up a quarter of everyone’s physiology (the other parts being yellow bile, phlegm and blood). Robert Burton’s The Anatomy of Melancholy was published in 1621 and was read and discussed widely. The Romantics made melancholytheir own in the 19th century, and had fans far and wide.
And then – here’s my guess – in the late 19th, and 20th centuries, feelings of alienation became associated with artistic expression and perhaps ordinary people, because they were not artists or writers, did not, could not, admit to feeling depressed. They were sensible and productive citizens, or soldiers. They were not poets or pretenders.
Or maybe our forebears felt it was unpatriotic to admit to feeling depressed, having been advised to keep calm and carry on. Or maybe depression just fell out of fashion. For whatever reason, depression has become a sign of weakness and we hope that if we bury our heads, it will go away.
It won’t.
It’s been around longer than Western society, and it says something about the UK and Ireland that we have almostno vocabulary for describing how we feel beyond the terms we learned in childhood. Where other cultures have developed words like Weltschmerz, saudade and mono no aware, we have no language to address the subtleties of feeling we experience as adolescents and adults, which puts us at a disadvantage.
We do not share the fact that sometimes we feel mental pain, that sometimes it can really hurt, that it can become unbearable, and that we might think about suicide. But depression is part of being human. Think back to the Greeks: they thought a quarter of you was filled with melancholy. That’s like, I don’t know, one of your legs. Imagine carrying round a leg filled with depression. Of course you’re going to give into it sometimes. You certainly won’t be able to ignore it. And others will understand when it plays up.
Depression, according to research, is a physical and mental responseto the prolonged release of stress hormones. Stress can be caused by your work, family situation, social pressures or even how you think about yourself. Depression occurs when your synaptic circuits are overloaded by cortisol – it’s like blowing a fuse, and the brain chemicals that keep us functioning normally, like serotonin, can’t get through the way they should. We’re lucky today to have drugs to prop up our synapses when they break down, and we have therapists to help us sort out our thinking, but wouldn’t it be great if we took the familiarity and talkability of melancholy in previous centuries and merged it with modern research and treatments? I have a feeling there would be fewer suicides.
As it is, we hide depression, and we hide from it. That means many people don’t recognise when they have it, which can be profoundly dangerous. It is not feeling sad or blue. It is not dressing in black and looking a bit gothic. Depression feels like the rawest, most searing kind of grief – the kind you feel at the loss of a loved one – but it is directed at nothing in particular. It is pain you experience every moment you are awake and it colours everything. It makes you paranoid, distrustful, desperate, angry, limited, lost, enervated and frustrated. It is how I felt when I suffered a major depressive episode, and I had no idea what was happening to me. The only relief my brain could offer was the thought of switching myself off, and my husband was terrified.
That’s why we all need to talk about it again.
Families are shocked and scared when their loved ones develop depression. They don’t know what it means or how to manage it, but if it was something we talked about openly, we would recognise it in others and encourage our friends and family to see a doctor. We would not be afraidto admit it, we would treat ourselves and others with greater compassion and kindness, we could protect ourselves from it, and we would know how to help.
For a start, let’s call it something else. Depression is the wrong name. A depression is wet weather or a dent in a mattress. It suggests something rounded and grey and blurry, which is a complete misnomer. My own preference is to call it mood flu, which suggests an illness that anyone can get, but that will go away. Because it will go away, if you get treatment. And even if you don’t get treatment, it will often go away on its own, although it will take longer.
Now is the time to start talking. Depressive illness can begin in autumn, and it’s no surprise really. Around us, the world looks like it’s dying (I bet you’ve had some mono no aware this week). In addition, like all living things, we thrive in light and warmth and, with decreasing light, our hormones tell us to wind down and rest. When we don’t get enough sleep, stress hormones are released – and remember what I said about too many stress hormones? I can’t help thinking that’s what’s behind Seasonal Affective Disorder.
I suggested in the office that we work longer days in summer and shorter days in winter, and my colleagues had a good chuckle. It’s exasperating. Not because people laugh at me (I’m used to that), but because we won’t even entertain the fact that a) we are animals and can’t necessarily control our hormonal responses, and b) work is important, but it is not everything. Of course, we need to work to pay the rent, and give us focus – positive and rewarding work makes us happy – but we aren’t automatons.
However, just like machines, if we wear ourselves out, we will break down.
It all sounds pretty reasonable, doesn’t it? There’s nothing too rocket science-y or weird or scary about mood flu. It happens. It’s normal. We can and do recover. There is no real reason why we don’t talk about it. Perhaps our reticence is just habit, and habits can be hard to break. New behaviours take a while to embed and can be painful to introduce, but I think it will be worth it.
World Suicide Prevention Day is designed to start conversations and I’ve given you plenty to discuss with friends and family. And if you don’t know how to begin, just say, “Hey, did you know autumn is mood flu season?” That, I guarantee, will get a response. Even a quizzical look is a start.
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Tara West is an Irish author based in Belfast. Her first novel, Fodder, was published by Blackstaff Press. Her latest, Poets Are Eaten as a Delicacy In Japan, was published last year by Liberties Press. Her memoir, Happy Dark, recounts her journey into and out of depression and is currently in development.
