This is a column I wrote for a New Zealand Women's Magazine.
(c)2000, Lauren Roche
Depression must be one of the least understood and most under-rated illnesses of our time.
It's a word that's bandied about by many people. "Oh, I was so depressed when 'Friends' went off air for summer." "I can't fit my size 16 jeans any more. How depressing".
So many people use the word as a substitute for sad, annoyed or disappointed, that the condition itself is viewed less seriously than it once was.
Depression is not a fleeting sense of sadness or annoyance. It's a serious illness and can be as life threatening as heart disease, diabetes and cancer.
Depression kills people through suicide, a higher accident rate, self-neglect, and increased risk-taking. It lowers quality of life by destroying self-esteem, motivation, energy levels and the ability to have fun.
I've had depression for most of my life, and believe that it's the worst illness I've come across, and as a GP, I see sick people every day.
Part of what makes depression so bad is the inability of other people to understand the pain it causes. To family and friends (and even some doctors) it is something that the sufferer needs to 'snap out of.' I wonder how many patients with epilepsy or high blood pressure are told they should snap out of their condition and get on with life.
There's no blood test, no plaster cast or wheelchair, no X-Ray or scar that can show just how badly depressed someone is. People seriously ill with other conditions may be admitted to hospital, where they're connected to tubes and monitors. Cards and flowers, hushed visitors and medical attendants all show that they are ill; that this person needs our support and care.
Someone with severe depression doesn't receive any of this attention. The sufferer carries their hidden sickness around with them, trying to be happy and well for the sake of others, who just don't understand what it's like to try to get through a day full of mental pain and negativity.
Depression has many physical symptoms, and is sometimes called 'The Great Mimicker', as it can resemble lots of serious physical disorders. Some of the most distressing features to the person with depression, though, are the sense of failure and self-hatred that the illness brings.
To me, one of the saddest aspects of depression these days centres around body-image and style, and how not fitting into the current ideas of so-called perfect shape unfairly sets a lot of us up for depression.
A recent survey has showed that women who are overweight have a far higher incidence of depression and suicide than our thinner sisters do. In men, the pattern is reversed; the thinner a man is, the more likely he is to attempt to take his own life. There was some debate about what this meant. Does depression lead to weight gain in women, or does the depression stem from the weight?
The figures in men tend to support the second view. We are supposed to revere thin women and beefy men. Anyone who doesn't fit our cultural definition of perfection should join a gym! Lift weights! Cycle endlessly till their legs look like twigs! Then stay that way.
Madder still, even the models, whose level of thinness is just not realistic for most of us, say that they feel fat. Cindy Crawford recently said she wished she were as thin as Kate Moss is.
Depression, fortunately, can be treated more easily that our body image can.
For some people, recovery can be made without medication. Things to try are
- gentle exercise. Make a regular date with yourself for a half-hour walk. This can be a good time to clear your head, and to think of ways around your problems.
- talk. If your friends and family don't understand how you feel (and this is a common complaint), phone a help-line. Visit a women's centre, or Citizen's Advice Bureau. Find a counsellor. See your GP.
- try St John's Wort (Hypericum). This herb is used successfully by many people in place of Prozac.
- beware of alcohol, which is a depressant itself, and interferes with the way anti-depressants work.
If your doctor recommends medicine, take it. Depression is a lot like diabetes, in that it reflects an imbalance of natural chemicals. In diabetes the insulin system doesn't work properly. In depression the chemicals involved are serotonin, dopamine and Noradrenaline. Prozac works by increasing the amount of serotonin available for the brain to use, allowing the normal emotional balance to be restored.
- finally, be kind to yourself, and recognise that you're the only you there is.
Good luck! Stay healthy.