Blogathon Post #14: Depression

Throughout the month of August, I'm aiming to write 25 blog posts. This is post #14 of 25. Find them all in the "blogathon 2014" category.

[Content note: depression, anxiety, mental illness, suicide, disordered eating]

Depression/Anxiety is a normal thing. You don’t need to medicate it. It’s part of life and a beautiful part at that. There are circumstances in our world that are extremely sad and depressing. As a human, it’s an honorable thing to allow oneself to feel that.
The Polish Ambassador

No.

No, I’m sorry, I can’t let this be.

A friend of mine posted this quote on Facebook the other day. It comes from The Polish Ambassador, an electronic musician also known as David Sugalski. Over the years, I’ve lost much of my interest in bickering on Facebook, so I didn’t raise my objections there, but I have serious problems with this quote, and I can’t just let them go unvoiced.

Preamble

Before I go, however, let me say this:

Nothing of what I’m about to say is meant to discount the lived experiences of The Polish Ambassador or anyone else. Depression varies in its symptoms and treatment, and since I’m not TPA, I can only take him at his word when he describes his experience. I’m glad he found a way to deal with his depression that worked. I don’t take issue with him, or anyone else, doing what they need to in order to conquer–or even just get a leg up on–their depression. Depression is awful. Do what you need.

What I do take issue with, however–very, very big issue–is the way he framed it. The way he puts the issue of depression is misguided and harmful. He’s not alone in his thoughts, however, and I think it’s important to push back against this particular argument.

Beautiful Agony

TPA starts by saying, “Depression/Anxiety… [is] part of life and a beautiful part at that.”

We love to romanticize depression. On Tumblr, browse the “#soft grunge” tag and you’ll find artfully edited photos of scars and Instagram-filtered pictures of cigarette cartons with phrases like “You’re going to die anyway” superimposed. “Soft grunge” treats depression and suicide like beautiful black roses–twisted, painful romantic ideals. We do it off of Tumblr too, like when we associate our favorite comedians’ or authors’ mental illnesses with their genius. Half the time, it seems, “tortured soul” is uttered in awestruck, not empathetic tones.

It’s certainly important to not stigmatize depression. Depression is a woefully common illness, far more prevalent than people think. Stigmatizing it and the people who experience it is a short path to nothing good. But, like blogger Sarah MacLeod writes, there’s a fine line between support and enabling:

Every time you reblog pictures of a computer screen that says “stupid sad girl” or Marlboro cigarettes with sticky notes pasted on them saying “because you broke my heart,” every time you contribute to a culture that makes depression seem like a quirky thing to add to your “about” section instead of a serious disorder with one of the highest death rates of any illness, you are actively making it okay for people to ignore their health problems and just be sad. That’s enablement.

The Polish Ambassador writes that depression is a beautiful part of life, but that’s not only wrong, it’s irresponsible. Saying that depression is beautiful encourages people who are experiencing it to bear it as an exquisite burden. It makes it sound like depression is something we should want to experience.

Remember, depression is an illness in the mind. Depression often turns people’s minds against them, discouraging them from seeking help or treatment as they sink further and further down. To add to this dangerous spiral your insistence that depression is some sort of beautiful agony which we should aspire to experience only further discourages people with depression from pursuing a solution.

That is not beautiful. That is not romantic. That is actively enabling people who suffer from a deadly disease. And that’s not okay.

Rainy Days

The Polish Ambassador also insists that depression is “a normal thing… part of life.” After all, he says, parts of life are sad and depressing. If we follow his argument out, treating depression is “disallowing” oneself to feel sadness at entirely appropriate times, a choice that TPA doesn’t appear to consider “honorable”.

If he were simply saying that depression is more common than people realize, an important thing to be aware of and take seriously, then I’d have no issue with this. I’d agree wholeheartedly. But this isn’t what he’s saying. TPA does what so many people do when talking about depression, and conflates sadness with depression.

Now, the two are often related. Depression can manifest as unhappiness, sure, and unhappy circumstances can trigger depression. But to suggest that they’re one and the same–not just in his own experience, but for every human out there–is awfully obtuse, and honestly not something I’d expect from someone who’s experienced depression.

Let me speak from my own experience. I’ve been sad, painfully sad before. When my close friend and high school mentor passed away, my heart was broken. I had to request extensions on my assignments due to my grief–the only time I ever did that in college. I felt like a thin shell of glass surrounding a Spencer-shaped figure of ice-cold water, ready to break and spill at any moment.

When M and I broke up, after four years of dating, I was crushed. We had been together for so long, it seemed impossible to imagine a life without her. I cried. I filled my journal with heavy black ink. Things were hard.

That was sadness–deep, painful sadness. But that doesn’t even come close to depression.

I spent three months at the beginning of 2014 in a depressed haze. The primary culprit was work, where the environment was so hostile and toxic that I found myself filled with dread every time I even thought of going there. That dread spread over my life like a heavy grey cloud, and before long, I felt helplessly trapped in a joyless world.

Depression began touching things that, by all accounts, it had no right nor reason to touch. It started with getting up in the morning; leaving the security of bed meant starting the countdown to work, so I remained under my blankets for hours past my alarm. Then I developed serious apathy toward food. I knew I should eat, but making food would take work, so I’d just eat a banana or drink some juice. I’d sit at home and burn time away on the internet because my motivation to do anything was gone.[ref]I’m no stranger to spending time on the internet, of course, but this was an entirely different beast. The internet became a simple time-filler, and I’d cycle through the same three or four sites, endlessly checking for updates, in the hopes of distracting myself.[/ref] Even on the weekends, when I was skiing or going to bars with friends, depression was just around the corner, reminding me in the most wet-blanket way possible that I still hated my work environment and it would only be a few days until I was back there.

Eventually, I found myself in the place that Erika Moen, Allie Brosh, and numerous other people who have experienced depression have described: I didn’t want to kill myself, but if I could just cease existing for a little bit, I would have been cool with that.

Fortunately, I got out. I got better. But while I recognize that there are many different ways to experience depression, I don’t for one instant believe, as The Polish Ambassador does, that depression and sadness are one and the same. Sadness, grief, and anguish are all typical parts of the human experience, for sure. They’re just not depression.

Treating depression does not mean disallowing oneself to feel sadness, and that sort of misguided misunderstanding, coupled with TPA’s judgment about what is “honorable,” is the sort of thinking that heaps further shame and stigmatization upon people who might otherwise seek help. Depression is an illness, not a normal part of life that needs to be weathered, and shame on anyone who attempts to shame a person out of seeking medical treatment.

The Big Bad Pharmaceuticals

The rest of TPA’s post (which, again, you can read here) is an all-too-familiar screed against Western medicine, pharmaceutical corporations, and the human-made. TPA states that “man made medications are poor quality imitations of things that already exist… in our natural world” and that “the pharmaceutical industry places profit over your/my/our health”. It’s a love letter to the fallacious appeal to nature, a pitch-perfect example of the anti-science leanings of the Left–that sort of more-organic-than-thou dismissal of Big Bad Science, Inc. that, for some reason, is rarely regarded with the same disdain as the Right’s anti-science stances.

Let me be clear. I’m hardly pro-corporation or pro-capitalism. I recognize that science, as an institution, is dominated by the viewpoints and perspectives of white men, that it is flawed, flawed, flawed. But unlike TPA, I don’t subscribe to the absurd, fallacious notion that “natural” somehow means “better”. Electronic music, for instance, requires a wide array of human-made inventions to exist, as opposed to, say, humming, yet I don’t see TPA leading a career in all-natural humming music.

Humanity has invented things like hygiene, antibiotics, vaccines, and fertilizers, all of which have greatly benefited society and human health. On the flip side, the natural world is filled with things I’d consider “bad”, like smallpox, ebola, or arsenic. Then, of course, there are the things that don’t fall neatly into either side, such as digoxin, a heart medicine chemically extracted from the foxglove plant. In its “natural” form–that is, in the plant itself–it will kill you, but at low levels, it can be used to treat heart arrhythmia. Is that good or bad? Natural or human-made?

I’m not claiming that everything human-made is great, or that everything natural is awful. That would be equally fallacious. Unlike TPA, I recognize that both “natural” and “artificial” things–if you can even meaningfully make that distinction–can be harmful or helpful, or even a little bit of both.[ref]And, seriously, how is it possible to still buy into the appeal to nature? I recognize this is my own experience talking, but I assumed that by now, we were all beyond that obviously errant argument.[/ref]

When it comes to human-made drugs for treating depression, Greta Christina said it best:

Medicine is a field where some people really do know more than others. Trained medical providers are very far from infallible, but they still know a hell of a lot more about medicine than Some Guy On The Internet. …

At the same time, medicine is a field in which some people have special training and expertise — but it’s also a field in which, by its nature, that expertise is often not precise or universal. This is especially true for psychiatry and mental health care. What works for one person often doesn’t work for another, and providers often have to proceed with some degree of educated trial and error to find a care plan that works for each particular person. Therefore, it is incredibly arrogant for Some Guy On The Internet to assume that they know what mental health care plan would work for me — better than my medical providers, who have detailed information about my particular condition and priorities and medical history, and better than me, who knows more about my condition and priorities and medical history than anyone.

It is depressingly common for sick people — people with mental illness, with chronic non-mental illness, even people with common colds — to get deluged with unsolicited amateur medical advice. At best, it’s annoying; at worst, it undermines your ability to make your own decisions, and your confidence in that ability. When you’re trying to make medical decisions for yourself, it’s already difficult enough without a barrage of uninformed, under-informed, and ill-informed advice filling your head. And it’s already difficult enough without advice that amounts to the message, “You’re doing it wrong. I know better than you. If you want to please me, you’ll do it my way.”

And for people with mental illness in particular, this is especially difficult. Mental illness has tremendous stigma, which people with mental illness often internalize, and we often (a) feel like we’re letting people in our lives down by having mental illness, (b) feel like having to get treatment for mental illness is a sign of weakness, and (c) are barraged with paternalistic messages telling us that simply having mental illness makes us incapable of making any decisions about our care. Unsolicited advice in this area is more than just annoying. At best, it is patronizing and demoralizing, which itself undercuts our mental health. At worst, it can lead people to make terrible decisions about their mental health care, with devastating results.*

So unless someone tells you that their health care provider is prescribing actual quackery (like homeopathy or something), or unless you have some crucial piece of information that you’re pretty sure the person you’re talking with isn’t familiar with (and “Psych meds are all horrible and nobody should take any of them/ the entire mental health care profession is borked and is not to be trusted” doesn’t count — believe me, we’ve heard that before), or unless you have some more substantial evidence for your position than “I know that the established standard of care is (X), but this one guy disagrees and wrote a book about it,” it is seriously fucked-up to undermine people’s relationships with their health care providers.

TPA found that human-made pharmaceuticals didn’t help his depression, and that other drugs such as marijuana and psilocybin did. I’m glad that he found a solution, and I wish that everyone who experiences depression could find similar relief. However, it is irresponsible beyond belief for him to romanticize depression, paint it as a normal part of life, insinuate its treatment is “dishonorable”, and discourage people from taking medicine that could help them.

Depression is a disease, and it can be deadly. Shame on The Polish Ambassador and anyone else who would argue against its treatment on the grounds of fallacious reasoning.