Depression and Stigma

Postcard4

Depression awareness is fronted here by John Kirwan. The man is a legend, not just for his rugby prowess but also because of his very public campaign to raise awareness for depression.  But could glorifying high-achievers with mental health difficulties may be more insensitive than inspiring.

Mark Brown thinks this may be the case:

If you’re a person who experiences mental health difficulties, as I do, you’ll be familiar with an oft-quoted list of inspirational fellow travellers, such as Winston Churchill and his famous “black dog” or national treasure Stephen Fry and his bipolar disorder.

The media retains a fondness for presenting exceptional disabled people as inspirational.

“Look,” they say. “Here is a person who has achieved so much. Do not lose heart, you too can overcome your disability if you follow their example.”

This may at first seem a benign point to make but, I wonder, does it do more harm than good?

The dominant positive media stories offer up high-achieving disabled people as examples of the human spirit triumphing over adversity. Other positive tales are of people rising to stratospheric heights “despite” a physical or mental health difficulty. 

In some respects people also do this to me…they heap praise on my openness with my battles with depression and the fact that I help people…but is it wise?

Where the inspirational figure is selected for us, and the gap between their life and ours is too great, the effect is not one of encouragement but of disillusionment – especially if their story is told in terms of personal qualities like bravery or persistence.

Knowing a famous person has the same impairment as you can be reassuring, but only in the vague way that hearing of a successful distant relative is reassuring.

In some respects this can work well however there runs a risk of further stigmatising sufferers…because depression can be so debilitating, the inability to rise above it like John Kirwan has can actually make one feel useless and pathetic.

Neuroskeptic accepts the points raised above “‘He’s got it, and so do you, so you can be like him’ is perilously close to ‘He’s got it, and so do you, so you should be like him – what’s your excuse?’” – but argues that celebrity sufferers contradict different stigmas in different ways:

I think some of these celebrity examples are useful, not as generic inspirations for ‘the mentally ill’ but as concrete answers to particular attitudes. Against the simplistic view that there’s a single ‘stigma of mental illness’, I think there are many different stigmas and they have to be tackled separately.

In the case of depression, the core stigma is that depression is a weakness, a moral failing. That depressed people are soft, weak, pitiable. This attitude is specific to depression – not even bipolar disorder is seen in the same way, let alone the other diagnoses. They have their own stigmas. Depression’s is weakness.

Now this is why Churchill is a good counterexample. Not just because he’s famous or ‘great’, but because he was famously tough. He faced down Hitler. He was blood, sweat and tears. In the most famous photos of him (and they are famous, out of all his photos, because they correspond to the mental image) he is almost unsmiling – but never despairing. Just resolute.

That he experienced depression undermines the myths surrounding that condition, in a way that an entertainer or other generic celebrity wouldn’t.

For me there is  disconnect with John Kirwan, mainly because of the messaging I think, though I can’t put my finger on it. The messages that most resonate with me are those of Mike King…mainly because I think his experience of depression is very similar to mine. I have filled in for Mike a few times on his show because the first time I met him, when I was a guest on his show, I think in that 4 hours we got to connect as mates, who both suffer the same thing in similar ways.

So I guess all I am saying to people out…is find a role model that resonates with you in how they battle and stay on top of depression. The black dog is certainly here to stay in my life, I just have to find ways to manage it.

The hard part often, though, is trying to get intransigent people and organisations to understand that medication and or traditional treatments for depression are not cures…certainly they weren’t for me, in fact in many respects they made my life much, much worse for which there will eventually be an accounting for.

Until that happens, until I can work out just exactly how I can defeat this thing that stalks me, I will continue to remain trapped in the loneliness of depression.

One day I will put down all my battles with depression into a book, explain how the drugs didn’t work, explain the constant battles with insurers and tell how depression has destroyed everything including relationships with friends and those I care for, until there was literally only me left standing, broken by it all, alone except for the thing that did this to me.

Help is Here
CRISIS AND HELPLINES

Lifeline

0800 543 354 or (09) 522 2999

http://www.lifeline.co.nz

 

Suicide Prevention Helpline

0508 828 865 (0508 TAUTOK0)

http://www.lifeline.org.nz

 

Youthline

0800 376 633

http://www.youthline.co.nz

 

Samaritans

0800 726 666

http://www.samaritans.org.nz

 

Depression Helpline

Available 8am to midnight.

0800 111 757

http://www.depression.org.nz

 

Casper

Community Action on Suicide Prevention Education and Research

0508 CASPER 0508 227737

http://www.casper.org.nz

 

DRUG AND ALCOHOL SERVICES

Al-Anon

0508 425 2666

http://www.aa.org.nz/

 

Alcohol and Drug Hotline

General: 0800 787 797

Maori Line: 0800 787 789

Pasifika Line: 0800 787 799

http://www.adanz.org.nz/Helpline/home

 

Alcoholics Anonymous

0800 229 6757

http://www.aa.org.nz

 

Narcotics Anonymous

0800 NA TODAY (0800 628 632)

http://www.nzna.org

 

Our friends at Engage Aotearoa have put together the most comprehensive list of community support and help services available in New Zealand.

http://engagenz.co.nz/downloads/EngageCommunityResourcesDirectory.pdf

The Key To Life Charitable Trust values and wholly endorses the work by our peers at Engage Aotearoa and we thank them again and again for the important work they do.

http://www.engagenz.co.nz/

The above list of resources are care of Mike King’s Key to Life

Auckland Psychology

http://www.aucklandpsychology.co.nz

 


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  • Micky

    Thought provoking article, having a friend with bi-polar, I know there’s no easy answer. One good thing JK has done is make the issue more “mainstream” openly talking about his problem. That would never have happened 20 years ago.

  • blokeintakapuna

    Depression and mental health is very much like back or neck
    pain. No one else can see it overtly – yet it’s there… and very much so for the
    sufferer.

    JK has been such an inspiration to so many and by bringing
    this subject into mainstream discussions is starting to dispel some of the myth’s
    and lack of understanding about this issue to so many out there. Yet there is
    still more to be done with educating “everyone” about it.

    The majority of people I know of have a somewhat simplistic
    and misunderstood awareness and knowledge of the illness and I often hear the
    ignorant telling the affected “Harden up – have a cup of concrete. She’ll be
    right. Be positive. Etc”

    But I guess, kinda like back pain – until you have it
    yourself, you really can’t “define” it to someone else.

    We all “know” the South Pole and Antarctica
    is cold… but until actually there, especially if holidaying on a tropical
    island… it’s simply too unique and difficult to “define or explain” to another
    just how “cold” it actually is…

    Daily exercise and a healthy, nutritious diet really helps though. Perhaps more than anything else…

    • Rex Widerstrom

      Ugh, the simplistic attitude of which you speak… Australians drive around with bumper stickers proclaiming “Toughen up, Princess”. Even for someone suffering from temporary sadness – say, grief at the loss of a loved one – it must be comforting to know some bimbo in a Hyundai or bogan in a ute couldn’t care less. For someone plagued by depression it’s just a reminder of the callousness of the general population.

      I advocate for free speech, but if there’s one thing I could get a free pass on and ban, it’d be those damned things.

      You’re right, too, that even those more predisposed to caring have trouble understanding. I was describing to a kind and generally caring friend another friend’s debilitating depression and he asked “But what does she have to be depressed about?” as though, say, winning Lotto could provide a cure.

  • Agent BallSack

    One of the people I always looked up to for fighting his mental illness (depression and more) was Spike Milligan. Not many people are aware after the war he was committed to several mental hospitals for his depression. His ‘cure’? writing the series of books on the war and reliving it in such a way as to be able to let go of the horror of what he had experienced. Not that he was ever cured of course but he managed it in a time when depression wasnt recognised as an actual physical illness and medication often as not was a frontal lobotomy.

    • Agent BallSack

      If you have never read ‘Hitler, my part in his downfall’ by Spike Milligan I highly recommend it.

      • Agent BallSack

        Excerpt:

        Milligan receives a letter marked O.H.M.S., which his uncle advises him not to open. After some weeks similar letters arrive marked “Urgent”. Eventually he opens one containing a “cunningly worded invitation to partake in World War II”. About then, in an attempt to impress girls at a gym, he slips a disc, whereupon he’s hospitalized to determine whether he’s faking. After three months of avoiding call-up, he is given “a train ticket and a picture of Hitler reading “This is your enemy””. He searches the train, but can’t find him.

    • blokeintakapuna

      I do recall parents and Uncles cracking up having a great laugh at Spike’s antics one day of picking up leaves fallen from tree’s in Autumn – painting them green and trying to put them back on the tree’s…

      …Just remembered that now, since you mentioned his name.

      Bad Jelly the Witch was great though…

      • IWantToBeLikeMallardOneDay

        Have you read the “According to Spike Milligan” series. Heathcliff in Wuthering Heights is a Pakastani. And in his version of The Bible, when the Israelites left Egypt, all of the Egyptian bank managers committed suicide.

  • PlanetOrphan

    I used to feel I had betrayed JKs’ confidence when the adds first started.
    But I think he really has helped many people, and the fact he can stand up and say it affected me even when I was powering in my career says a lot about depression.

    I agree about the drugs as well, clinically they do help, but the cost is often not outlined or even addressed. They can leach calcium out of your body just as fast as P can, a lot of them are based on heavy metals, and give you a nervous energy that almost feels “normal” when you are depressed.

    But nothing beats a good diet and exercise.

    I was poisoned with Cadmium several years ago, and the lack of calcium on top of depression made the Black Dog look like a family pet, I ended up taking 25 caltrates a day (Which made my heart feel like a clenched fist) for close to a year to get rid of the cadmium, and that’s when I realised how important calcium was for my “ghosts’ strength” , without calcium I was in a bottomless pit.

  • Chad Chambers

    I don’t think it is helpful at all to be intimating medication doesn’t work. It works well for some. No, it’s not a cure but at the same time there is no cure, only management, and medication is just that, management of the problem.

    Also, anyone with a high public profile putting as much effort into publicising the taboo subject that is depression deserves a knighthood. Poor form to be inventing reasons why this action of John Kirwan is damaging to ordinary people suffering with depression.

    This quote is particularly stupid…

    Neuroskeptic accepts the points raised above “‘He’s got it, and so do you, so you can be like him’ is perilously close to ‘He’s got it, and so do you, so you should be like him – what’s your excuse?’”

    Who the hell is Neuroskeptic? An amateur psychologist? No one I know with depression thinks like this, they just want to feel right and get on with their jobs and family life in peace.

    • Whafe

      Chad, have to comment re your line above that Cam indicates that medication doesn’t work.. That is not so, it is Cam’s blog, he can write what he likes, he is an addvocate that there are far better ways to combat depression than drugs… He always states that medication hasn’t worked for him…

      • Chad Chambers

        That’s fine, so medication doesn’t work for him, or at least that’s his view. No need to broadly state “the drugs didn’t work”, even if it is his blog. Many sufferers might read it and decide “I trust Cam’s judgement on all things so I’ll trust his judgement on mental health too”. Cam is not a doctor unless I’m mistaken.

        It’s clearly stated by real doctors that medication is not a cure but a tool, along with therapy, and contact with friends/family, to help manage the situation.

        Not sure that Cam can write “whatever he likes” on serious issues like this. After all, he is a sufferer, not a professional.

        • I’ll state whatever I fucking like…the drugs don’t work, I will never ever take another anti-depressant as long as I live…those drugs caused the utter destruction of my life…and the fall out continues. I’m fucking over your sanctimony and po-faced finger pointing.

          • Chad Chambers

            I’m sorry but I and the medical profession disagree. Anti-depressant medication does work for most people in conjunction with appropriate therapy. There might be a number of reasons why they didn’t work for you and that’s something you and your psychologist need to get to the bottom of. Aggressive finger pointing at those you disagree with is not going to help.

          • Simon Walker

            Actually thats not true. In cases of mild-moderate depression the empirical literature is pretty clear. There is little benefit ascribed to meds over placebo. You’re welcome to look at Cochrane reviews on the subject, i think they are public domain.

          • Simon Walker

            Here’s one i found in public domain..

            http://jama.jamanetwork.com/article.aspx?articleid=185157

          • Chad Chambers

            Cam’s depression doesn’t appear mild. In his own words, “it’s destroyed his life”. Hardly mild-moderate.

    • James Gray

      Sooo… “Because this is such a great idea, you’re a terrible person if you point out why it may not be such a great idea”.

  • Whafe

    Agree with Micky, very thought provoking…
    I do agree that JK has made the issue more mainstream and you feel somewhat better to bring the topic up, has it eleviated the social thoughts on it, not entirely….
    It is not an easy thing for others to understand at all….
    But am an advocate that exercise and diet are a huge benefit in helping ones depression…… Along with learning what can trigger the black dog… Often easier said than done hey?

  • Rex Widerstrom

    Thanks for raising this Cam. It seems churlish to criticise the people who bravely put themselves out there as suffering from depression and the excellent organisationms which back such campaigns but I agree with you, the end result can leave you feeling inadequate.

    To a large degree I feel this is because the high-profile person usually talks about their battle in the past tense, and often uses explicit terminology such as how they “overcame” depression.

    Compare that to an alcoholic who, even if they’ve been clean for decades, will still characterise themselves as such and will always remind you that it’s one day at a time and that they’re fighting an ongoing battle.

    I suppose some people may be fortunate enough to be “cured” of depression and anxiety but for many it is, as you so vividly describe in your last few paragraphs, something that is likely to to remain their entire lives.

    That needs to be acknowledged, otherwise the message that may be taken away from campaigns such as the Kirwan one is that you need to be as tough as JK to beat it and if you can’t, you’re somehow inadequate. Of course this is in no way the intent, but when depression is eating at your self-esteem it’s easy to think that way.

    • Whafe

      Indeed an interesting concept, I have been clean for 20 years now, I am still an addict or alcoholic though… That in itself is an interesting one to explain to people, not the alcoholic bit, but the fact 20 years later am still one.
      Where by very few speak of their depression that way… There is still far more of a poor perception of depression out there than addiction etc etc… it is a very hard topic indeed…

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