Thursday, March 31, 2011

"Depression Myths," a study of AOL writing

Greetings, citizens!

Today I am going to analyze an article written by an AOLNews staffer, Jordan Lite, drawn primarily from comments he obtained from one Doctor David Sommers, later referred to as "Duckworth." (I cannot for the life of me understand why, but I will play along and hope I have just missed something here.) Hopefully this will help give my sometimes too-philosophical rants a grounding in the concrete realities of mental health discourse.

Please read the article in question before proceeding.

First, let me just say that the author has some interesting wording in differentiating between "depression" and "the blues," which I guess I can't exactly fault, but still feel odd about. "The blues," in this context, seems very invalidating, and I think that any upset or moodiness, whether full-blown depression or not, still deserves to be taken seriously.
Anyhoo, that being done, I am going to discuss the article's handling of each myth.

1. "Myth: Depression only affects women. Fact: Depression affects everyone."

Well, right from the start I'm upset because we are talking about "depression" as a mysterious entity that affects people, which displaces the sense of affliction from social, or even physical causes, onto a blameless "illness" that can only be studied by Psychiatry. Temporarily ignoring this somewhat fetishistic practice, (fetish, in this case, meaning "an object that stands in for something else, while absorbing all of its potency), I will concede that it is true that everyone is capable of being depressed. It pains me to hear of "depression" as a "thing" that affects people, however.

As a quick side note, a recent guest on the Colbert Report suggested that it is always important to "start with 'a person' first;" he was referring specifically to developmental disabilities, suggesting you never call someone "Autistic," but rather, "'a person' with Autism." Though this still suggests that Autism is an entity, it takes away some of its autonomy, as the entity now only has meaning by being "with" the person in question. This is different from something like "depression" because the condition of Autism is, as far as I can see, life-long and innate - though please, please correct me if I'm wrong here. I stop to mention it here not because it really relates to my argument directly but because it is a very important thing to think about.

Getting back on track, then, the article explains how depression "affects" everyone for various reasons and how people find various ways to cope with it; how men are more likely to seek alcohol or drugs, and are therefore less likely to be diagnosed as having "depression," but they still "have" it. Barring the over-medicalized language, I agree with this assessment. The state of being depressed can happen to anyone for a variety of reasons, but I believe women are more likely to be identified with it because of social scripting. But it does happen to men and in some ways it can be even more crippling when it does, because there does still exist a stigma against men being depressed.

Don't believe me about the stigma? AOL had to write an article just to address the myth about it. Sad.

As another quick sidenote, this stigma about men and vulnerability is all-pervasive - rape is another particularly virulent one, which I mention because it is extremely important, AND because it leads to poor mental health when a man is not believed about his survivorhood. 

2. "Myth: Depression is an adult problem. Fact: Children can get depressed, too."

Agreed, 100%. The article hits on a very important point here when it addresses that adults are often better able to articulate their feelings of depression and therefore have more of a voice to be heard; children and teenagers will usually express their pain in other ways, ways that the adults in their life are not necessarily trained/willing to read. Personally, my depression was written off almost exclusively as "teen angst." I don't believe that exists - I think people get depressed when, in the teen years (sometimes earlier), they realize how horrible the world can be and see it starting to affect them more.
I think we will all be better off when we stop making excuses for other people's misery - that is, explaining it away as something that doesn't require attention - and start taking care of each other.

3. "Myth: Depression isn't a medical problem; you could get over it if you wanted to. Fact: Depression is a medical problem that can require help to get over."

What I like (by which I mean hate with the white hot passion of a thousand suns) about this one is how, like is so often done in Psychiary, "getting over it" is pitted as a direct and exclusive opposite to "medical problem." They work oh-so-actively to suggest that if you can't solve a problem through pure grit and willpower, it must be a medical issue that requires a doctor to save you. By that logic, failing a math exam is a medical problem! More poignantly, by that logic, getting robbed at gunpoint is a medical problem.

Some things you can't fix or solve on your own, but that doesn't mean you have a medical problem. Virtually every experience imaginable becomes coded in chemical and cognitive pathways in the brain; it's called "learning." And sometimes, medicine/therapy can help to intervene in those pathways and alleviate some of the negative emotions that come with. But in my experience, more often than not, this kind of tinkering will deal with half of the problems at most, while burying the remainder under self-doubt. Even when medicine acknowledges the social influences largely responsible for feeling depressed, it puts the onus of not being depressed about it on the person in question: it suggests that depression is caused by your own natural inability to handle being in a depressing situation. Medicine can't do anything about the hurtful people in your life, so they relentlessly encourage you to focus on how you need to change.

But all of this is missing the point that you shouldn't have to change if the people who are upsetting you are not also being asked to change, and they rarely are. I think medicine would make flying leaps and bounds if it focused more on helping people who were depressed find ways to deal with being depressed, rather than trying to make depression go away. If you can't deal with the social problem - and that's what depression really is in my opinion, by and large - then at least acknowledge it exists and that medicine can't cure it beyond acting as a salve at best.

4. "Myth: Depression is all in your genes. Fact: Depression runs in families, but genes are not determining factors."

The actual language of the article in addressing this summary is very confusing. The author suggests that identical twins raised in separate settings are likely to have the same status with regards to depression; initially, that suggests genes to me, but then again I also understand that identical twins are often given the same treatment regardless of home life setting, because they are identical. This confounds the nature/nurture argument.
All that aside, I'm glad to see an article suggesting that depression might have something to do with environment, like family setting, which I assume is how they differentiate depression "running in families" from genes being "determining factors." I agree whole-heartedly. A genetic predisposition may make you more likely to experience the feelings of depression, but environment is ultimately what's responsible for it. If there's nothing to be depressed about, you probably won't be depressed. The trick is figuring out what is depressing you, which isn't always obvious, because we don't talk about such things very often in our society.

5. "Myth: Depression is a normal part of being a teenager. Fact: Adolescent moodiness is not the same thing as teen depression."

Hmm. I have mixed feelings about this part, because I think it uses a problematic approach to "normal." If by "biologically imperative," then I agree - hormones and puberty do not a depressed affect make. But in response to the world around us, I would argue that being depressed is a pretty normative response, one that is often quashed by the expectations of our social groups. A teen may feel suicidal but not say anything because they know they "aren't allowed" to; maybe they have lost all interest but no one notices because they aren't allowed to do that, either. Regardless of whether it is a "normal" experience or not, however, the lead weight feeling of depression is different from sadness and anxiety, and I appreciate that the distinction is being drawn. I just hope people will understand that you don't have to be talking about hating all of your friends and wanting to kill yourself before it is "bad enough" to qualify as depression.

6. "Myth: Antidepressants will change my personality. Fact: Antidepressants won't change one's personality."

Feh. The language of this part of the article reminds me of the contemporary semantic debates about what's going on in Libya. No, antidepressants won't change your personality, they'll just change how you feel about yourself and others and the entire world. Okay, I may be going a bit overboard here - maybe - but my point stands that medicine can flatten you out. The doctor Duckworth suggests that there is no consistent evidence concluding that medicine will impede emotional range, but I think that is pure bullshit. Even if no official studies have ever been conducted, or have all been confounded by some extremely high-paid, interest-funded study (psychopharmeceuticals make BANK), I can tell you from personal experience and the experience of my friends and loved ones that many anti-depressants will flatten you like an iron. For another take on this concept, I refer you to the stellar, if somewhat gross, Furi Curi anime (it's only 6 episodes and well worth a dedicated watch).

Kudos to Duckworth for acknowledging that pills can't do much to help with persistent negative thoughts, however, and focusing on what they can do: physical alteration. Sleep, eating, etc. Give me a pill that helps me get to sleep on time and eat what I need and not be exhausted all the time, and I'll show you a pill that anyone who is depressed could probably benefit from, if that's all the pill does. Of course, with side-effects, pills are usually not so forgiving.

7. "Myth: Antidepressants help everyone. Fact: At best, 60 percent of people get better with antidepressants."

More kudos to the team at AOL for acknowledging medical limitations. As the JAMA article suggests, most antidepressant medications are about as effective as placebos, and many are going to come at a high cost anyway. "Psychotherapy" is seen to be more effective. I say we take it a step further in that direction and say that the people causing depression ought to be getting psychotherapy! Or if it is not a person but an overall situation, well, more energy towards improving it, when possible.

8. "Myth: Women with postpartum depression are bad mothers who kill their children. Fact: Postpartum depression isn't a character flaw, and psychosis is rare."

The fact that this myth even has to be addressed makes me want to cry a little, and it shocks and offends me. But if it must be done, I'm glad AOL is trying. I pretty much agree with the rest of the article on this point.

Thanks for sticking with me, citizens, and cheers to the New Mad Nation.

Sincerely,
R

4 comments:

  1. Hey - I am officially applying for citizenship of the New Mad Nation! Dude, you are so right on in your analysis on this topic. Depression for most is the natural (and dare I say normal) reaction to the dysfunctional and harmful environment individuals are forced to live with. Removing oneself from the harmful environment is the most effective start to healing; but this is impossible for children & teenagers - not to mention the social pressure of not being able to "not be all right." You have a new fan, dude! Keep rocking. Peace.

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  2. Juanita, thank you SO MUCH for your support. I have no idea who you are but I am thrilled to have you as a member of the New Mad Nation. You can rest assured that we will continue to produce new material every week to agitate and inspire. Feel free to offer suggestions as I want to make sure that I am always representing the community.

    Peace, indeed. :)

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  3. Oh I just realized who you are. Sorry Juanita, I feel stupid now. :P

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  4. No need for an apology! I could have warned you xD! Keep up the good work. I'm going to see what you have up for this week.

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