Depression: Why Talking Isn’t Enough

Depression: Why Talking Isn't Enough

Talking about mental illness openly is an important step towards ridding humanity of a stigma that’s breathtaking in its ignorance and dangerous in its effect. But something more needs to happen.

The mental illness umbrella has a broad reach and the disorders that fall beneath it are as diverse as the people affected by them. Some disorders, such as anxiety and depression, lie on a spectrum of normal human behavior and it’s likely that most of us, if not all of us, have teetered somewhere within its reach.

The depth and breadth of the mental illness tag means that an illness such as depression, which is not dangerous to anyone but the sufferer, is being bundled with disorders that are. This continues to feed a stigma that pathologises not only the illness, but also the person. It has implications for all of us.

A formal diagnosis of clinical depression requires the presence of a cluster of symptoms over an extended period. The symptoms are characteristic of normal human experience – sadness, hopelessness, lack of vitality, lack of engagement, disordered sleeping and eating patterns. Each is a normal and valid human response though sometimes, the duration and intensity can become too much and this is when a diagnosis of clinical depression may follow.

I’ve never had clinical depression, but I’ve experienced sadness so deep and engulfing it stole me for a while. I can still remember the ache. I’ve felt desperately hopeless at times and on others frighteningly disengaged. I don’t know how it was that I found my way through. I just did. I also know, with every cell in my body that it could just as easily have gone the other way.

Depression is a deficiency in chemistry, not character. It can happen to anyone. Though it is true that some personality traits make people vulnerable to depression, those same traits also make those people warm, successful, wise, funny, kind, capable and strong. The strength needed to carry on each day with a mental illness is immense.

There is absolutely no evidence – none – that depression causes people to be dangerous or harmful. It’s true that many who have behaved anti-socially have depression, but they also have skin, parents, possibly a mortgage, a job, children. It’s a numbers game and the number of people who suffer from depression is so high, and its reach to exceptionally wide, that people with depression are going to be represented on some level in vile, criminal acts. Doctors and teachers will also be represented. So will diabetics, mothers and taxi drivers. That depression is sometimes represented in the profile of the anti-social does not mean it’s the cause and to suggest otherwise is spectacularly misinformed.

The need to understand and make sense of the world around us is something that has lead humanity to greatness on many fronts. It is our curiosity and our capacity to extend ourselves to satisfy that curiosity that progresses our relationships, society and humanity. It can also be our downfall.

Some things can’t be explained. For all of our collected wisdom, empathy and intelligence, some things just don’t make sense, and they never will. The drive for closure and for understanding means that society has a tendency to reach for anything to fill the knowledge gap. The easiest ‘anything’ will be that which we understand the least. When it comes to unfathomable human behavior, it’s often whatever mental illness diagnosis is within reach. This not only maintains the stigma, it flourishes it.

Talking about mental illness is important, but in order to destigmatise it, we need to demystify it. Depression can be understood as another adaptive process – a normal response to an often abnormal situation. We all have needs we cannot give up – the need for connection, appreciation and belonging are a few. If the need is not met, attempts will be made to let it go, ignore it or have it met elsewhere. If the need remains important, and the environment unsupportive, the need will be ignored but it will never disappear. The best way to ignore something is to push it well out of the way – to, quite literally, depress it.

The more we stigmatise depression, the more we inadvertently encourage this response. We stop talking. We stop normalising. We stop responding. Isolation, shame and disconnection thrive. The more we grab onto depression to explain the inexplicable, the more we encourage people to ‘depress’ and to keep quiet about their own struggles. The very thing we are fighting, we will force.

As long as we view depression as a maladaptive response, rather than embrace it as existing on the spectrum of a normal one, people will continue to depress. It’s no wonder then that depression is on the rise. We can only speculate as to how different the statistics would be if we were a humanity that embraced emotional vulnerability, rather than pathologised it. The capacity is there, just waiting on the will.

When we accept depression for what it is – a normal part of being human, perhaps then the stigma will start to loosen.

This article appeared on The Huffington Post UK on 1 April 2015. 

(Image Credit: Unsplash | Ravi Roshen)

4 Comments

Samantha

This article says it pretty much how I’ve tried to explain it to people who do not understand what I am going through – anxiety.

Karen, can you possibly point out some more science-y articles that can explain the physiological changes in the body that causes the feelings of depression and anxiety?

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David

I believe your article has tapped into a huge gap of knowledge and discussion. Thank you for writing it. It encouraged me to find new thought patterns that ultimately help me find meaning.

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How we are with them, when they are their everyday selves and when they aren’t so adorable, will build their view of three things: the world, its people, and themselves. This will then inform how they respond to the world and how they build their very important space in it. 

Will it be a loving, warm, open-hearted space with lots of doors for them to throw open to the people and experiences that are right for them? Or will it be a space with solid, too high walls that close out too many of the people and experiences that would nourish them.

They will learn from what we do with them and to them, for better or worse. We don’t teach them that the world is safe for them to reach into - we show them. We don’t teach them to be kind, respectful, and compassionate. We show them. We don’t teach them that they matter, and that other people matter, and that their voices and their opinions matter. We show them. We don’t teach them that they are little joy mongers who light up the world. We show them. 

But we have to be radically kind with ourselves too. None of this is about perfection. Parenting is hard, and days will be hard, and on too many of those days we’ll be hard too. That’s okay. We’ll say things we shouldn’t say and do things we shouldn’t do. We’re human too. Let’s not put pressure on our kiddos to be perfect by pretending that we are. As long as we repair the ruptures as soon as we can, and bathe them in love and the warmth of us as much as we can, they will be okay.

This also isn’t about not having boundaries. We need to be the guardians of their world and show them where the edges are. But in the guarding of those boundaries we can be strong and loving, strong and gentle. We can love them, and redirect their behaviour.

It’s when we own our stuff(ups) and when we let them see us fall and rise with strength, integrity, and compassion, and when we hold them gently through the mess of it all, that they learn about humility, and vulnerability, and the importance of holding bruised hearts with tender hands. It’s not about perfection, it’s about consistency, and honesty, and the way we respond to them the most.♥️

#parenting #mindfulparenting
Anxiety and courage always exist together. It can be no other way. Anxiety is a call to courage. It means you're about to do something brave, so when there is one the other will be there too. Their courage might feel so small and be whisper quiet, but it will always be there and always ready to show up when they need it to.
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But courage doesn’t always feel like courage, and it won't always show itself as a readiness. Instead, it might show as a rising - from fear, from uncertainty, from anger. None of these mean an absence of courage. They are the making of space, and the opportunity for courage to rise.
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When the noise from anxiety is loud and obtuse, we’ll have to gently add our voices to usher their courage into the light. We can do this speaking of it and to it, and by shifting the focus from their anxiety to their brave. The one we focus on is ultimately what will become powerful. It will be the one we energise. Anxiety will already have their focus, so we’ll need to make sure their courage has ours.
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But we have to speak to their fear as well, in a way that makes space for it to be held and soothed, with strength. Their fear has an important job to do - to recruit the support of someone who can help them feel safe. Only when their fear has been heard will it rest and make way for their brave.
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What does this look like? Tell them their stories of brave, but acknowledge the fear that made it tough. Stories help them process their emotional experiences in a safe way. It brings word to the feelings and helps those big feelings make sense and find containment. ‘You were really worried about that exam weren’t you. You couldn’t get to sleep the night before. It was tough going to school but you got up, you got dressed, you ... and you did it. Then you ...’
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In the moment, speak to their brave by first acknowledging their need to flee (or fight), then tell them what you know to be true - ‘This feels scary for you doesn’t it. I know you want to run. It makes so much sense that you would want to do that. I also know you can do hard things. My darling, I know it with everything in me.’
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#positiveparenting #parenting #childanxiety #anxietyinchildren #mindfulpare
Separation anxiety has an important job to do - it’s designed to keep children safe by driving them to stay close to their important adults. Gosh it can feel brutal sometimes though.

Whenever there is separation from an attachment person there will be anxiety unless there are two things: attachment with another trusted, loving adult; and a felt sense of you holding on, even when you aren't beside them. Putting these in place will help soften anxiety.

As long as children are are in the loving care of a trusted adult, there's no need to avoid separation. We'll need to remind ourselves of this so we can hold on to ourselves when our own anxiety is rising in response to theirs. 

If separation is the problem, connection has to be the solution. The connection can be with any loving adult, but it's more than an adult being present. It needs an adult who, through their strong, warm, loving presence, shows the child their abundant intention to care for that child, and their joy in doing so. This can be helped along by showing that you trust the adult to love that child big in our absence. 'I know [important adult] loves you and is going to take such good care of you.'

To help your young one feel held on to by you, even in absence, let them know you'll be thinking of them and can't wait to see them. Bolster this by giving them something of yours to hold while you're gone - a scarf, a note - anything that will be felt as 'you'.

They know you are the one who makes sure their world is safe, so they’ll be looking to you for signs of safety: 'Do you think we'll be okay if we aren't together?' First, validate: 'You really want to stay with me, don't you. I wish I could stay with you too! It's hard being away from your special people isn't it.' Then, be their brave. Let it be big enough to wrap around them so they can rest in the safety and strength of it: 'I know you can do this, love. We can do hard things can't we.'

Part of growing up brave is learning that the presence of anxiety doesn't always mean something is wrong. Sometimes it means they are on the edge of brave - and being away from you for a while counts as brave.
Even the most loving, emotionally available adult might feel frustration, anger, helplessness or distress in response to a child’s big feelings. This is how it’s meant to work. 

Their distress (fight/flight) will raise distress in us. The purpose is to move us to protect or support or them, but of course it doesn’t always work this way. When their big feelings recruit ours it can drive us more to fight (anger, blame), or to flee (avoid, ignore, separate them from us) which can steal our capacity to support them. It will happen to all of us from time to time. 

Kids and teens can’t learn to manage big feelings on their own until they’ve done it plenty of times with a calm, loving adult. This is where co-regulation comes in. It helps build the vital neural pathways between big feelings and calm. They can’t build those pathways on their own. 

It’s like driving a car. We can tell them how to drive as much as we like, but ‘talking about’ won’t mean they’re ready to hit the road by themselves. Instead we sit with them in the front seat for hours, driving ‘with’ until they can do it on their own. Feelings are the same. We feel ‘with’, over and over, until they can do it on their own. 

What can help is pausing for a moment to see the behaviour for what it is - a call for support. It’s NOT bad behaviour or bad parenting. It’s not that.

Our own feelings can give us a clue to what our children are feeling. It’s a normal, healthy, adaptive way for them to share an emotional load they weren’t meant to carry on their own. Self-regulation makes space for us to hold those feelings with them until those big feelings ease. 

Self-regulation can happen in micro moments. First, see the feelings or behaviour for what it is - a call for support. Then breathe. This will calm your nervous system, so you can calm theirs. In the same way we will catch their distress, they will also catch ours - but they can also catch our calm. Breathe, validate, and be ‘with’. And you don’t need to do more than that.
When things feel hard or the world feels big, children will be looking to their important adults for signs of safety. They will be asking, ‘Do you think I'm safe?' 'Do you think I can do this?' With everything in us, we have to send the message, ‘Yes! Yes love, this is hard and you are safe. You can do hard things.'

Even if we believe they are up to the challenge, it can be difficult to communicate this with absolute confidence. We love them, and when they're distressed, we're going to feel it. Inadvertently, we can align with their fear and send signals of danger, especially through nonverbals. 

What they need is for us to align with their 'brave' - that part of them that wants to do hard things and has the courage to do them. It might be small but it will be there. Like a muscle, courage strengthens with use - little by little, but the potential is always there.

First, let them feel you inside their world, not outside of it. This lets their anxious brain know that support is here - that you see what they see and you get it. This happens through validation. It doesn't mean you agree. It means that you see what they see, and feel what they feel. Meet the intensity of their emotion, so they can feel you with them. It can come off as insincere if your nonverbals are overly calm in the face of their distress. (Think a zen-like low, monotone voice and neutral face - both can be read as threat by an anxious brain). Try:

'This is big for you isn't it!' 
'It's awful having to do things you haven't done before. What you are feeling makes so much sense. I'd feel the same!

Once they really feel you there with them, then they can trust what comes next, which is your felt belief that they will be safe, and that they can do hard things. 

Even if things don't go to plan, you know they will cope. This can be hard, especially because it is so easy to 'catch' their anxiety. When it feels like anxiety is drawing you both in, take a moment, breathe, and ask, 'Do I believe in them, or their anxiety?' Let your answer guide you, because you know your young one was built for big, beautiful things. It's in them. Anxiety is part of their move towards brave, not the end of it.

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