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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Behaviour is never from ‘bad’. It’s from ‘big’. Big hungry, big tired, big disconnection, big missing, big ‘too much right now’. The reason our responses might not work can often be because we’ve misread the story, or we’ve missed an important piece of it. Their story might be about now, today, yesterday, or any of the yesterdays before now. 

Our job isn’t to fix them. They aren’t broken. Our job is to understand them. Only then can we steer our response in the right direction. Otherwise we’re throwing darts at the wrong target - behaviour, instead of the need behind the behaviour. 

Watch, listen, breathe and be with. Feel what they feel. This will help them feel you with them. We all feel safer and calmer when we feel our people beside us - not judging or hurrying or questioning. What don’t you know, that they need you to know?♥️
We all have first up needs. The difference between adults and children is that we can delay the meeting of these needs for a bit longer than children - but we still need them met. 

The first most important question the brain needs answered is, ‘Is my body safe?’ - Am I free from threat, hunger, exhaustion, pain? This is usually an easier one to take care of or to recognise when it might need some attention. 

The next most important question is, ‘Is my heart safe?’ - Am I loved, noticed, valued, claimed, wanted, welcome? This can be an easy one to overlook, especially in the chaos of the morning. Of course we love them and want them - and sometimes we’ll get distracted, annoyed, frustrated, irritated. None of this changes how much we love and want them - not even for a second. We can feel two things at once - madly in love with them and annoyed/ distracted/ frustrated. Sometimes though, this can leave their ‘Is my heart safe?’ needs a little hungry. They have less capacity than us to delay the meeting of these needs. When these needs are hungry, we’ll be more likely to see big feelings or big behaviour. 

The more you can fill their love tanks at the start of the day, the more they’ll be able to handle the bumps. This doesn’t have to be big. It just has to be enough. It might look like having a cuddle, reading a story, having a chat, sitting with them while they have breakfast or while they pat the dog, touching their back when they walk past, telling them you love them.

All brains need to feel loved and wanted, and as though they aren’t a nuisance, but sometimes they’ll need to feel it more. The more their felt sense of relational safety is met, the more they’ll be able to then focus on ‘thinking brain’ things, such as planning, making good decisions, co-operating, behaving. 

(And if this today was a bumpy one, that’s okay. Those days are going to happen. If most of the time their love tanks are full, they’ll handle when it drops a little. Just top it up when you can. And don’t forget to top yours up too. Be kind to yourself. You deserve it as much as they do.)♥️
Things will always go wrong - a bad decision, a good decision with a bad outcome, a dilemma, wanting something that comes with risk. 

Often, the ‘right thing’ lives somewhere in the very blurry bounds of the grey. Sometimes it will be about what’s right for them. Sometimes what’s right for others. Sometimes it will be about taking a risk, and sometimes the ‘right’ thing just feels wrong right now, or wrong for them. Even as adults, we will often get things wrong. This isn’t because we’re bad, or because we don’t know the right thing from the wrong thing, but because few things are black and white. 

The problem with punishment and harsh consequences is that we remove ourselves as an option for them to turn to next time things end messy, or as a guide before the mess happens. 

Feeling safe in our important relationships is a primary need for all of us humans. That means making sure our relationships are free from judgement, humiliation, shame, separation. If our response to their ‘wrong things’ is to bring all of these things to the table we share with them with them, of course they’ll do anything to avoid it. This isn’t about lying or secrecy. It’s about maintaining relational ‘safety’, or closeness.

Kids want to do the right thing. They want us to love and accept them. But they’re going to get things wrong sometimes. When they do, our response will teach them either that we are safe for them to come to no matter what, or that we aren’t. 

So what do we do when things go wrong? Embrace them, reject the behaviour:

‘I love that you’ve been honest with me. That means everything to me. I know you didn’t expect things to end up like this, but here we are. Let’s talk about what’s happened and what can be different next time.’

Or, ‘Something must have made this (wrong thing) feel like the right thing to do, otherwise you wouldn’t have done it. We all do that sometimes. What do you think it was that was for you?’

Or, ‘I know you know lying isn’t okay. What made you feel like you couldn’t tell me the truth? How can we build the trust again. Let’s talk about how to do that.’

You will always be their greatest guide, but you can only be that if they let you.♥️
Whenever there is a call to courage, there will be anxiety - every time. That’s what makes it brave. This is why challenging things, brave things, important things will often drive anxiety. 

At these times - when they are safe, but doing something hard - the feelings that come with anxiety will be enough to drive avoidance. When it is avoidance of a threat, that’s important. That’s anxiety doing it’s job. But when the avoidance is in response to things that are important, brave, meaningful, that avoidance only serves to confirm the deficiency story. This is when we want to support them to take tiny steps towards that brave thing. It doesn’t have to happen all at once.l and it doesn’t matter how long it takes. Brave is about being able to handle the discomfort of anxiety enough to do the important, challenging thing. It’s built in tiny steps, one after the other. 

We don’t have to get rid of their anxiety and neither do they. They can feel anxious, and do brave. At these times (safe, but scary) they need us to take a posture of validation and confidence. ‘I believe you, and I believe in you.’ ‘I know this feels big, and I know you can handle it.’ 

What we’re saying is we know they can handle the discomfort of anxiety. They don’t have to handle it well, and they don’t have to handle it for too long. Handling it is handling it, and that’s the substance of ‘brave’. 

Being brave isn’t about doing the brave thing, but about being able to handle the discomfort of the anxiety that comes with that. And if they’ve done that today, at all, or for a moment longer than yesterday, then they’ve been brave today. It doesn’t matter how messy it was or how small it was. Let them see their brave through your eyes.‘That was big for you wasn’t it. And you did it. You felt anxious, and you stayed with it. That’s what being brave is all about.’♥️
A relationally unsafe (emotionally unsafe) environment can cause as much breakage as as a physically unsafe one. 

The brain’s priority will always be safety, so if a person or environment doesn’t feel emotionally safe, we might see big behaviour, avoidance, or reduced learning. In this case, it isn’t the child that’s broken. It’s the environment.

But here’s the thing, just because a child doesn’t feel safe, doesn’t mean the person or environment isn’t safe. What it means is that there aren’t enough signals of safety - yet, and there’s a little more work to do to build this. ‘Safety’ isn’t about what is actually safe or not, it’s about what the brain perceives. Children might have the safest, warmest, most loving adult in front of them, but that doesn’t mean they’ll feel safe. This is when we have to look at how we might extend bigger cues of warmth, welcome, inclusiveness, and what we can do (or what roles or responsibilities can we give them) to help them feel valued and needed. This might take time, and that’s okay. Children aren’t meant to feel safe with every adult in front of them, so sometimes what they need most is our patience and understanding as we continue to build this. 

This is the way it works for all of us, everywhere. None of us will be able to give our best or do our best if we don’t feel welcome, liked, valued, and free from hostility, humiliation or judgement. 

This is especially important for our schools. A brain that doesn’t feel safe can’t learn. For schools to be places of learning, they first have to be places of relationship. Before we focus too sharply on learning support and behaviour management, we first have to focus on felt sense of safety support. The most powerful way to do this is through relationship. Teachers who do this are magic-makers. They show a phenomenal capacity to expand a child’s capacity to learn, calm big behaviour, and open up a child’s world. But relationships take time, and felt safety takes time. The time it takes for this to happen is all part of the process. It’s not a waste of time, it’s the most important use of it.♥️

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