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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Anxiety is a sign that the brain has registered threat and is mobilising the body to get to safety. One of the ways it does this is by organising the body for movement - to fight the danger or flee the danger. 

If there is no need or no opportunity for movement, that fight or flight fuel will still be looking for expression. This can come out as wriggly, fidgety, hyperactive behaviour. This is why any of us might pace or struggle to sit still when we’re anxious. 

If kids or teens are bouncing around, wriggling in their chairs, or having trouble sitting still, it could be anxiety. Remember with anxiety, it’s not about what is actually safe but about what the brain perceives. New or challenging work, doing something unfamiliar, too much going on, a tired or hungry body, anything that comes with any chance of judgement, failure, humiliation can all throw the brain into fight or flight.

When this happens, the body might feel busy, activated, restless. This in itself can drive even more anxiety in kids or teens. Any of us can struggle when we don’t feel comfortable in our own bodies. 

Anxiety is energy with nowhere to go. To move through anxiety, give the energy somewhere to go - a fast walk, a run, a whole-body shake, hula hooping, kicking a ball - any movement that spends the energy will help bring the brain and body back to calm.♥️
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#parenting #anxietyinkids #childanxiety #parenting #parent
This is not bad behaviour. It’s big behaviour a from a brain that has registered threat and is working hard to feel safe again. 

‘Threat’ isn’t about what is actually safe or not, but about what the brain perceives. The brain can perceive threat when there is any chance missing out on or messing up something important, anything that feels unfamiliar, hard, or challenging, feeling misunderstood, thinking you might be angry or disappointed with them, being separated from you, being hungry or tired, anything that pushes against their sensory needs - so many things. 

During anxiety, the amygdala in the brain is switched to high volume, so other big feelings will be too. This might look like tears, sadness, or anger. 

Big feelings have a good reason for being there. The amygdala has the very important job of keeping us safe, and it does this beautifully, but not always with grace. One of the ways the amygdala keeps us safe is by calling on big feelings to recruit social support. When big feelings happen, people notice. They might not always notice the way we want to be noticed, but we are noticed. This increases our chances of safety. 

Of course, kids and teens still need our guidance and leadership and the conversations that grow them, but not during the emotional storm. They just won’t hear you anyway because their brain is too busy trying to get back to safety. In that moment, they don’t want to be fixed or ‘grown’. They want to feel seen, safe and heard. 

During the storm, preserve your connection with them as much as you can. You might not always be able to do this, and that’s okay. None of this is about perfection. If you have a rupture, repair it as soon as you can. Then, when their brains and bodies come back to calm, this is the time for the conversations that will grow them. 

Rather than, ‘What consequences do they need to do better?’, shift to, ‘What support do they need to do better?’ The greatest support will come from you in a way they can receive: ‘What happened?’ ‘What can you do differently next time?’ ‘You’re the most wonderful kid and I know you didn’t want this to happen. How can you put things right? Do you need my help with that?’♥️
Big behaviour is a sign of a nervous system in distress. Before anything, that vulnerable nervous system needs to be brought back home to felt safety. 

This will happen most powerfully with relationship and connection. Breathe and be with. Let them know you get it. This can happen with words or nonverbals. It’s about feeling what they feel, but staying regulated.

If they want space, give them space but stay in emotional proximity, ‘Ok I’m just going to stay over here. I’m right here if you need.’

If they’re using spicy words to make sure there is no confusion about how they feel about you right now, flag the behaviour, then make your intent clear, ‘I know how upset you are and I want to understand more about what’s happening for you. I’m not going to do this while you’re speaking to me like this. You can still be mad, but you need to be respectful. I’m here for you.’

Think of how you would respond if a friend was telling you about something that upset her. You wouldn’t tell her to calm down, or try to fix her (she’s not broken), or talk to her about her behaviour. You would just be there. You would ‘drop an anchor’ and steady those rough seas around her until she feels okay enough again. Along the way you would be doing things that let her know your intent to support her. You’d do this with you facial expressions, your voice, your body, your posture. You’d feel her feels, and she’d feel you ‘getting her’. It’s about letting her know that you understand what she’s feeling, even if you don’t understand why (or agree with why). 

It’s the same for our children. As their important big people, they also need leadership. The time for this is after the storm has passed, when their brains and bodies feel safe and calm. Because of your relationship, connection and their felt sense of safety, you will have access to their ‘thinking brain’. This is the time for those meaningful conversations: 
- ‘What happened?’
- ‘What did I do that helped/ didn’t help?’
- ‘What can you do differently next time?’
- ‘You’re a great kid and I know you didn’t want this to happen, but here we are. What can you do to put things right? Do you need my help with that?’♥️
As children grow, and especially by adolescence, we have the illusion of control but whether or not we have any real influence will be up to them. The temptation to control our children will always come from a place of love. Fear will likely have a heavy hand in there too. When they fall, we’ll feel it. Sometimes it will feel like an ache in our core. Sometimes it will feel like failure or guilt, or anger. We might wish we could have stopped them, pushed a little harder, warned a little bigger, stood a little closer. We’re parents and we’re human and it’s what this parenting thing does. It makes fear and anxiety billow around us like lost smoke, too easily.

Remember, they want you to be proud of them, and they want to do the right thing. When they feel your curiosity over judgement, and the safety of you over shame, it will be easier for them to open up to you. Nobody will guide them better than you because nobody will care more about where they land. They know this, but the magic happens when they also know that you are safe and that you will hold them, their needs, their opinions and feelings with strong, gentle, loving hands, no matter what.♥️
Anger is the ‘fight’ part of the fight or flight response. It has important work to do. Anger never exists on its own. It exists to hold other more vulnerable emotions in a way that feels safer. It’s sometimes feels easier, safer, more acceptable, stronger to feel the ‘big’ that comes with anger, than the vulnerability that comes with anxiety, sadness, loneliness. This isn’t deliberate. It’s just another way our bodies and brains try to keep us safe. 

The problem isn’t the anger. The problem is the behaviour that can come with the anger. Let there be no limits on thoughts and feelings, only behaviour. When children are angry, as long as they are safe and others are safe, we don’t need to fix their anger. They aren’t broken. Instead, drop the anchor: as much as you can - and this won’t always be easy - be a calm, steadying, loving presence to help bring their nervous systems back home to calm. 

Then, when they are truly calm, and with love and leadership, have the conversations that will grow them - 
- What happened? 
- What can you do differently next time?
- You’re a really great kid. I know you didn’t want this to happen but here we are. How can you make things right. Would you like some ideas? Do you need some help with that?
- What did I do that helped? What did I do that didn’t help? Is there something that might feel more helpful next time?

When their behaviour falls short of ‘adorable’, rather than asking ‘What consequences they need to do better?’ let the question be, ‘What support do they need to do better.’ Often, the biggest support will be a conversation with you, and that will be enough.♥️
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#parenting #positiveparenting #mindfulparenting #anxietyinkids

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