Why I Hate The Mental Illness Rhetoric about Depression

Following the death of Robin Williams, I watched Facebook flood with articles and discussions of depression. It’s a tough subject at the best of times, even harder following the fresh sting of loss.

Emotions were high, so I prepared myself for an onslaught of insensitive posts about suicide being selfish, cowardly, etc. I was dismayed, though, to see phrases like “depression is a life-threatening illness” and “depression is out to kill you” dancing alongside the other comments.

I’ve watched the fight to raise awareness about depression for quite some time, and it seems that we’re finally reaching a place where people sort of understand that depression isn’t a character flaw…but I’m not sure that where we’re headed is any better.

Although it’s important to recognize that depression can be rooted in physical causes, vitamin deficiencies or hormonal imbalances, it’s equally important to recognize that it isn’t always rooted in physical causes. Sometimes it is entirely emotional or situational.

AND THAT’S OKAY.

What’s not okay is to diminish the impact of a person’s emotional process or environment, which is exactly what this “life-threatening disease” model does.

A while back, I talked about reaching the point of no return when I was in the cult. It was the moment that I realized that I would rather die than continue to live the life I was in—that wasn’t an overstatement. I was suicidal for almost two years before I finally left, and one of the things that gave me the courage to break away from the toxicity of the IFB was my suicidality. When I look back on my life, I don’t see that struggle as “dangerous” or as part of a “disease.”

It was a crisis, to be sure—but it was a good crisis. When death was more appealing than my life, I had nothing to lose in trying to make my life worth living. My depression was the signal to me that things couldn’t just go on the way they were. Something had to change.

Had I been taken to a doctor during that time, I could have easily been dismissed as “mentally ill,” given some pills, and sent back into abuse. I might have spent years more, maybe even the rest of my lifetime, trying to battle “depression” (the symptom) rather than the true “disease” (abuse).

I get that the “illness” proponents are trying desperately to end the stigma around depression, but as someone who was depressed for non-medical reasons (still good reasons), I don’t see a true end to stigma.

We might have shifted slightly in our opinion of depressed people, but only because we’ve shifted from thinking of them as emotionally unstable to medically unable to be happy…so technically, the stigma is still there. Sadness, hopelessness, loneliness, desperation—they’re all still “bad.” We’re just more willing to say, “It’s not your fault.”

But I don’t want my emotional state to be acceptable only if it’s caused by an imbalance somewhere. I don’t want to live in a society where being sad is demonized to the point that I either keep it hidden or I go get a pill to make it go away.

I want my emotions to be okay, no matter what. I want to live in a society where having an emotional struggle is as acceptable as having a medical problem. I want to live in a society where depression can be a valid indication that something is off in my environment rather than just an indication of something being off in my body.

The disease model is convenient in a society where minorities and oppressed groups are far more likely to experience depression. It allows us to shake our heads over a “diseased brain” rather than considering what societal factors may be creating an environment in which depression can thrive. It allows us to ignore problems like abuse, discrimination, bullying, economic distress, and prejudice as we scurry around trying to find the magic bullet that will force everyone to be happy with the way things are.

Yes, I struggle with depression. I struggled a lot in high school and college. I struggle less now, but I still struggle (usually when I’m not embracing my emotional work and end up stagnating in the emotion I don’t want to work through).

But NO, I do not have a mental illness or a disease. I don’t have a chemical imbalance. I’m not helpless or in danger because of it. I’ve learned to embrace my downward cycles as an indication that it’s time to make changes in my life or focus on healing old wounds that have been ignored. I’ve found hope. I found my own way of working through it, with the assistance of some amazing people who had the guts to tell me that my emotions weren’t bad or dangerous on their own. It was fucking hard, but it was worth it in the end because I understand my moods better than anyone now, and I know I can sit through the dark times…and grow through them too.

I’m not saying there is never a medical reason for depression. I’m not saying that medication can’t be helpful. I’m not saying that offering assistance isn’t necessary.

But I am saying that the rhetoric that paints depression as nothing more than a physical illness is as damaging, in my opinion, as the rhetoric that paints depression as a character flaw.

What would happen if we stopped talking about depression as if it were the boogyman hiding in the corners of our minds? What would happen if we didn’t assume that emotions were an illness or teach people to be afraid or ashamed of what they are going through?

Maybe, just maybe, we could actually begin to address depression intelligently, allowing each person to figure out what physical, social, and mental components are at play for them. Maybe we’d actually see people capable of working through their depression rather than succumbing to it.

 

Book Review: The Program by Suzanne Young

Trigger warning: discussion of suicide and suppressed memories

In a future that isn’t too different from our present, suicide has been declared an all-out epidemic among teens. In a desperate attempt to “cure” them, the nation has developed a treatment program that involves the involuntary confinement of anyone “at risk” of suicide (including those who know someone who committed suicide). The treatment involves altering the brain to remove painful, traumatic memories . . . or as Sloane learns, any memories associated with “dangerous topics.”

After Sloane’s brother commits suicide, Sloane and her boyfriend James (who was also her brother’s best friend) do their best to hide their grief in order to avoid being flagged. Unfortunately, their plan doesn’t work. Shortly after her boyfriend is taken into the Program, Sloane is deemed at risk and taken too. She emerges with her memory wiped of her brother’s suicide and of her entire relationship with James.

However, unlike what the Program promised, she’s not given a fresh start and a happier life now that her memories are gone. Instead, she finds herself overwhelmed with emotions that she doesn’t understand, a grief that seems to have no place, a love that seems to have no object. Her body remembers what her mind can’t, and it tortures her as she struggles to put the pieces together.

This is an intense book—so intense that I had to take multiple breaks from reading it. Not five-minute breaks. More like month-long breaks.

But it’s fantastic. I almost think it should be required reading.

Despite being set in the future, I feel like Suzanne Young was referencing more reality than speculation through most of the book.

Memory wipes, for instance, are already in the making. A couple of years ago, one of my psych teachers showed the class a video discussing the new “hoped for” treatment for PTSD that involved preventing traumatic memories from forming and blocking already formed memories. They had already even had a few test subjects.

I’m not sure if Suzanne Young based The Program off of this developing “treatment,” but she definitely understands the drawbacks to which the developers seemed to be blind. Memory isn’t just held in the brain. Muscles hold memories too. Even now, I can sit down and play songs on my violin that I can’t consciously remember the notes to because my fingers remember the way the movement feels.

And yes, my body remembers my abuse even when I can’t consciously recall the details. It’s terrifying and confusing to have my body react to something that I can’t see or even fully remember. My vagina doesn’t care if I can pull up an exact image of my sexual abuse or not. It spasms just the same. My bottom doesn’t care if I can recall how many times a belt was drawn across my bare backside; the muscles clench anyway when I’m exposed to triggers.

For someone who has spent over twenty years with patchy memories, the most terrifying thing I can imagine is a treatment that removes my memories. If I were to imagine hell, hell would be knowing something bad happened but not being able to remember it. People live that hell every day, yet science thinks they are offering a solution to pain by offering to put people in that hell.

But memory isn’t what drives The Program (It may be what drives the sequel, but I’ll have to wait to find out where she takes that).

Rather, the main thrust of the book seems to be about the way society responds to depression and suicide. Perhaps it’s exaggerated a little, but not a lot. Even today suicide risk is one of the things for which a therapist is required to break confidentiality. Friends and family members are encouraged to report if they believe someone is contemplating killing themselves.

And the response? The same! Lock you up; take away your autonomy.

Now if that isn’t a recipe for desperation and isolation, I don’t know what is.

In the book, Sloane and James are afraid to even cry in genuine grief. They have no one to confide in about their feelings except each other, and even then they have to be careful about where they confide to each other for fear that someone will notice them looking “sad” and report them. They have a school therapist, but the therapist is all but useless because…how can they trust someone who has the power and responsibility to flag them for what they are feeling?

The bottled up emotions don’t dissipate. They become stronger until even normal emotions seem overwhelming. They are drowning in their emotions, but it’s the only choice they have because the alternative is to lose themselves entirely.

The Program directors try to make themselves look good on the television and to parents, but amongst the teens it’s pretty well understood that the Program isn’t a cure. It’s an erasure. The “epidemic” of suicide grows because teens would rather die than be taken into the Program.

I felt as though Suzanne Young were pulling back the veil on our own societal stigma around suicide—a topic so taboo that most people can’t bring themselves to talk about struggling with it, leaving them to flounder in their emotions alone.

Those who do talk are given medication that may not erase memories but certainly deadens their emotional response. They’re shamed and treated like they have a horrible disease, often hospitalized whether they want to be or not.

And perhaps because we view depression as an illness that needs to be cured rather than something that should be worked through, we encourage people to assume that once “infected,” they can’t think rationally. They start to act as though they can’t think through their feelings, and it all becomes a rather tragic self-fulfilling prophesy (or group-fulfilling prophecy).

Ultimately, despite the lives that are saved by drugs and bed restraints, I don’t think our solution is any more effective than the Program is. We make suicide the problem rather than the symptom. We treat those who struggle with the desire to kill themselves as though they are broken rather than autonomous, rational individuals who are in pain.

In essence, we create a war against those we are trying to save. 

I think Suzanne Young wanted to make us think about what it would be like if, instead of punishing and shaming those who feel depressed and suicidal, we supported—genuinely supported—them with resources that empowered them to navigate their own emotions and thoughts constructively rather than locking them into a destructive pattern of fear and reaction.