Black Dog of Depression

Argus title : Black dog of depression can often be chased away

Three weeks ago I was feeling depressed. There were distressing reports in the news and I was mourning the death of old friend and colleague, Irene Parry. It happened to be National Depression Week.

I hadn’t the heart to write a serious article about current affairs – or indeed National Depression Week – so wrote something which was in part about Irene, but was also a tribute to my favourite tea shop, “The Mock Turtle”. I explained that it has the power to raise my spirits when I feel sad or depressed.

Aficionados of the Mock Turtle enjoyed the article. Several of Irene’s friends contacted me to say they liked it too. However, it obviously deeply wounded one anonymous correspondent to the Argus, who disagreed with my references to depression.

The correspondent wrote angrily that this columnist should “restrict herself to subjects she does understand”. He objected to my use of language, saying I oughtn’t to have described myself as “depressed”.

He wrote “Depression is a chronically debilitating condition. It is not cured, only controlled – and not very well – by medication such as Prozac.” He added “It is not relieved by a visit to a tea shop however good.”

I take issue with this at several different levels. The word “depressed” can mean the experience of being temporarily cast down, describe a deeper state of despair or refer to what is sometimes known as ‘clinical depression’. All are legitimate usages.

The word has been deployed in the sense in which I used it, by many authors, including Congreve, Dickens, Austen and George Eliot.

The Oxford Dictionary records that, as early as 1621, the word “depressed” was used to signify a state of “low spirits”. The first use of the word “depression” to describe “dejection” was in 1665. This was long before depression was categorised as a ‘mental illness’ by the medical profession – and international drug companies made a fortune out of it.

Every century faces despair in its own way. Bramwell Bronte used opiates and alcohol to dull his misery. His sisters, Charlotte, Emily and Anne, being female, had no access to these drugs. They faced their demons in the blustering gales of the Yorkshire moors and returned to cups of tea in Haworth Parsonage.

The order and ceremony of a tea shop is very conducive to calm and therefore can be restorative. Though laudanum was the drug of choice for many 19th Century writers I suspect most of them would have understood the power of a cup of tea in combating depression of spirits.

Throughout the ages people have experienced low spirits, misery and dejection. One of the ways in which they have understood their experience – and to an extent controlled or transcended it – has been by speaking and writing about it, often using very powerful imagery. For example, Winston Churchill, who experienced periods of utter despair, referred to it as the “black dog”.

The ability to speak out can be a means to freedom. That is why ‘talk therapies’ are recommended by agencies working with depression, with or without use of medication. This being the case, it seems unwise to fetter use of language or allow it to be ‘colonised’ by the psychiatric profession.

Doctors risk demeaning human experience when they ‘diagnose’ it as illness. It can destroy impulses to creativity and growth which may lie within it. This is particularly true of depression, which can be a crucible in which great and creative changes take place.

In past centuries, what is now referred to as clinical depression would often have been experienced and understood by the sufferer as the absence of God. To give way to despair would have been a mortal sin. Sufferers, such as John Bunyan or William Cowper, were expected to face it with fortitude as an act of faith or for their soul’s sake.

Over the past century, things have changed. Instead of Christian teachers talking about God and recommending faith and prayer, we now have G.P.s and psychiatrists diagnosing illness and issuing pills.

Scientists look for clues in the chemical compositions of brains. Doctors prescribe medication on a continuing basis as if they are issuing insulin to a diabetic or warfarin to a stroke patient. They can, on occasion, be as impervious to the real needs and experiences of those seeking their help as were the religious leaders of previous centuries.

One in 5 of us now experience a period of severe depression. It may be that our communities are afflicted by a chemical brain disorder of epidemic proportions, transmitted in ways we have not yet discovered. However, it is far more likely that depression is a personal response to wider dis-ease in our society.

This would explain why many of those who suffer depression have experienced abuse in childhood or violence, exploitation, discrimination or oppression in later years.

I wrote in my previous article that “depression is often not an illness but a reasonable response to terrible events or circumstances which seem senseless, unalterable or out of control.”

The correspondent strongly objected to this saying that depression “is rarely, if ever, a response to world events”.

However, this too is open to challenge. The loss of faith or a firmly held belief system can cause depression. Many Victorians suffered acute despair as old certainties collapsed in the face of Darwin’s theory of evolution.

The impact of war can be devastating, leading to post traumatic stress disorder and depression. Memory of atrocities, torture, holocaust and genocide may lead people to suicide.

Depression is a particular danger when war is considered pointless or unjust. Hence the suicide rate amongst Vietnam war veterans remains far higher than the U.S. national average.

Depression is more prevalent in groups which experience disadvantage and unfair discrimination. In this country (and many others) women are far more likely to experience depression than men – particularly if they are married. Old people too are particularly prone to depression, often masked by dementia.

The anonymous correspondent believes that “depression is not curable” and can “only be controlled” by medication. I do not accept this. Agencies working with depression, such as the Depression Alliance, remain confident that depression can be beaten.

To advocate long term medication on the basis that depression can be contained but not ‘cured’ is itself a counsel of despair. There may be a case for it when people’s circumstances are unalterable – for example during some terminal illnesses – but not otherwise.

Short term medication can do no harm if it brings sleep to the weary and temporary anaesthetic to deaden acute pain. But to continue medication indefinitely can be counterproductive, leading to chemical dependence or other addictions. Worse, it may become a barrier to addressing the causes of despair.

Though I sympathise with the correspondent, I would hate other people who are experiencing depression to read his letter and think that there is no hope for them.

I don’t pretend to be an expert on depression. But I do know something about it. In my teens I experienced serious breakdown and was hospitalised and heavily medicated.

Years later I worked with people who had experienced depression. I do not believe I spoke with one person whose behaviour was not explicable in term of their personal circumstances. In all cases their lives were capable of change.

The experience of depression is a terrible thing and I can well understand why some people do take their own lives. But I am also very aware of the extraordinary joy which comes when despair is overcome.

I vividly remember the day it happened to me. I suddenly realised that the cloud I had been struggling through had lifted. I noticed that the sun was shining, the sky was blue and the birds were singing. It was as mundane as that.

I was free and I was walking on air.

I would want the same for everyone who lives with depression.

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