Myths about Depression
article courtesy Brisbane ACT centre
Depression
is frequently on TV, radio and the internet. The media uses catchy sound bites
– for depression, this has created many myths. Since these myths create an
inaccurate picture of depression and may lead you to strategies that aren’t
likely to work, let’s take a look at them.
Myth 1: Depression Is Abnormal
“Abnormal”
means “out of the ordinary.” To be abnormal something must occur rarely.
However, about 10 percent of Australians suffer from depression every year. The
annual rate of any mental disorder or addiction is about 20%, and lifetime
nearly 50%. The vast majority of normal people do report short periods of
depression. It’s hard to argue that something like depression is abnormal when
so many people experience it at some point. This is like calling the common
cold an abnormal occurrence. Having a cold doesn’t feel good, but it certainly
isn’t abnormal.
A
different way to think about depression is that it actually plays a key role in
healthy living. It signals that your life is not working well. Taking this view
about depression makes it easier to stop blaming yourself and get on with
changing things that need to be changed and can be changed.
Myth 2: Depression Is an Inevitable Response to Life Stress
Life
stress is a trigger for depression about half the time. 25% of clinical
depression is really a reaction to some form of setback. Depression is often
part of negative life events. When bad events unfold, it’s natural to feel bad.
This isn’t unhealthy. It’s the attempt to suppress them or escape from negative
feelings that causes problems.
The
problem with this myth, that depression is
an inevitable response to life stress, is that many
people experience life stresses, some devastating, but don’t go on to suffer from depression. This has in
part to do with models we observe as children, how we learn to cope. If a parent responds to stress by
withdrawing from meals and avoiding conversations, there’s a fair chance the
children will try similar coping strategies as adults.
Myth 3: Depression Is About Experiencing Emotions
Depression
is often thought as an active state of feeling bad, yet a lot of depression’s
behaviors are designed to protect us from negative feelings, such as loss,
rejection, and shame. Depression is as much about NOT feeling as it is about
feeling. Depression is free-floating sadness, irritability, and shame, but
depression is also an experience of numbness and detachment. Depressed people
complain of feeling alone in a room full of people – a state of apathy and
disinterest in social activities, often avoiding. Depression may help us avoid
feelings.
Sadness
is part of the human condition, just like our other basic emotions, and when
allowed to, it flows in and out of our awareness throughout the day. There are
many things in life that should trigger sadness, such as learning that a good
friend has cancer, being treated unfairly by your boss, or being spoken to
unkindly by a loved one. Often times the things in our lives leading to sadness
are not immediately apparent, not standout obvious stressful events.
When
you’re depressed, sadness, anger, and tearfulness seem to appear out of the blue
– disconnected from the real world, often not the feelings you’d expect to have
in the situation. This can happen when you avoid experiencing your emotions in
a more direct and grounded way. Because the situations that produce sadness
aren’t being addressed, sadness becomes dislodged and starts hunting for a
home. Even a minor event can become a lightning rod for these dislodged
feelings. Depression is often the emotional result of turning away from and
refusing to directly experience unwanted feelings, thoughts, images, or
memories.
Myth Four: Depression Is a Biological Illness
The myth
of serotonin deficiency causing depression is believed as dogma by most people,
doctors and even psychiatrists. It is scientifically untrue, dozens of studies
over decades have proven this. This is not saying that people do not suffer,
nor that drugs do not do things, but is fever a paracetamol deficiency? Does a
plaster for a broken limb cure a plaster imbalance? Medications numb our
feelings, and this can be helpful in the short to medium term. Generally not so
much over the longer term. More about this issue in a specific post.
The
pharmaceutical industry promotes this myth to sell billions of dollars of
drugs. Professionals tend to believe it decreases stigma, “I’m not weak it is
just my biology”, but over 15 years of studies show the more we believe the
straight biological cause the more we discriminate against others and
ourselves. If your genes are wonky I don’t want you marrying my child. You’re
different to the other person, less resilient and I won’t hire you. You’re
different to me. These are speculations, but the scientific evidence is clear,
more belief in straight biological cause equals more discrimination.
Depression
is an interaction of thoughts, feelings and behaviours that of course affects
our biological processes. This does not mean that it is caused by them. The
quickest way to alleviate depression is directly focus more effectively
managing upon the individuals thoughts, feelings and behaviours, and the
context of life that surrounds them. Everything we learn alters our biology,
when you have learnt to play the piano your brain has changed, mindfulness
practice directly changes our amygdala, frontal cortex, broad brain areas which
are also affected by the behaviours we call depression.
Myth five: Medication Is the Best Treatment for Depression
“Antidepressant”
medication is actually quite weak in effect size, negligible for the fast
majority of depressions, and far less effective than simple behavioural strategies
such as mindfulness, exercise for health, and engaging in the things we care
about even a tiny bit more day by day. And these latter powerful strategies are
helpful in the short, medium and longer term, without troublesome side-effects.
None of which can be said for SSRI/SNRI medications, the most commonly used
“antidepressants” – all of which cause physiological dependence, most people
find difficult to withdraw from, sexual side-effects are more common than not,
and over the longer term they increase the risk of osteoporosis, gastric
ulceration, falls, motor vehicle accidents and more.
Myth six: Depression Is Something You “Have”
Saying
that one “has depression” may seem to absolve responsibility, however as
mentioned decades of study show that stigma remained, in fact increased with
increased biological beliefs. The idea that depression descends upon us is not
consistent with the scientific evidence.
People
who develop depression start engaging in depressive behaviours long before the
mood symptoms arise. Avoiding potentially unpleasant feelings and avoiding
situations that trigger these feelings are 2 types of avoidance that lead to
what we call depression. These are not choices that you make, but behaviours
that lead to immediate relief, totally understandable and normal, but can
worsened things over the long term so incrementally you’re not aware of it.