Depression in the 21st Century

Man goes to doctor. Says he's depressed. Says life is harsh and cruel. 
Says he feels all alone in a threatening world. 
Doctor says, "Treatment is simple. The great clown Pagliacci is in town tonight. Go see him. That should pick you up." 
Man bursts into tears. Says, "But doctor... I am Pagliacci." 

- 'Watchmen' (2009)

The outpouring of grief on social media when a celebrity dies is a curious phenomenon. I often see this public display of grief derided because we didn't "know" the deceased person personally, or criticised for masking the daily deaths of countless ordinary people. Sometimes the tide can turn when the circumstances surrounding the death turn out to involve substance abuse, and I've seen those conversations turn very nasty indeed. 

Today I woke up to the news that Robin Williams has died, from apparent suicide at the age of 63. Facebook, Twitter and myriad social networking sites are full of grief-ridden posts and videos of fans' favourite moments from his career. In amongst that, I've seen at least half a dozen comments along the lines of "so what, suicide affects hundreds of people every day and that doesn't take over the internet". 

It's a pretty shitty attitude to take in the wake of someone's high profile death, but I can't argue with the fact stated there. 

The World Health Organisation estimates that 1 million people die from suicide every year. That figure has risen by 60% in the last 45 years - some of which may be down to the way deaths are recorded, but doubtless there has been a significant increase in the incidence of suicide.

This number translates to approximately one death around the world every 40 seconds. In England alone, someone dies from suicide every 2 hours, and at least 10 times that number make an attempt on their lives.

Suicide and depression are not intrinsically linked, but according to the Mental Health Foundation, at least 90% of suicide victims suffer from a psychiatric disorder at the time of their death. 

It is said that Robin Williams was suffering with severe depression at the time of his death and had been seeking treatment. His death is no more or less tragic than the hundreds of thousands of people who have taken their lives this year already, but his celebrity status and the sadness expressed by so many on social media could give us all a golden opportunity to talk about mental health and break down some of the most damaging and cruel myths surrounding it.

I would like to take a moment to highlight why I haven't used the common phrase "committed suicide" here. This is how people commonly discuss the act of taking one's own life. We don't talk about any other manner of illness-related death like this. It is how we talk about murder, and other crime. You can commit murder, assault, robbery. By saying that someone who has died from suicide "committed" it, we place their death in the framework of a deviant act that they have enacted against themselves. It is that archaic notion that suicide is a sin, a conscious,  deliberate, selfish and indulgent choice made by someone to end their lives. 

Let me tell you now, that this is not how suicide happens. It is not how depression works.

When I posted on Facebook today about Robin Williams, I described depression as "an enveloping darkness". It is all-consuming. It is heavy and it hurts. There is no logic or reason to how it develops and controls your life. It is indiscriminate and does not care if you're male or female, white or black, rich or poor, privileged or oppressed. 

Robin Williams was known as one of the funniest men on the silver screen. I grew up watching his films and laughing until my ribs hurt every time. And yet he carried this dark secret for so many years, and so do thousands upon thousands of people around the world. Right now, there are probably people in your life battling just to get through the day. Maybe they're open about it, maybe they bury it and try to act out the part of a normal functioning person. But it will be there. 

Buzzfeed published a list of "21 Things Nobody Tells You About Depression", and while the use of cutesy gifs to illustrate this is questionable, the points made are pretty accurate. 

We don't talk about mental health very well in this country. People get awkward and embarrassed about it - and often, too often, people are downright ignorant and cruel. I've lost track of how many times I've heard phrases such as "pull yourself together", "try to focus on the positives", "just try harder", "get a grip" - all in response to people talking about depression. It is not a "really sad feeling". It's not that rational! It's an invisible disease and because of that, people so often dismiss it. 

I was 13 years old when depression found me. At 14, I took an overdose of prescription tablets and ended up under the care of a psychiatrist. Over the next few years, I was up and down. Mostly functioning well enough - I got through my GCSEs and A levels with good grades, went to university for a year. But it was always there in the background, always messing with my judgment and self-esteem, influencing decisions that I now look back on and think "what the actual hell?!". At 19, it took a stronger hold. I left my job and spent roughly 2 months unable to leave my flat - actually, mostly unable to leave my sofa. My then-boyfriend would go to work and suggest that maybe I could try to vacuum and wash the dishes. He would come home 9 hours later and I would be in the same spot, having forgotten to eat or wash, not having been able to do a thing around the house. It sounds like idleness, but there are no words to explain why I couldn't do things. I couldn't. That's it. I would try, but after two hours of trying and failing to get up and walk to the kitchen, I would give up and slump even further into a black hole of hopelessness and loneliness.

The world looked physically different to me, almost as if my entire surroundings had a black vignette effect. People would talk to me and their voices would echo around my head, the words entering my brain but meaning nothing. And I would nod and smile and say words back to them, but my mind was far away, screaming and howling that I just needed to fade away. The panic that set in when I tried to push myself harder to do things was absolutely crippling. I could get as far as getting dressed, shoes and coat on, but then I would find myself curled up in a ball against the front door, hyperventilating with my heart pounding through my chest and limbs shaking at the very thought of stepping outside. And there were numerous days when it got too much, when I couldn't see a way out, when I felt I was just not meant for this world and I needed to get out. And on those days, I would collect together all the pills I had amassed over time, lay them out on my bed, fill a large glass with water and wait for the moment when it felt right to take them all. 

I don't remember how or why my life changed and the cloud lifted. But at some point, the days where I could function outnumbered the days when I could not. I went back to work, and my life carried on. Life has thrown me plenty of shitstorms since then, but blessedly the enveloping darkness has stayed in the background and I've carried on functioning. 

The myth is that you can recover from depression. That's not how it works. Like an addiction, it doesn't ever go away. You learn to manage it, sometimes with medication, sometimes with other coping strategies, but it is always there. It will always be a part of me and I will always be aware that it could take over my life again. I manage this by talking to my husband very openly, and he does his best to understand. 

For others, the fight was too much. For the one million people a year who take their own lives, the next day, hour, minute was too hard. It is not a selfish or indulgent whim. It is an act of purest, agonising desperation. And we can only begin to halt that by breaking down the pervasive ignorance surrounding mental illness and suicide, by abandoning judgment, educating ourselves and reaching out to those around us who are suffering with it. 

So, take a moment today to change something for people with depression. Donate to a mental health charity, offer up your time to someone you know with depression, challenge your own perceptions of the illness and ask yourself what you can do to make a potentially life-saving difference to someone. 

Feel sad for Robin Williams and his family, and also for everyone worldwide who is a victim of this awful, intangible disease.

Mental Health Foundation: http://www.mentalhealth.org.uk/

Samaritans: http://www.samaritans.org/  08457 90 90 90 

Mind, mental health charity: http://www.mind.org.uk/