Doctor, Doctor… Pt 2
A week or two ago I wrote a blog post about what makes people go to the doctor, what illnesses they blame on their own actions and what they blame on outside circumstance. One of the interesting things I commented on in that post is how rarely people visit their GP for mental health issues compared to other complaints, and I suggested that the stigma of having mental health issues might be a major factor.
Sadly, I read an article today that shows the stigma of mental health that hinders people seeking help isn't going to go away any time soon. Speaking in The Guardian's Comment section, Giles Fraser suggested that we may be too happy just to pop to the doc and get some jolly old pills to cheer us up when sadness is a very normal side of the human condition. (I am being trite and paraphrasing hugely there, and strongly recommend you to go and read the original article).
Now, I think Giles has a good point about a certain amount of sadness in our lives, and would agree that sometimes circumstances make us sad. If we're overworked, bereaved, getting divorced or whatever we may well be far from happy. We should accept these times as part of the cycle of life. But the difference is, if you are sad for any of these kind of reasons you know that, while dreadful to go through, time and the support of friends will heal. There will be an end to it, and one day you'll feel better.
Depression never ends. For many sufferers it's a debilitating and life changing as any chronic physical illness, and you know why? Because it is physical. What Giles does is conflate that kind of unhappiness we all feel from time to time with depression, and therefore make light of what's a life-changing chronic illness for many many people.
And this is a problem. We've talked before about people seeing illness as "their own fault", and depression in particular is one of those things seen by many people as "their own fault". More than any other kind of illness, mental health has a moral taint. If you know you're sad because you're bereaved or going through a bad life experience then that's one thing. However, the idea that depression is something people feel because they are mentally weak, unable to cope with life, is still a common one. In fact, if course, it's the other way around. Depression as a mental illness leaves people unable to cope, not the other way around.
Now this is a departure from my usual kind of post on this blog, and I make no apology for it because the stigma of mental illness is huge and needs to be broken. So I will declare that this blog post is quite personal and declare my "conflict of interest". I have no qualification in mental health, but then neither does Giles so I don't see why it should hold me back. While I'm lucky enough never to have had truly severe depression, I've been affected by mild to moderate depression in cycles throughout my life. Sometimes, I have been bad enough that I've been unable to leave my house and even go to the local shops for milk. Sometimes it's been a struggle to keep my house clean, feed my children a reasonable diet and get to work. Sometimes, I have been to the doctor and received a prescription for fluoxetine, which helped me for the reasonably short while I took it, but where possible I try to do without.
Why do I try to go without visiting the doctor? When I'm depressed it's very hard to leave the house and face people. It's hard to smile and say hello to people (and because I live in a smallish village this happens a lot). It's hard to interact politely even at the most basic level when you're consumed with blackness. When I'm depressed, the words I usually depend on to articulate my thoughts desert me, so how am I supposed to articulate what's wrong with me in a 4 minute appointment with my doctor? The same would go for counselling. How would I find the words? I generally find that for me, medication is what kick starts the process, what makes me feel able to talk about my feelings. And if I don't even go to the doctor for medication, how can I talk about it? It's a cycle.
The other reason, if course, is fear. Fear that I'll be seen as weak, not normal. Fear that my children will be put on some kind of register if I'm seen as an "unfit mother", fear that somehow word will spread around my small village that I'm "not quite right in the head" (ironically I often think mental illness would be easier in a big city, where outward displays of mental illness are considered a more usual thing to see).
I suppose what I'm trying to say is that Giles Fraser's view of people going to the doctor and requesting pills for all of life's downsides is, if anything, quite the opposite. I struggled for years with depression before ever getting my courage up to go to my GP. I thought I should be able to cope, I didn't want to be one of those people who asked for pills for every little thing. And the fact that Giles has the platform of a national newspaper to say he believes that's what people do may be seen as a consensus view by someone who really needs to seek help. Someone who really does need pills for their medical condition might believe that if they can just buckle up and keep a brave face on things, they will defeat their demon. And keep the stigma alive by not talking about it.
Medication for depression is necessary for thousands of people. I'm lucky that most of the time I can muddle on through without, but it's good to know it's a safety net if I really need it. Many people don't have that. For them, it's necessary for them to function as an average human being. To go to the supermarket, to smile and say hello to neighbours, to hold down a job and be a loving spouse and parent. Let's give them our unconditional support, not tell them to ditch the pills, eh Giles?