Readers who follow my
work will know that I am always on the lookout for signs of "what depression is to us" - evidence, in our daily discourse, of how we understand mood disorder informally. Asked directly, many people might say that depression is a mental illness and thus a
disease. But in the sphere of more or less unexamined thought, depression is the Rodney Dangerfield of aliments.
Yesterday's New York Times contains a worrisome indicator, in the form of a letter to the editor. The author is commenting on an article that I discussed in this space last week, about the way that the British balance cost and benefit in assessing medical interventions. The correspondent says that at age 57 she is taking several drugs in the treatment of a high-stage colon cancer. Since the medications are expensive, she indicates, she might worry over whether she should instead conserve health care dollars for someone younger; but then she sees how pharmaceutical companies waste resources by advertising remedies for (presumably minor) ailments, "too much or too little . . . incontinence, tingling in legs, hair loss, sleep, sexual drive or depression."
Now I am no fan of drug company advertising, and I see the optional nature of hair restoration. Impaired sex drive is demoralizing if you're the sufferer — certainly we worry over it when antidepressants are the cause — but we may want to concede the letter-writer's point. With incontinence we're getting far into the realm of conventional medical concern. Still, what leaps out from that list is depression. How did mood disorder get to be a petty annoyance?
Setting mental suffering and impairment aside (and why should we do that?), have we lost sight of the many conditions for which depression is a risk factor or that depression complicates gravely: heart disease, stroke, diabetes, and arguably, yes, certain cancers? Surely these illnesses are not on the "trivial" list. Here, I am alluding to a small fragment of an argument I make at length elsewhere.
Apropos, this week my younger son called me into his room to look at an on-line exercise from his high school Spanish IV textbook, Enfoques. On the computer screen was a vocabulary quiz in the form of multiple-choice questions. One went: which of these four does not belong? The choices were la depressión (depression), la gripe (flu), la enfermidad (Illness or disease), and la tos (cough). You can make a case for enfemidad, on the grounds that the other three are specific, while illness is general; perhaps you can make a case for tos, since cough is a symptom while the other words refer to disease. But according to the program, the odd term out is . . . you guessed it. "Dad," my son said, in that dry tone teenagers use with their clueless parents, "It's not happening."
