Depression

Why We Call Major Depression the "Dark Passenger"

Keeping up the struggle to win the depression battle and maybe the war.

Posted Aug 07, 2018

Shawn Burn
Source: Shawn Burn

It was with great interest I read the NY Timesopinion piece “The Great God of Depression: How Mental Illness Stopped Being A Terrible Dark Secret” by Pagan Kennedy. Although I agree with her basic premise that people with depression are no longer pariahs and stereotyped as pathetic and dangerous, I disagree with her suggestion that today, a confession of depression is not a big deal. In fact, studies find that healthy people underestimate the social burdens of experiencing depression. 

Depression is what social psychologists call a “concealable stigma.” This means that many people hide their depression from other people because they have the impression that disclosing their depression will lead others to look down on them, shun them, or discriminate against them. This impression sometimes results from stigmatizing messages that lead them to feel labeled, judged, lectured to, and rejected if they disclose their depression. 

For example, in my experience as a person with major depressive disorder, I’ve been told that I need to “think more positively,” “be grateful,” take pharmaceutical drugs, and seek greater spirituality. I have heard minimizing comments like, “Everyone feels down in the dumps sometimes.” Hearing these things makes me feel shamed and blamed and shuts me right up! It increases my secrecy when I am in need of love and caring and in danger of offing myself. The truth is that I sometimes feel depressed despite knowing I am blessed in so many ways. Drugs aren't a viable option for me. I actively work to counteract my depressive thoughts with positive thinking and cognitive behavioral techniques. I exercise and eat right. I have dedicated my life to doing good works and being of service. I am somewhat successful in my professional life and for the most part I have healthy relationships. I know that the objective evidence is that I am a “good person” who is “right with God.” I’ve had therapy to address emotional issues from my past. It has all helped. But while I am largely successful in keeping my depression at bay, it still dogs me. 

The part of Kennedy’s opinion piece that I most appreciated was the story of the successful novelist/celebrity William Styron. In the 1980s and 1990s Styron “came out” as a person with major depression and in so doing, became a depression guru who reduced the stigma of depression. But what particularly resonated with me what that Styron had long periods of good mental health where he felt purged of his “pack of demons.” Despite this, managing his depression and suicidality was a recurring lifetime struggle, which it is for so many of us. Styron self-disclosed to help and give hope to others, something I do when I share my mental health challenges with my students. 

When my depression strikes I try to remind myself that it will likely pass if I hang in there but like Styron, I can’t guarantee that it won’t ultimately get me. I have empathy for those, like Anthony Bourdain and Kate Spade, who lose their inner war (not only is it exhausting to wage the war but the siren call of death is strong in those with major depression). Styron did not die of his own hand but he knew he might. A note he left to be opened in case of his suicide is similar to what I say to my students with major depression. Styron said, “Everyone must keep up the struggle, for it is always likely that you will win the battle and nearly a certainty you will win the war. To all of you, sufferers and nonsufferers alike, I send my abiding love.” 

US Suicide Prevention Hotline: 1-800-273-8255

NDMDA Depression Hotline: 1-800-826-3632

References

Barney, L. J., Griffiths, K. M., Jorm, A. F., & Christensen, H. (2006). Stigma about depression and its impact on help-seeking intentions. Australian & New Zealand Journal of Psychiatry, 40(1), 51-54.

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological medicine, 45(1), 11-27.

Crocker, J., Major, B., & Steele, C. (1998). Social stigma: The psychology of marked relationships. The Handbook of Social Psychology, 2, 504-553.

Garcia, J. A., & Crocker, J. (2008). Reasons for disclosing depression matter: The consequences of having egosystem and ecosystem goals. Social Science & Medicine, 67(3), 453-462.

Quinn, D. M., & Chaudoir, S. R. (2009). Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. Journal of personality and social psychology, 97(4), 634.

Y-Garcia, E. F., Duberstein, P., Paterniti, D. A., Cipri, C. S., Kravitz, R. L., & Epstein, R. M. (2012). Feeling labeled, judged, lectured, and rejected by family and friends over depression: Cautionary results for primary care clinicians from a multi-centered, qualitative study. BMC family practice, 13(1), 64.