For a culture in which anti-depressants are now advertised in People magazine I continue to be amazed at how resistant most people are to going on them. You would think with all the commercials that most Americans were freely taking these “happy” pills. Instead what I see is people that resist taking them and if they do, having a lot of shame about it. I have been in social settings with people where one person discloses that they have been on medicine and all of a sudden everyone is free to talk about it. You can see a huge sense of relief when people see that others are going through similiar experiences. Depression can be such an isolating illness that people just don’t believe how many other people suffer from it.
The National Institute of Mental Health reports that 16.5% of people have major depression in their lifetime with about 9.5% of the country depressed in any given year. Women are 70% more likely to have it then men. (a topic for another day) Of course this data is on major depression and gathered from people that have been diagnosed and or treateed for it.
So with an illness that has double the percentage suffering from it then diabetes (8.3% per the CDC) why is there such a stigma against both the illness and the treatment? Americans love the “pull up by the bootstraps” mentality. I find that most people believe that depresion is a choice. By that I mean people believe that they can control depression and if they were just doing the right things it would go away. They may get reinforced in that belief because in a certain number of people they get depressed and it eventually does go away. I believe that this happens most with situational depression. A person has an episode after a trigger event such as a loss of a loved one.
The people I generally see in therapy report episodes or chronic depression that date back years. They come in to see me because it is no longer manageable. Even than when they have problems getting out of bed and doing the daily actitivites of their lives, they resist the idea of medication. I have never had a client respond positively when I first bring up medication. No one I have worked with wants to go on anti-depressants or stay on them if they are already on them.
I have to than ask the question to my clients “why wouldn’t you want to take a medicine that may make you feel better?” It always comes back to the belief that there is something wrong with them if they are taking medicine. They always believe that they should cure this on their own. We don’t think they when we have medical conditions, why should it be so different with a mental health condition?
Now anti-depressants aren’t the miracle that the drug companies make them out to be. Studies have shown widely different sucess rates. There are also studies that placebos can have the same effect. My experience is that for most people anti-depressants can work well. Now I obviously see people for talk therapy and the research does show that the combination of talk therapy and medication has the best outcomes for sucess in treating depression. I also know people that had very severe depression become functional on anti-depressants, but never really beat the depression. It gets less symptomatic but not cured. I see this more in clients that have serious early childhood traumas. This can be linked back also to my earlier post about how trauma affects the brain.
I was heartened to see Catherine Zeta Jones come out recently to talk about her Bipolar Disorder. If more people were open about their depression and other mental health issues it would make it easier for those suffering to get help. While I practice in an area where therapy can be considered a fairly normal part of the human experience that is not the case for many people. I have done work with various public servants and there is a huge stigma to getting help. It is looked at as a sign of weakness. I also heard lots of stories about the high drinking rates in those professions. I am sure there is no coincidence there. Culture shifts take time. I hope that as a younger generation, that was given a lot more attention to expressing their feelings, ages then perhaps we will see a shift and reduction in stigma. Until then if you or someone you know has depression get help. There is no benefit in suffering from a highly treatable illness.
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