Mind over matter: The guilt of depression

[haggholm]

I'm pretty familiar with depression. I have experience of it both first-hand, second-hand, and third-hand (i.e. as a sufferer, as someone who knows sufferers, and as someone who has heard and read about sufferers). Depression launches a many-pronged assault on those who suffer from it; it is a subtle and complex thing. One of the more devious and peculiar ways in which this manifests is in the way it causes guilt in its sufferers.

There are some people, I'm told, who upon hearing that someone is depressed will tell the depressive It's all in your head; just shake it off, or something to that effect. This is, by and large, callous (if spoken out of anything but ignorance) and totally ineffective, except insofar as to effect guilt. I've never been told this, personally, but I didn't need to—I came up with the accusation all by myself. In fact, in my experience, most depressives seem to feel this. (It's not a large sample, admittedly, but 100% of a small sample may still be taken to indicate something…)

This often takes the form—often explicitly—of a feeling that Other people have it so much worse than me, yet I can't even cope with this. I don't know how often I've said it. I've lost count of the times I've heard it. Why, I would ask myself, am I such a whiner—incapable of coping with this little depression, when X dealt with an alcoholic father, Y has an emotionally abusive stepfather, and Z has dealt with so many crises—yet they have all come through strong where I am weak?

And it's really kind of strange. If I catch a cold—and I'm just getting over quite a bad one—I don't feel guilty about it. Why should I? I contracted a virus that my immune system was incapable of dealing with quickly and effectively enough, so I got sick. Theoretically I could perhaps have prevented it, by eating more vitamins, getting more sleep, washing my hands more often, or some other means—but oh well, I didn't; I got sick and now I'm better and that's the end of the story. I also don't feel shame that my immune system is (arguably) weaker than that of someone who was exposed to the same pathogens and didn't end up sick.

With a mental illness—such as depression—it's not like this at all.

Because it's a disorder of the mind, there is this notion that one should just shrug it off—Just get over it! But it doesn't work like that, as any sufferer of depression can tell you. My mind can no more shrug off depression than my body can shrug off a viral infection; much less easily, in fact, because by and large my immune system does a good job of keeping me on my feet. Why is this? Why is it that if I am brought low by a viral or bacterial infection, by fractures, contusions, concussions, or lacerations, by food poisoning or a chemical imbalance in my blood like high cholesterol or low blood sugar, that's acceptable (in a moral sense)—but if I have a chemical imbalance in my brain, I'm supposed to just shrug it off? Or—if my mental disorder is more complicated or less easily pinpointed than that—if my thoughts are just twisted into a Gordian knot, why is it that my mind is assumed to be a cutting blade?

I don't know the answer to these questions—the only real answer I have is If you talk like that to depressives, kindly do us all a favour and shut up because the tough love method only goes so far and only with certain people, and depressives as a rule have low enough self esteem as it is without being told they're lazy for not magically fixing themselves. But I do wonder, and it occurred to me that this might be related to a very peculiar division.

Did you notice that I made a very clear distinction in the earlier parts of this little essay between physical disorders and mental ones? Very possibly not—we're used to making that distinction—but I did, very deliberately, although I cringed every time I did it. Because, really, that distinction is largely nonsensical. It is, I believe, chiefly based on a lack of understanding—a primitive time when the physical nature of thoughts and emotions was entirely mysterious (as opposed to now, when it's only mostly mysterious…) and, critically, not understood to be a physical process. Understanding of anatomy was virtually non-existent (consider the ancient peoples who thought that the heart or stomach was the seat of consciousness!) and belief in spirits was rampant. These days it is intellectually evident not only that the brain is the physical seat of consciousness, but also that the mind itself is an emergent effect of very physical processes: Chemical, electrical, and so forth.

The consequences of this are, of course, complex and manifold, but primarily it creates a kind of disconnect in the way we regard ourselves. Nobody frowns at an expression like body and mind, as though they were separate things! We would not speak thus of body and liver, body and spleen, or body and large intestine. It also leaves room for concepts along the lines of mind over matter, which implies that mind is not of matter. Without this illusion or delusion, there'd be little room for ideas such as physical disorders being qualitatively different from mental disorders; they are all physical disorders, albeit some more intimately involved with the mens (or mentis: Latin for mind, hence mental et al.). I think it is detrimental in a much more general sense; it opens the way for so many mistakes of thinking: The body being subordinate to the mind, the mind's reactions to physical stimuli being shameful, and so on. In the context of the original topic, however, it is this: Depressives are often fooled, or fool themselves, into thinking that a mental disorder is non-physical; that the mind is non-physical; and that the metaphysical mind should therefore control the disorder.

In my own battle against depression, one of the largest milestones was overcoming this sense of shame. Ironically, what saved me was a massive tragedy. In 2004, my father died, suddenly and unexpectedly, of an aneurysm. Shortly thereafter, my younger brother, unable to cope with this on top of his own, previous problems, committed suicide. My family was of course plunged into a state of shock and grief—call it a form of depression. This is expected, and obviously nobody can blame anyone for feeling terrible after having lost two members of their family. In other words, I ended up in a state of deep and justified depression—a depression for which I felt no guilt.

I felt slightly worse than I had before.

This taught me a great deal. I realised that I had gone from deeply depressed to slightly more deeply depressed—but I had already been so low that the change was not really drastic. I also realised that People who have it so much worse cope better was preposterous, because I had already had it quite badly. It was not a set of external circumstances—like poverty or abuse—but circumstances of brain chemistry and so forth, but I had already had it badly, all the same. Suddenly people started telling me how impressed they were that I held together—how strong I must be—when I had said the same to others for years, and imagined myself so very weak! The disparity in strength was an illusion. Those people you may be looking at and admiring for their strength under pressure greater than that you suffer—they're just doing their best to hang on, just like you; you may one day find, as I did, that there's a low point where you keep going not because you are strong but because there is nothing else to do.

Or you may be overwhelmed by tragedy or bad brain chemistry or bad wiring in the head, and there's nothing more intrinsically shameful about this than passing out when you get up too fast or suffering from diabetes.

In writing this, I feel like I have expressed myself poorly, either because I wrote less well than usual or because the material demands higher standards. Whichever may be the case, I apologise, and I hope to revisit this at some point, rearrange it, and sum it up properly in closing. For now, I leave you with these thoughts in the hope that their relative rawness will encourage you to develop them further where I have failed to do so for you.

I hope, above all, that this does not leave you feeling pity for me or unequal to my strength—if you feel either, please re-read it, and read it more carefully this time! I write about my own experiences not to boast my strength, but to illustrate how this perception of strength is usually an illusion; not to show what awful circumstances I found myself in, but that depression is depression no matter the external circumstances and deserves to be taken seriously whether something obviously awful happened or not. I don't want pity for anyone, only understanding—and that being said, I'm happy to say that I've come a long way since 2004. These are things this essay was not meant to effect.

What I do hope—the ultimate (pipe?) dream in writing this essay—is that someone will read it who does feel this irrational guilt, weigh my words carefully, and find that his or her guilt is unnecessary—the condition is no one's fault—and the weight on guilt be lifted off shoulders that already bear a very real and legitimate burden.