Depression is Not an Evil Monster
Apr. 4th, 2016 09:22 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
tim"And you can stay busy all day
He’s never going away"
-- the Mountain Goats, "Keeping House"
I've lived with depression for 24 years, more than two-thirds of my life. That's not to say that I subjectively feel depressed all the time, thankfully, just that for me, depression is a chronic illness. Sometimes, it incapacitates me. Sometimes, I have periods of time that make me ask myself, "So is this what it's like to be a normal person?". Most of the time, it's present as ambient noise that rarely quiets completely.
It is currently popular to talk about depression as a thing exterior to a person, like a virus that uses a person as a host but has no real life of its own. I guess it's popular among people with good intentions: they want to de-stigmatized depression. But the metaphor of depression as an evil monster that takes you over makes me wildly uncomfortable. The evil-monster metaphor frames depression as a thing a person has, like a suitcase, that can be put down -- not an intrinsic part of a person. Alternately, it frames depression as being like a demon on your shoulder, whispering lies in your ear: it's a bad part of yourself, it's your "jerkbrain". It's an interloper that is occupying your mind and body with no regard for you.
I think the evil-monster metaphor has a little bit to do with the popularity of cognitive-behavioral therapy (CBT) and the widespread believe that CBT is the only acceptable therapy for depression. CBT, at least in its popular manifestations, is all about how some parts of you are more worthy than others. The negative parts are thought distortions that need to be ignored or silenced, while the parts of you that are productive and compliant are the valuable parts of you, since those are the parts that other people can make use of. Like good children, the good parts of you are the ones that do what they're told and don't sulk.
When depressed people commit suicide, we are told that they lost their battle with depression. That they fought hard, but depression won. Those of us who survive might be told we're bravely fighting a war with the illness that non-depressed people want very much to believe is not a true part of us.
What if living didn't have to be a struggle? What if survival didn't have to be a fight? What if depression is part of me, not a bad or shameful thing that I must exile, label as a disease, or try to kill?
Autistic people often write about the harmful effects of person-first language. While neurotypical people often refer to autistic people as "people with autism", many autistic people argue that this phrasing relegates a central part of their identity to the status of an appendage. Autism, they say, is not a disease; there is no "real person" underneath who isn't autistic; they are autistic people, not neurotypical people who have been afflicted with the supposed calamity of autism. Person-first language is especially harmful when used by parents to describe their children: a parent who says they have a "child with autism" is expressing a wish for the child they really wanted, the neurotypical child, a fictional person who they desperately imagine is hidden somewhere, all the while failing to appreciate the real child they have.
I think "person with depression" is harmful for the same reasons as "person with autism" is. "But," you might say, "being autistic isn't necessarily painful or unpleasant, except when the rest of the world expects autistic people to force themselves to act as if they're neurotypical. Depression, though, isn't that inherently negative? Who would want to be depressed?"
It's true that I've never wanted to be depressed, and when I am depressed, I generally wish I wasn't. When I'm temporarily not depressed, I never wish for the next depressive episode to arrive soon. The last thing I want to do is romanticize depression or minimize the pain of it, pain that I know firsthand, better than I'd like to.
But calling me a "person with depression", or saying that I have depression or am fighting depression, makes it hurt more, not less.
So it's true that, unlike with autism, depression would be inherently painful regardless of others' expectations. Still, though, I think a major part of what makes depression difficult to cope with is the expectation that we must always be able to work, always be able to interact socially, and always be able to be happy, or at least act as if we are to avoid making others uncomfortable with our sadness or numbness.
Depression already taxes the resources of most, if not all, people who experience it. But guilt over not being able to work (or not being able to work as well as non-depressed people) is another thing. Shame over being unable to interact socially, even when you want to, is another thing. Depression is a complicated thing with interrelated causes, but shame and guilt are something we impose upon depressed people from the outside, and thus, things we could stop imposing.
I don't know what it's like to be in the mindset that leads to completing suicide, and nobody else who's living does either. So I can only speculate: do people who commit suicide die of depression? Or is the shame of not being able to participate in life, to work and produce value for capitalism, to feel that you are fully present and able to provide emotional support for friends and family rather than being lost in numbness, a secondary yet just as lethal factor? Shame may be secondary to depression, but other people's reactions to our depression often create a feedback loop where the shame of feeling inadequate as a person makes depression worse, making the shame worse.
Accommodating Depression
The social model of disability has been one of the most life-changing and mind-changing ideas I've ever encountered. People can be impaired in various ways: they might have difficulty walking or not be able to walk, they might not be able to see, or they might not be able to experience positive emotions. In each case, the impairment may be more or less impairing at various times in a person's life, which doesn't make it any less real.While impairment is individual, disability is social: it's imposed from the outside. A person with a mobility impairment, for example, is only disabled to the extent that engaging in normal life activities requires the ability to climb stairs and walk long distances. Elevators, ramps, and accessible vehicles, if universally available, are accommodations that allow people with mobility impairments to participate in society. The problem isn't the person who can't walk: it's the people who built a building with no ramps.
So what do accommodations for depression look like?
We could stop expecting everyone to be able to work all the time, both by providing everyone with adequate time to rest and by collectively supporting people who are too impaired by depression to work full-time.
We could modulate expectations of social availability, both by reorganizing offices to give private work space to people who need it, and more broadly, tolerating that everybody is not going to be up for being social all the time, and that even people who aren't introverts may have times when they just aren't up for social interaction. We could stop complaining about people who use their smartphones to cope with social situations they don't have the resources to navigate.
We could stop the toxic focus on positive thinking that serves to isolate and atomize people, to blame victims, and to redistribute responsibility for coping with illnesses and solving social problems from privileged people onto relatively disprivileged people.
We could listen to our depressed friends rather than telling them to cheer up or that they ought to think or feel differently.
We could acknowledge that stress has corrosive effects on physical and mental health and that physical and mental health are inseparable. We could view stress as an environmental problem, like pollution, rather than treating it as an individual affliction that can be remedied with a yoga class.
Depression will never be comfortable, but just as we understand that it's possible to make people in other kinds of pain more comfortable, we can make the world a more comfortable place in which to be depressed. And that would have the side effect of making the world a better place for everyone: who wouldn't benefit from time to rest, from having their emotions treated as real, and from having other people accept all of their moods and not just the happy ones?
Loving Your Demons
Another problem I have with the evil-monster model of depression is that it's a deficit model. It frames depressed people as broken, as much as it often tries to say otherwise. Depression has adaptive value. As Andrew Solomon points out in The Noonday Demon, people who are hiding in a cave are the ones who are going to survive when lions show up, not the people who do a lot of positive thinking and believe in their ability to fight the lions.Depression doesn't lie. Pain is real. Depressed people have a more accurate view of the world than non-depressed people do -- the trouble is that functioning requires some degree of lying to yourself. I hope you wouldn't tell someone with a migraine "your pain is lying to you;" you can probably realize that even if you don't know the cause of their pain, it's still real. And the same thing is true about depression. I find it profoundly invalidating to be told "depression lies." I am not deluded when I'm depressed, nor am I deluded when I'm in a good mood. I'm just experiencing the world mediated by different filters, neither of which is the correct filter. My experience when I'm not depressed is no more real or objective than my experience when I'm depressed; feeling at ease doesn't mean I'm able to understand more clearly.
Can I accept the depressed part of me, embrace it, give it what it needs -- which, sometimes, might be a day spent under the covers with headphones on, even if the rest of the world would prefer I spend that day working? Can I accept the self-loathing part of me, the part that wants to die, as parts of myself that deserve love, without necessarily letting those parts drive?
The evil-monster model makes non-depressed friends and family members of depressed people more comfortable. It's comforting to believe that there is a happy person somewhere underneath, and if we could just kill off the depression, that happy person will appear.
The problem is, when that's your mindset, you love an imaginary person. There is no happy person underneath. What you see is what you get: a person who might not be happy most of the time, but who still needs your love and acceptance.
It's understandable to want to think that depression is an evil monster that came to take away the happy person you once loved. For one thing, culturally, we're very uncomfortable with negative emotions and negative thinking. We preach that having a positive attitude is the key to surviving any illness, which makes temporarily-well people feel that they will be able to conquer any illness they may contract through sheer willpower, while demonizing people who don't survive (It must have been their fault. They must have not thought positively enough.) We're also very uncomfortable with acknowledging the pervasiveness of trauma, the extent to which we live in an abuse culture. If we look at depression as a "chemical imbalance" or the result of random neural misfirings -- as an individual deficit rather than a product of structural violence -- that takes the scrutiny off us and excuses us from asking how we're harming children. Depression-as-evil-monster is tempting because it shifts blame onto a faceless abstraction, an invisible disease, an inanimate thing. In truth, everyone is to blame. But if we can see that, we can start to make it better.
It's possible I was born with some genetic propensity to depression, but it's definitely true that whatever propensity I had, my environment activated it. I might not have become a chronically depressed person had I not been subject to abuse and neglect as a child. But life is not a series of database transactions; I can't roll myself back to who I was "before the trauma." Who I am is a product of all of my experiences, and some of those experiences are the experience of living with chronic depression.
You cope with chronic depression. You manage it... or else you don't. If you die, you did not die of depression. You died because you lived in a culture that makes it incredibly hard to be a depressed person. So please don't tell me that I fight with depression, that I have depression, or that depression isn't me. I might not feel great all the time, but I'll feel better the more I learn to embrace every part of me, to give every part of me what it needs, rather than disowning parts of myself, cutting off parts of myself, declaring parts of myself to be worthless. In good moments, I can believe that every part of myself has value, that every part of myself exists to support the survival of the whole. Can you?
If the goal is to make depression go away, that means making depressed people go away, or at least putting us somewhere where we don't make the abled people uncomfortable by existing. If you want us to get better or die, don't act surprised when we die. If your goal is to cure depression, to slay the monster, you will never be able to do a thing to make life better for depressed people in this world, those of us who won't see a cure, who have to live with our entire selves, even the parts you don't like.
On the other hand, if you want to help depressed people to survive, you would do well to understand the social model of disability and see how chronic depression is a disability -- that would equip you to work towards greater accommodations for depression. Rather than fighting for a cure or encouraging depressed people to get better, know that what lets us survive is the ability to cope and manage. Don't ask us if we're better yet. Ask how you can help us live.
Further reading
- Valerie Aurora, "Suicide and society: Where does responsibility for preventing suicide lie?"
- Melissa King, "The Sick Day that Never Ends: Capitalism's Pricetag for the Disabled and Marginalized"
- Inconsistent Universe, "Labor and Suicide"
- Sunny Taylor, "The Right Not to Work: Power and Disability"
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(no subject)
Date: 2016-04-04 10:37 pm (UTC)