We internalize society’s stigma towards depression.
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There are a few naïve phrases about mental health that I just can’t take anymore. We might even call them mental health macroaggressions. There’s the classic “pull himself up by his bootstraps,” the absurdity of which is a whole topic unto itself. Then there’s, “She’s just doing this for attention,” which, in many cases, if true, would actually be worse than if the actions were involuntary.
The worst of all was when I worked with kids who had been removed from their homes due to severe, often unspeakable abuse. Many times, the abusive parent would not be remorseful in the slightest, saying something to the effect of, “Well, that’s how I was raised and look at how great I turned out.” (News flash: You may want to reevaluate your self-concept there). But the most common and most tragic of these statements is, “I don’t know why I’m depressed. I don’t have anything to be depressed about.”
One reason this phrase is so heartbreaking is that, unlike some of the other ones, it’s not coming from a place of malice or callousness, but of hurt. People tend to use this belief to pile on the self-criticism they’re already experiencing, making the situation worse. On top of everything else, now they also feel guilty for having an illness.
It’s not uncommon for clients with depression to long for some other, more socially acceptable diagnosis to explain their state. They see a physical issue, such as a thyroid or blood sugar problem as being a preferable diagnosis. Even other mental health conditions, like Autism Spectrum Disorder or ADD, may alleviate the moral guilt that comes with a depression diagnosis.
This destructive pattern comes from two interrelated sources: 1) Internalized prejudice and ignorance regarding mental health; and 2) Linguistic ambiguity about the word “depression.” The solution to both is to change our terminology about depression.
People experiencing depression are often affected by negative messages they hear from those around them. After a while, they come to believe these messages implicitly. This is especially true for children. We are hard-wired by evolution to integrate the social messages we receive into our experience of reality. This phenomenon forms the basis of not only cognitive behavioral therapy, but of marketing and political propaganda.
If it’s difficult to conceptualize this, imagine how we develop our conscience. When we’re little, we try to steal the cookie from the cookie jar and our parent says, “No, that’s wrong.” Every time we try to sneak a treat, they catch us and repeat this message. After a while, the association is so strong the parent doesn’t even need to be there, and when our hand extends, we will “hear” their message.
This process is called introjection and is related to issues like “stereotype threat,” in which a person who is marginalized “takes on,” often unconsciously, the negative beliefs and behaviors they hear from others and are expected to exhibit. In this way, people with depression have internalized social biases and must identify them if they wish to heal.
The other problem is that the word depression is casually thrown around to mean all sorts of things other than clinical Major Depressive Disorder. People may say something like, “I’m depressed because I didn’t get the raise I was expecting at work,” or something similar. But these are situational or environmental stressors that have nothing to do with atypical functioning of the brain. And while in some cases, a severe environmental stressor may precipitate a clinical depressive episode for some people, usually, they are nowhere near as severe and incomparable to Major Depressive Disorder. Environmental stressors are a normal part of life for everyone. Clinical depression is not.
Often, clients exhibit extreme resistance to changing their self-punishing views. They may say something along the lines of, “Well depression is mental. It can be treated with behavioral changes.” I point out that medical conditions like diabetes function in the same way. Some people with diabetes can get it under control by making adjustments in their lifestyle, like eating healthier and getting more exercise.
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But for some people, their diabetes is sufficiently severe that no amount of behavior change will be adequate. These people may need to take insulin to treat their chemical deficiency. And so it is with depression.
People with clinical depression are experiencing a deficiency in neurotransmitters such as serotonin, dopamine, and norepinephrine. Their brains are not properly secreting enough of these chemicals. As with the pancreas and diabetes, the brain is an organ within the body that is malfunctioning. This could be true regardless of what they’re experiencing in life and may have no external cause whatsoever.
For these reasons, I’m going to suggest the term “Neurotransmitter Deficiency” to replace “depression” and “Major Depressive Disorder.” There is precedent in renaming conditions for better public understanding. The American Psychiatric Association determines the terminology of mental health disorders and they’ve been known to respond to such need. For example, “Intellectual Disability” had much different and more problematic names before the DSM-5 was published in 2013 (Trent, 2016). I hope they pay attention to this issue. But in the meantime, we can educate ourselves and those around us that depression is a serious medical disorder.
Source link : https://www.psychologytoday.com/za/blog/shrink-mindset/202410/is-the-word-depression-a-microaggression
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Publish date : 2024-10-04 18:56:01
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