Do you have “depression”?

What I’d like to write about here is, I think, an intense irritant to most mentally ill people. That is, the way people loosely use the term “depression” to refer to things that are not medical depression and get themselves all twisted up and end up stigmatising us. I am making it sound more simple than it is, because there are depression-like elements which are not the same as clinical, medical depression. For instance I might feel sad because my grandmother died. That to me is grief, not depression, and a totally appropriate response. On the other hand it might persist for months and months and be out of all proportion (this sounds hard, but to mourn the death of an elderly relative to the point where you cannot function is out of proportion) and that could be depression. So I’ve been in search of a definition of depression. (Hint: do not look in the OED, as they waffle on about monetary systems). According to NHS choices:

…as a general rule, if you are depressed, you feel sad, hopeless and lose interest in things you used to enjoy. The symptoms persist for weeks or months and are bad enough to interfere with your work, social life and family life.

They also add that there are specific symptoms such as sadness, hopelessness, guilt, irritability, lack of motivation, difficulty in making decisions, lack of enjoyment from life, suicide, self-harm and anxiety. Obviously you do not need to have all of those things. There are also some physical elements and social elements of depression.

Now we can all become sad, or feel guilty or have the other symptoms to some degree. Where I – and I am assuming medical folk although, as I am not a medical bod I do not know this – make a distinction is that in depression, these symptoms persist, and have an impact on your daily life. In many cases, have a major impact on a person’s life. I would also add that these symptoms may have no cause, or be an inappropriate response to something. For example, a severe episode of depression in me that required hospitalisation and cost me my job was triggered by my anxiety over giving a presentation. This is even though I had done presentations on the same topic before. I just got a thing about it, and my brain’s response was major depression. That is what I mean by an inappropriate response to something.

People loosely use the term “depression” as  sort of shorthand for “I don’t feel 100% good here.” So you will hear people say “I am so depressed, my team lost at football.” They don’t mean they are depressed – they are not going to be crying themselves to sleep or suffering terrible insomnia while thinking they deserve to die, for instance. They are (unfortunately) using it to mean “I am sad” even though it is a temporary and ephemeral sadness. I think most of us who have suffered depression find this infuriating. It trivialises our suffering and means that those who use it in this way are likely to think that we who are diagnosed as depressed are also feeling “just a bit sad”. I would go so far as to say that this loose use of “depression” to mean trivial sadness is at the heart of stigma.

“Pull yourself together,” “smile! it’s not that bad”, “I had depression once and all I needed was some exercise and hard work”. 

These are some of the phrases that I have heard which irritate me the most. (In particular, the “smile!” one. If you say that to me in the street I will be mentally cursing you and wishing I was a violent person so I could punch you!) I wish, really wish, that the medical profession would come  up with another term for depression – something we could use to explain that we have an illness and not have it confused with someone’s momentary sadness. I certainly have experienced low mood which I would not characterise as depression. I get it regularly, I will suddenly feel reflective and a bit down usually because I have read a sad book, been thinking of absent loved ones, feel under the weather (physically – I am a big baby when it comes to physical illness) or similar. This isn’t depression. I may feel sad, I may even have fleeting anxiety, hopelessness or lack of motivation, but it is not depression. It lasts until the next happy thought, until I talk to someone I love, until something funny is on the TV. It does not need medication and yes, I can pull myself together either by myself or with hard work or exercise. But it is not depression and I would not call it that.

I think I am preaching to the choir here – I would say most people who have had medical depression in the past would not mistake it for something you could just pull yourself out of, something easy to tackle and quick to go away. But there are still foolish people misusing the word and sometimes I wish I had the courage to tackle them all the time and make them realise that with every stupid use of the word “depression” they increase the chance of people thinking depression is not a real illness.

I did have a Christian point to make too. It is sadly still common to read Christian books talking about mental illness – particularly depression – and denying that it is indeed an illness. Many Christians around the world still believe that depression is essentially a sin or a response to sin. I have now reached the point where I can see what they are saying, although I think they have got it wrong.

Some Christians say (if I was writing for Wiki someone would have pointed out the weasel words by now!) that people feel depressed because they are sinful. That it is an illness given to those who have unrepentant sin in their life in an effort to make the repent or that it is simply guilt, and nothing else. I think they misunderstand the terms. If you said to someone in the midst of a serious depression, “if you repent of your sin your depression will go away” then I for one would have been delighted to repent of anything you cared to name if it meant that my mood would lift. But the fact is that I could not find such a sin. I searched through my life and I searched through the Bible and I did not find unrepented sin in my life. I found sin, yes, but I also found that I had already confessed all to God and was trying my very best not to sin again. I could not repent of what was not there, and I suspect that the same is true for most/all depressed persons, especially Christians. As I said earlier, to me depression in the medical sense is an inappropriate reaction to something – feeling low because you are a secret adulterer for instance, is not called depression it is called guilt. Yes, you can feel low, sad, miserable because you are guilty – but it is not hard to spot what you are guilty of. And you do not have depression. I don’t believe that most people with depression as diagnosed by a doctor are feeling guilt over some sin – mainly because I know when I first became depressed I got the opportunity to talk with a doctor about my feelings and it would have come out in that conversation that there was something wrong in my life which was making me feel guilty.

I did feel guilty when I was depressed – but I felt guilty because I was such a terrible person that God must have regretted creating me, not for anything specific. I think it is too easy for Christians to realise that guilt can cause depression-like symptoms and that depression can include guilty feelings and to elide them together and say that depression is just our guilt.

Before we make sweeping judgements on a person – or on everyone who has depression we should get to know them. I know many people who have had depression who were good and faithful Christians and it simply is not true to say that all depressed people are just feeling guilty for sin. Just because some people may feel sad because they are guilty does not mean that everyone taking anti-depressants is guilty of some crime. I think it is very foolish to assume things about anyone, particularly someone who is mentally ill and possibly already feeling suicidal. How much worse can we be to one another that we tell someone who is suicidal that God is punishing them for their sin, a sin they neither know of nor can find? If there is one thing I would like to tell Christianity in general it is that we should not assume we know what God is saying to a person, what God doesn’t like about that person, until we at least know that person.

So to conclude, because I have rambled on a bit and I am sorry this is not the best plotted piece of writing, I think that we – Christians and non – loosely use the term depression to describe things which are not medical depression but something else. I believe depression is an inappropriate response to something (or to nothing at all) and that to confuse it with feelings of guilt without knowing a person and their life, is a very foolish and harmful thing to do.

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Comments

  1. I was diagnosed with Severe Depressive Disorder 18 years ago and yes it is a medical illness. Mental illness runs in my family. My grandmother, who never recieved treatment, had severe depressive episodes. My great uncle committed suicide. I attempted suicide three times in my 20’s. I didn’t want to die, but I didn’t want to live either. I was prescribed medication I would take it for awhile, feel better and then I would quit taking it. I learned after the third hospitalization when a psychiatrist told me that I could not continue doing that because the episodes can grow increasingly worse. I have taken medication for my condition on a regluar basis (except for one snag in the road, which I will talk about below) for the past 10 years and I’ve never felt better!

    People who have never suffered through it can in no way wrap thier brain around how painful and isolating life can be when you suffer from chronic depression. I would experience this inner conflict…I did not want people to be around me or their happy go lucky attitudes…at the same time I was so very lonely. It felt like a trap…no way in and no way out.The most devestating part of depression for me was that I had no hope, no way of seeing that I would have a future beyond my illness. In fact, I allowed my illness to define who I was for way too long! When I came to know Jesus Christ, the lack of hope and loneliness transormed into having purpose and feeling fulfilled. He always takes the pain we experience and turns it into something good that will help others and glorify Him.

    So, do I think I’m healed of depression and I will never experience it from time to time even though I take medication? Absolutely not! God can do anything. He is capable of healing. What I know to be true is that my body is decaying day by day because we live in a fallen world, but inwardly I am being renewed with the hope of eternal life and the renewing of my mind that comes from hearing the word of God daily. His thoughts become my thoughts. HIs vision of who I am and who He created me to be becomes how I percieve myself. Did this happen over night? No way!

    In fact, at the time I came to know Christ, there were Christian influences around me that confused my understanding of healing. Because of this I quit taking my medication AND it was the last time! I went for nearly a year without medication and my life began to spiral out of control. I was a full-time student working on my bachelor’s degree and a single mother. At one point the stress became so intense that I suffered from a panic attack and short-term psychosis. The miraculous thing is that through that time I never lost that hope. I never had a single thought of suicide. I believe that was only by the grace of God. I believe God is the repairer of brokeness. He makes us whole. I am not healed physically, but I am healed spiritually. There”s a difference.

    I do agree with what you are saying about the guilt. It doesn’t cause depression. At the same time I also believe depression makes the human soul much more vulnerable to feeling it and experiencing it. I was genetically predisposed to depression and certain life experiences can trigger the depression. Some of these experiences were beyond my control and some I brought on myself. I did things that I thought God could never forgive me for and in no way love me! But that was a lie! There is also such a thing as “false guilt.” I’ve been down that path as well.

    We do have an Enemy who hates us. The devil plays on our weaknesses. But, God’s grace is more than sufficient to be strong where we are weak. And I won’t allow the illness that I have to define who I am. I was created in Christ Jesus to live and to keep my eyes on Him even when I stumble and lose my way, He never lets go of me. The same is true for you!

  2. Thank you so much for your comment, and sharing your story with me!

  3. i AM SORRY THAT YOU ARE HAVING THESE THINGS HAPPEN.
    IF YOU CAN GET TO A SITE CALLED ASLAN’S PLACE IN THE USA OF DR. COX YOU MAY BE ABLE TO READ MORE AND GET THE PRAYERS HE HAS BEEN LED TO DEVELOP THAT JESUS HAS HELPED OTHERS.

    BLESSINGS

    GARRY

Trackbacks

  1. […] sin we have committed, some fault, some lack of faith or demonic activity. In addition, I have written before on the laziness of saying “I have depression” when we are merely sad, and that, too, is […]

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