By Dr. Jacqueline Brunshaw
Clients often tell me: “I have no motivation lately. I’m snapping at my kids; I’d rather stay home than go out; I can’t sleep and I can’t concentrate at work. But I’m not depressed — I can’t be depressed!”
“Why can’t you be?” I ask.
“Because that would be a sign of weakness. I should be strong,” they often respond.
“Where does ‘should’ come from?” I ask again. “Is it your own internal critic telling you that, or is it society? We explore how they have come to equate being depressed with being weak — that’s the message they received from family and from society at large — and now they’ve internalized this view of depression as shameful.
When you hear the words depressed, depression or mental illness (or even just the word “mental”), what do you immediately think? That the person is suddenly incompetent, or an inept parent? That he or she is suddenly unreliable and apt to make errors?
That they are weak and really just need to “snap out of it” or “buck up”? Do asylums come to mind, grim places of the past where the “insane” were locked away with no hope of recovery?
Sadness and clinical depression are two different concepts. We all feel sad from time to time. Grief and stress can cause sadness.
Clinical depression, however, means a group of specific symptoms is present, which can include: feeling low for more days than not in a two-week period; loss of motivation; disturbed appetite or sleep; feeling restless; feeling unusually irritable or agitated; loss of interest in previously enjoyed activities; feeling self-critical or worthless; difficulty in concentrating; loss of libido; and, in severe cases, thoughts about or attempts at suicide.
Are any of us immune from this cluster of symptoms? Absolutely not. According to the Centre for Addiction and Mental Health (CAMH), one in five Canadians will experience a mental illness in their lifetimes. Count the people in your workplace or home. It is likely that someone you know will become more than sad during his or her life. CAMH also estimates that 70% of mental illnesses emerge during childhood or adolescence. If they are left untreated, these individuals may suffer needlessly for years, often too ashamed to ask for help — or worse, not even realizing that they can (ironically, poor availability and accessibility of services compound the problem). CAMH estimates 66% of individuals suffering from mental illness refuse professional help due in part to their fear of being stigmatized. This fear is legitimate: Only 50% of Canadians say they would tell a friend or co-worker that a family member had a mental illness compared to 72% who would share information about a family member having cancer. It’s a major problem — how to get these individuals or their family members to ask for help.
Why does it matter if they don’t come forward? Because people take their lives from depression. The most recent report (2002) by Statistics Canada found that suicide is one of the leading causes of death for both men and women from adolescence to middle age; for youths aged 14 to 18, it is the second-leading cause of death after car accidents. Suicide among the elderly is steadily increasing.
Overall, mortality rates due to suicide among men are nearly four times higher than among women. Youth and seniors remain high-risk groups today. These rates do not even include attempted suicides, at any age.
Millions of dollars have been spent on campaigns to promote emotional health, but stigma persists. Nevertheless, concerted efforts continue. Elite athletes such as Olympian Clara Hughes now openly share their own experience with depression; Hughes is the national spokeperson speaking out as part of Bell Canada’s five-year $50-million Let’s Talk mental health initiative. Bell also recently donated $1-million to Queen’s University — the site of a series of student deaths since 2010, some of which were suicides — to establish the Bell Mental Health and Anti-Stigma Research Chair. Research goals will include understanding why two-thirds of people with mental illness still refuse to seek help, eliminating the stigma that lingers around mental illness, reducing suffering for individuals and families, and ultimately, saving lives. Let’s all help eliminate stigma right now, in our homes and workplaces — and save the life of someone close to us. Maybe even our own.
–Dr. Jacqueline Brunshaw is a psychologist and director of psychology at Cleveland Clinic Canada.