Jeremy Laurance: Sometimes we really can think our way out of depression

Medical Life

Boy, it's been a good week for depressives. An international cricketer, Michael Yardy, announces he is withdrawing from the World Cup with depression, one of the few sportsmen to "come out" as a sufferer, and a former cricketer, Geoffrey Boycott makes a few ill-advised comments – unleashing a flood of outrage.

Sympathy was extended from all quarters to Yardy, rightly so, while Boycott was damned for being insensitive, ignorant and crass. Depressives everywhere rejoice! Your illness is recognised and your suffering acknowledged. Good news then. But is it good sense? Boycott's remarks were insensitive. But were they ignorant? The "gruff Yorkshireman" – or belligerent old fool, take your choice – said he had "not been in the position where my quality of play has been poor and got to me mindwise" and that "I've been lucky, I've been good enough." This particularly incensed Barbara Ellen, writing in The Observer, who with heavy irony said: "Did you hear that, Michael Yardy, this depression you've got is all about not being up to scratch. YOU ARE NOT GOOD ENOUGH, MICHAEL YARDY!"

Alastair Campbell, former No 10 spinmeister and honorary spokesman for depressives everywhere, was similarly appalled. "How would Boycott have felt if I had suggested to him that his cancer had resulted from poor performance as a sportsman or sports commentator? I'm afraid that's not how it works. For depressives, depression just is, the same as for cancer sufferers, cancer just is, and if you catch a cold, you just do."

These remarks were intended to be kind and to highlight that depressives are victims of a chemical change in their brains, as cancer sufferers are of the uncontrolled growth of cells taking over their bodies. We know this because depression responds (in many cases) to treatment with drugs, which help re-set the brain's chemical balance. But depression is also a sickness of ideas. Depressives think sick thoughts – and "Michael Yardy, you are not good enough" is the classic form of the depressive mindset. Would Yardy's depression have come on if he had hit a string of centuries? I doubt it.

We know depression is a sickness of ideas because changing the ideas, or re-framing them, can bring about a cure. The most effective treatment for depression is cognitive behaviour therapy, in which the sufferer is taught to identify negative thoughts, analyse and question them and try to construct an alternative way of viewing the same facts.

The unique feature of depression is that as you can think yourself sick, so you can think yourself better. It is not like other illnesses in this respect, and that ought to be a source of hope. Geoffrey Boycott may have been crass – but he wasn't wrong.

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