It's the 20th anniversary of World Mental Health Day today. Twenty years of awareness-raising about mental illness and yet, when talking to a friend's father about writing this blog I dropped the 'd' word, his response was to roll his eyes heavenward and exclaim "oh I don't believe in all that, you're either happy or a bit pissed off".
Anecdotal evidence I realise, but I wondered nevertheless whether this attitude was an isolated one, perhaps the result of belonging to a generation whose answer to curing 'the blues' is giving yourself a stern talking to. Unfortunately not.
Let's just get one thing straight: everybody does not get depressed, as India Knight seems to think, writing in her Sunday Times column this weekend. Depression is not just feeling a bit down. It is a debilitating illness, estimated to affect one in five women and one in ten men, which negatively affects relationships, the ability to work and, in severe cases, can lead to suicide. I don't mean to patronise when I say that only those of us who have been depressed know about depression but, as one commentator put it, "We've all had a cold, but we haven't all had pneumonia".
So why then does Knight, while claiming to understand the illness, attack so vehemently the manner in which we are currently talking about it? Knight takes main offence with the slew of celebrity autobiographies coming out in the run up to Christmas with depression as a uniting theme. She complains that this 'misery lit', (catchy, right?), confessing the details of depression, is somehow unnecessary and even self-indulgent as the illness is no longer 'taboo'.
In some ways Knight is right about there being less stigma, as research by Aviva published earlier this week shows. It revealed that more than a quarter (28%) of UK employees believe there is less stigma associated with mental health issues in the workplace than a year ago. Interestingly, of those who felt that stigma has decreased, around half (48%) attributed this to a better understanding of mental health amongst colleagues and (here's the clincher) more than a quarter (28%) believed that celebrities talking openly about their mental health has created awareness and understanding. So maybe 'misery lit' ain't so miserable after all.
Knowing that, despite money and fame and all the things we presume bring lashings of happiness, depression does not discriminate: it doesn't care about your bank balance, your class or your status, helps sufferers to know that they are not alone.
But Knight also admits that she 'long[s] for someone to simply say: “I felt like crap for two years and then I got over it.”' As if it were as simple as changing some particularly dirty sheets after a long snooze. I don't claim to be an expert on depression, my only qualification being the six years I battled it before finally killing it off with a lethal combined injection of therapy, anti-depressants and a radical lifestyle overhaul. Needless to say, I didn't just 'get over it' overnight'.
So, we're all talking about depression more openly and we're (nearly) all agreed that it's a good thing. But, (and isn't there always a but in the depressive's mind?) treatment for the illness still has a long way to go.
It's said psychiatry lags behind other medical specialities and that treatment is too often ineffective or inadequate. With only a comfy chair and a box of tissues at the psychiatrist’s disposal (I'm exaggerating, of course) and anti-depressants like Prozac that some argue are merely a placebo, put simply, psychiatry just doesn't have the information to understand brain malfunctions properly yet. This obviously has serious repercussions for the estimated 350 million people suffering from depression around the world.
Neuroscientist Prof. Joe Herbert from Cambridge University hopes that a new dawn in our understanding of depression is just over the horizon, thanks to advances in brain science and better knowledge of the role of genetics, brain chemicals and stresses in social and working environments on the brain. It's encouraging to learn that drugs companies are busily testing to find out if nerve cells in the brain hold the key to unlocking an effective treatment for depression and that it could be clever things called flavanoids (the thing responsible for pigment in plants) that might hold the key to the next generation of anti-depressants. Luckily for us, we may not have to wait, as those delicious sounding flavanoids are found in common foods and drinks including green tea, raspberries and tomatoes although research is still under-way to prove their effectiveness.
There are economic as well as humane reasons for a taking treatment seriously, evidence from the World Health Organisation shows the risks of mental illness increasing as a result of debt and unemployment. They argue that a lack of attention given to the prevention and treatment of depression in the workforce may only serve to make it more difficult for countries to emerge from economic austerity.
The World Federation for Mental Health favours a recovery model that empowers people to take charge of their own illness, their treatment and their lives. This approach, coupled with advances in cognitive science to help us understand the illness, may finally give proper relief to those suffering.
If we want to see the black dog finally put to sleep, we have to take depression seriously: in the way we talk about it, and the way we treat it.