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Talking About Depression

August 13, 2014

This blog post is inspired by a blog post from my former debate coach at Rutgers, Storey Clayton,who wrote about the suicide of Robin Williams (You can read his blog post here). I suggest you read it if you have the time but for those who inevitably don’t, one of the premises of the post that I’ll be elaborating on is how depression is treated as a clinical disease by the majority of society, with a basis only in the malfunctioning physiology of the patient and not in reaction to worldly forces.

I agree with Storey’s premise that depression needs to be acknowledged as an often justified reaction to the cruelty the world can inflict on yourself or others. Justified doesn’t mean that it’s the most useful reaction to have. It just means that it’s understandable how a certain chain of events could lead to a person experiencing depression and it’s related emotions.

I disagree with Storey the depression never has a physiological internal influence. I think some people may have a higher than normal amount of certain mood-altering brain chemicals which may make them more sensitive to depression and related emotions (I intentionally do not use the phrase ‘chemical imbalance’, because it brings us back to the issue of clinical-ism where the imbalance is only perceived compared against a supposed healthy ‘normal’).

However, despite the instances where depression and/or suicide may be exacerbated by pre-existing physiology, I still adamantly agree with Storey’s stance that the best way to help depression is fixing the ills that justifiably make someone depressed.  For reference, I will call this the ‘holistic’ method, which includes making the environment around someone less triggering for depression. I will refer to the counter-philosophy of treating depression as an abnormal physical disorder with drugs and clinical therapy as the ‘internal’ method.

For those who disagree with my above premise but are still reading, you may be thinking “Kurt, if you admit that depression is sometimes exacerbated by a disease-like imbalance, wouldn’t the internal method still solve that issue?”

In order to answer this question, we need to examine depression through the context of ableism.

I took a fantastic English course in the Spring that had a focus on social justice literature. Before I took that class, I didn’t really understand how disability could be a social justice issue. Race, gender, etc. made sense to me because I always understood them as socially constructed. But I was under the false-impression that disability was some kind of objective physical difference, unaffected by external force. I realized soon I was very wrong.

The only reason why a physical feature could ‘disable’ you is because society has structured itself in a certain way to may that physical feature a drawback. Thus, as I understand it, disability is a social justice issue because what makes you disable is ultimately a societal construct.

For example, if society elects to make all buildings wheelchair accessible, suddenly being paraplegic becomes less of a disability. On the flip side, if society elects to making all buildings wheelchair inaccessible, a paraplegic becomes much more disabled. As the point that a disability can change based on the social structure, it is in no way an objective feature to grade anyone on and the answer most from a holistic societal approach.

For internal method advocates, I know my definition of ablesim probably hasn’t won you over yet. I know that you are probably thinking “If depression is a disability by our own devices, then let’s use the internal method to cure it as a form of social justice!”

The thing is, and the crux of my abelism definition, is that most of the severity of anything hurting a person (be it disease or depression) can only really be solved holistically by addressing the societal source. The internal method can only grasp at symptoms with mixed results.

Here is a thought experiment:

Let’s say there is community of 100 or so people who live on an island. This island is a former nuclear testing site and thus the ground gives off dangerous radiation. The radiation has a 30% chance of causing cancer in people in at least once in their life. 15 people (or 15% of the island) have a gene that makes their body more susceptible to the radiation. Their chance of getting cancer is much higher, with a 75% chance.

Why am I talking about a fictional Bikini Atoll island?

I think it works as a simple analogy to depression. Applied to depression, cancer would equal depression, the gene would be equivalent to some people’s chemical makeup that can exasperate depression, and the radiation is equivalent to the ills and cruelty of people and society that can lead to someone becoming depressed.

As you could guess, each year many people in this island community develop cancer. We can give them internal treatments such as chemo therapy and while that may lessen the symptoms of the cancer, it’s root cause will make cancer continually occur.

In the same way, only trying to treat depression’s clinical symptoms never actually address the source of where all this depression is coming from. You can do your best make depression go away with drugs or what not, but until you acknowledge the underlying radiation island causing depression, such work is throwing sand in the wind.

Now imagine how this island community would feel if people refused to acknowledge the radiation that was killing them, that they only got cancer because they were born with an avoidable cancer causing gene. We would think such a society was in denial, yet we do the same thing in how our culture talks about depression!

In the same way society creates physical disability in how it’s structured (such as using an inhabited island as a nuclear testing ground), society also perpetuates depression by creating real reasons and causes to be depressed.

Back to the island. In this thought experiment wouldn’t the ultimate goal be to scrub the island of radiation or move the community off the island (a holistic method of treating the cancer)? Let’s say that such a thing was possible: that in this scenario we can scrub the radiation from the island. Even the most die-hard internal method advocates would opt to clean the island in addition to their internal treatment.

“Kurt, you just admitted the internal method and holistic method are not exclusive to each other. Why can’t I treat depression with drugs while also trying to address the societal cause?”

While I don’t totally agree with the premise, if your conclusion ends there then I will be happy, because I think we reached a good medium.

But here is the thing!

That is NOT how society thinks about depression. When people make calls for only discussing Robin Williams in terms of his mental health, to treat it as a disease that needs to be quarantined away from conversation, they are not achieving the agreeable combination that you, the reader, may feel would be best. Which was sort of the point of Storey’s blog post and the point of this one. You may not agree with me on everything, but by now I think I’ve made a compelling case that depression is beyond just a physical disease and we need to be aware of it’s roots from humanity existing in an often cruel and depressing world.

Back to the island.

So with new research into radiation removal and chemo therapy happening on the island, we may have reached what you would think of as a happy medium, where internal methods can alleviate symptoms while we are aware of a holistic approach to solve the root issue.

Now let’s say you couldn’t have a combination. Let’s say you could ONLY give the islanders chemo therapy OR ONLY scrub the radiation from the island. Which one would you choose? From this choice, I think the necessity of the holistic method becomes clear. I would choose radiation scrubbing because as most could reason, the symptoms of cancer only exist insofar as there is something causing them.

This illustrates how overwhelmingly important it is to recognize how our external world is affecting us because changing that is how all things change. If given the choice of only giving people intense psycho-therapy drugs OR actually creating a world where there was no cause in the depression t with, I think we would choose the latter.

I still know some of you have been unconvinced of my arguments ever since you started reading (but thanks for reading all the way to the end anyway). Most still believe that even in a Utopia, depression is a purely internal illness and will affect you no matter how society structures itself.

Just make the most basic observation at your Facebook newsfeed and you will see how such a belief is wrong. After the suicide of Robin Williams, I am sure you have seen many people expressing grief and sadness in statuses and tweets. When these millions of people on social media felt sad at his death, was it because they all experienced the symptoms of some latent mental illness causing irrational grief at the coincidental time of William’s death?

Or was it because some things in life, like the death of a beloved entertainer, will justifiably cause depression?

Rest in peace Robin Williams. May we in time become aware of the hidden demons that affected you and so many others.




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