Living With Depression
What can you tell us about your book “Living with Depression”
I decided to write “Living with Depression” to highlight my experiences as a person who has lived with depression and as a professional who specializes in its treatment. I wanted readers to understand both sides of the coin, from a patient’s perspective and from a doctor’s perspective. I thought it would make for a meaningful read, given that this dual perspective hadn’t been incorporated in a book before.
I take readers through the diagnosis of depression, as well as traditional and holistic treatments. I talk about the good, the bad and the ugly about living with depression. I start with my depressed childhood, my suicide attempt, the lifesaving changes that helped me heal, and my steadfast commitment to pursuing a degree in psychology to help others. I also address stigma and offer national and global resources – as well as a list of almost 400 high profile people from around the world who live with a mood disorder to inspire readers. My goal was to make “Living with Depression” a go-to book on depression. It's won two awards, and I'm super proud that it's seen as ready-resource on the subject of depression.
For those who are unsure what exactly is depression?
Well, for one thing, depression is not about being weak, lazy or having some kind of character flaw. Depression is a medical condition that has neurobiological origins. Depression attacks the mind, body and soul, siphoning out the very things that make life worth living - like joy, hope, clarity and spirit. More specifically, depression is a clinical disorder of mood that distorts thinking and reasoning, creates physical aches and pains, lowers the immune system and sets into motion corrosive and hopeless emotional states.
Why is there such a stigma with depression?
I loved that you asked this question. Mental illness is the most stigmatized illness in the world. And because of this fact, nearly 90 of people with depression don’t seek treatment. The reason there's so much stigma is that misinformation and unchallenged social experiences keep prejudice and discrimination alive. Social rules about shame regarding mental illness can be found virtually everywhere – from the kinds of names kids use on the playground like crazy, whacko, or psycho; to how we describe an unreasonable person being a maniac or nut job - to those who need medication taking happy pills or psycho drugs. Hollywood highlights schizos and lunatics in movie depictions and news stories frighten us by suggesting people with mental illness are dangerous and violent. Through these damaging and unfounded beliefs, the public is trained to believe that mental illness is an undesirable trait, a failure in character and something to be feared. This is why many children and adults who struggle with depression resist getting help. They fear others will see them in an unfavourable light. They don’t want the social blemish of having depression. It’s like a scarlet letter, a mark of shame.
Why is it on the rise?
The myths that surround depression are brittle and rigid – and are tough to break in spite of scientific discoveries and technological advances showing it’s a real medical illness. Research says that knowledge of the origins of mental illness appear, by itself, not to be enough to dispel stigma. So, what does work? Witnessing people living successfully with mental illness helps kick stigma to the curb. This is why it’s so meaningful when high profile people talk openly about their struggles and successes living with depression. Recently, when Bruce Springsteen disclosed that he’d lived with serious depression, there was a huge surge in new referrals in my practice - particularly from young men struggling with depression. It was as if his story helped others feel less alone, less ashamed and allowed depression to be seen for what it is – an illness, not a weakness in character. I just love when celebs or high profile people share their stories. It gives permission to others to get help, and it offers great hope too.
What are the signs that you have depression?
Clinical depression is when a person experiences weeks of staggering sadness, irritability, apathy, fatigue, and negative thinking. There are many more symptoms, too many to name here in this article, but generally speaking, depression begins slowly, creeping in a little at a time before it sucker- punches you flat out for the count. Depression can be mild, moderate or severe, so it’s vital if you’ve experienced any changes in your mood or thoughts to get a full medical checkup. This is done for two reasons. One, to rule out that what you’re experiencing isn’t a physical illness that is mimicking depression. And the second is to triage your condition so a referral for appropriate treatment can begin. Remember that being sad a few days in a row or upset from time to time is part of the human experience. But when you find yourself having trouble in your day to day activities for several weeks, it might be a mood disorder.
What are the different types of depression?
There are many different kinds of depressive disorders, so it’s important to seek a mental health professional for proper diagnosis. That being said, the best way to understand depression is to view it in two categories:
Unipolar (where mood roots itself in a depressive state)
and
Bipolar (where mood fluctuates between the lows of depression and the highs of mania).
The two most recognizable unipolar disorders include Major Depressive Disorder (MDD), which is the most serious of the unipolar disorders. Some of the hallmark symptoms of MDD include depressed mood, fatigue, slowness of thinking, changes in appetite and sleep, and a debilitating sense of hopelessness—which can lead to despair and suicide. MDD can also have a postpartum onset, sometimes called Postpartum Depression, and a seasonal onset, sometimes referred to as Seasonal Affective Disorder. The other is called Dysthymic Disorder (DD), which is a less intense, but more chronically enduring kind of depressive illness. I had both MDD and DD, which is called a Double Depression. And I can tell you that the illness slowly infected my life, and then it swallowed me whole, chewed me raw, left me bone weary and barely tethered to life.
There several kinds of bipolar disorders. Bipolar I disorder is the most serious of the bipolar disorders and is diagnosed after at least one episode of mania. Mania is defined as an elevated mood where euphoria, impulsivity, irritability, racing thoughts, and decreased need for sleep significantly impair judgment and daily functioning. Bipolar Disorder II disorder is characterized by at least one major depressive episode and an observable hypomanic episode. Hypomania is a milder form of elevated mood than is mania and does not necessarily impact daily functioning. Sometimes called “soft bipolar disorder,” the symptoms are less intense that bipolar I, but more chronic. And then there is Cyclothymic Disorder, where numerous hypomanic periods, usually of a relatively short duration, that alternate with clusters of depressive symptoms. A less intensive kind of Bipolar Disorder, it is usually difficult to diagnose.
What is the first thing you should do when you realise that you have it?
It is enormously important to get a full physical check-up if you think you’re struggling with depression. Remember, depression is a mood disorder – a real medical illness - and getting evaluated ensures a proper diagnosis. I’d also like to say that it’s vital for readers to know that each person's depressive experience may be uniquely different. A good way to think of this is to see that my depression may be vastly different than your depression. So try not to compare your depression, your treatment, or your recovery rate to anyone else's.
How can family members and partners of the depressed person use this book?
“Living with Depression” can help family members, partners and friends in three ways.
1) The book is designed to shed light on what depression looks like and what it feels like, so it’s an excellent resource for anyone who loves someone with this illness. Readers will learn that depression is not a static illness. There’s an ebb and flow to symptoms that many non-depressed people misunderstand. For example, an adult who’s feeling hopeless may still laugh at a joke. A child who’s in despair may still attend class, get good grades and even seem cheerful. Coming to learn the textures of depression will set realistic goals for recovery - and will help family and friends deal more compassionately with their loved one.
2) Readers will learn how their own involvement will help their loved one find symptom relief. The participation of family and friends in talk-therapy treatment plans, daily living, medication management and emotional support is covered in the book, as well as how to use resources and set up safety plans if their loved one is too depressed to help him or herself.
3) Finally, readers will learn the best ways to talk and encourage a loved one who is struggling with depression in non-stigmatizing ways. They will also learn how to deal with stigma that may come their own way too.
Please tell us about your background and training.
I was born into a middle class family in the United States, growing up on a sweet little island off of New York called Long Island. Though I had a close-knit family experience growing up, I was always tired, sad and lonely. Unaware that what I was experiencing was depression, I slowly descended into a debilitating despair as a teenager, attempting suicide at age nineteen with a handgun. The fallout from my major depressive episode required me to take a medical leave of absence from college in order to recover. It was a long and hard journey, but with the help of a psychologist, I learned how to live a healthy life despite having depression. Crediting psychotherapy as a life-saving experience, I decided to study further and obtained a Doctorate in Psychology. I’m really proud to say that I’ve spent the majority of my twenty plus years as a practicing psychologist using my personal experiences with depression to inform my clinical work and research. I really want others to know that there’s no shame living with a mental illness, and that there are ways to create a meaningful life in spite of it.
What is next for you?
I’ve written a parenting book called “Depression and Your Child: A Guide for Parents and Caregivers” which comes out this September. And I’m finishing a children’s picture book about depression too. My goal was to write a trilogy of nonfiction books on depression. And I’m so happy to have a publisher who believes in my work and readers who relate to my story.