Depression, Stigma, and our Toxic Culture
“A black cloud of grief came shrouding over Achilles.
Both hands clawing the ground for soot and filth,
he poured it over his head, fouled his handsome face
and black ashes settled onto his fresh clean war-shirt.
Overpowered in all his power, sprawled in the dust,
Achilles lay there, fallen …
tearing his hair, defiling it with his own hands”— Homer’s Iliad: Book XVIII
Whenever we hear of a suicide by a widely known public figure there tends to be a well-intentioned uptick in articles published attempting to destigmatize depression by reminding us that it is an illness like any other, and consequently, suicidal ideation or the act of suicide itself should not be condemned as a moral failing or a sign of weak character. Characteristic of this approach is the following by the former president of the American Psychiatric Association:
In the last decade, neuroscience and psychiatric research has begun to unlock the brain’s secrets. We now know that mental illnesses – such as depression or schizophrenia – are not “moral weaknesses” or “imagined” but real diseases caused by abnormalities of brain structure and imbalances of chemicals in the brain.” Unlocking the Brain’s Secrets, by Richard Harding, MD, then President of the APA, in Family Circle magazine, November 20, 2001, p 62.
I’m happy to see such articles, because for at least a brief moment in our public consciousness we remind ourselves and others that depression is the silent killer. Briefly allowing such painful conversations a seat in our public discourse may be what those suffering from this awful condition need in order to come out and seek the help and support that is so desperately needed but often neglected due to our collective ambivalence about just what it means to be depressed.
The flipside to this is that by writing articles like these we’re furthering the misconception that depression is an illness rooted in a brain disfunction caused by a neurochemical imbalance. In our attempt to reach out and destigmatize depression, we inadvertently advance a biomedical conception of depression that equally sadly mistaken. In our attempts to replace a mistaken view about the underlying nature and causes of mental illness, we supplant such false narratives with reductionist biological accounts that are every bit as dubious. In doing so we make the following errors:
- The chemical imbalance theory is a myth, and has been known to be so for decades.
- Talking about mental illness in terms of biology actually has no impact on levels of stigmatization. In fact, biomedical explanations of mental illness often reduce levels of empathy for those suffering from these conditions. Biological explanations for mental illness often makes stigmatization worse.
- By attributing depression and suicide to disfunctions in one’s brain, we ignore and lose sight of the psychological and social forces that play an equally powerful role in the formation of depression. If we think “poor guy, if only his brain hadn’t been broken”, we shift our focus to the underlying neurology and refrain from asking questions about the social forces that often create an atmosphere so unbearable for people that ending your life seems like the only escape. When we focus our attention on the individual’s brain, we stop caring or working towards creating a society that is more tolerable to live in. We shift the blame and responsibility to forces beyond our control and thereby do not engage in the project of altering social conditions (such as poverty) that are heavily correlated with depression. We rob ourselves of the power we have to actively make a difference and shift that responsibility over to psychiatry and medicine.
The well intentioned posts of support are a cause for optimism, but let’s try to make sure we don’t undermine our own power to make a difference by wrongly focusing on the neurobiology of the person suffering from the terrible stranglehold of depression.
About the Author: Andrés Ruiz has an M.A. in Philosophy and is working on his MSW with the goal of becoming a licensed psychotherapist. He writes on Philosophy, Psychology, and Psychiatry.
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