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O'TOOLE: Help stamp out the stigma of mental illness

• May 1, 2018 at 3:00 PM

“The plunge in mood can be sudden and deep, taking her unawares,” writes Daphne Merkin in her 2017 memoir, “This Close to Happy: A Reckoning With Depression.”

“One minute she’s feeling more or less OK, the next like shooting her head off. It can occur on a Monday afternoon, for instance, when she’s returned home from a dentist appointment to an empty apartment and the very motes in the air strike her as desolate. She feels isolated, stuck in a cave of grief, of ancient and permanent sorrow.”

The Centers for Disease Control and Prevention reports that almost 45,000 people in the United States committed suicide in 2016. That same year, suicide was the second-leading cause of death for Americans ages 10-34 and the fourth-leading cause of death for Americans ages 35-54. There were twice as many suicides as homicides.

When there is a murder, people march through the streets with signs and shout demands for justice. They call for changes in the system that would prevent murder. But when a death occurs by suicide, communities tend to remain silent when they could be promoting mental health awareness and demanding resources to prevent future suicides.

There’s a stigma attached to mental illness that doesn’t exist with other illnesses. Mental illness suggests moral failure, character deficiency, laziness. Many people believe that a person suffering from mental illness need only take some pills and/or regularly meet with a therapist to get well. It’s usually not that simple. Mental illnesses often cannot be cured, though they can be managed. Symptoms may disappear for weeks, months, even years, just to reappear again.

One reason major depression, the most common mental illness, has a stigma is because people just aren’t comfortable hearing about it.

“We live in a society that is embarrassed by interiority unless it is presented in a shrill, almost campy style under the aegis of the recovery movement, with its insistence on dramatic personal testimony,” Merkin wrote. “Rigorous self-reflection — a sober and nuanced wrestling with personal demons — went out with the great, vexed Victorians.”

I’ve witnessed the hero worship of a recovered addict firsthand. He had written a memoir about his addiction. His father had written a book about the nightmare of helplessly watching his son disappear into addiction.

Because I’m a mom, I could empathize with the father’s story. It was my favorite of the two, and the best written. Father and son gave a book reading together. The son got whoops and cheers and the majority of the applause. When it came time for book signings, people rushed to the son’s table, while the father sat quietly, mostly unbothered. Coincidentally, the father’s book had discussed how our culture glamorizes addiction and recovery.

Major depression is the most common mental illness in America. According to the National Institute of Mental Health, 16.2 million adults suffered a major depressive episode in 2016. Sixty-four percent of these adults suffered severe impairment with their episodes.

Women are more likely to suffer a major depressive episode than men; however, men are less likely to seek treatment and more likely to take their own lives.

Most of the first-person books about depression are written by men. Men tend to write about depression differently than women, which affects how people view depression in women. Merkin finds that in the male depression narrative, “the subject is spared the need to expose his own vulnerability or examine his own problems; everything is linked to circumstances outside his own psychology.” For example, depression is caused by alcohol or drug withdrawal, a significant death, genetic susceptibility, or a serious medical diagnosis.

Women writers own their depression, but they tend to include so little description of wellness that readers conclude that women’s depression is a reaction to unlucky circumstances such as a bad childhood, a thwarted job, a failed romance.

Some depression memoirs do the opposite: They describe a hyperfunctioning subject with a few depressive episodes. Many I’ve read have been written by doctors, actresses or entertainment lawyers. Where are the books by the ordinary people in ordinary jobs just trying to do the best they can and having to endure depressive episodes, too? Why is depression acceptable in celebrities and the wealthy and highly accomplished, but not in the anonymous, ordinary people?

So what is depression? It causes feelings of sadness and a loss of enjoyment in activities you once found pleasurable. It can also include changes in appetite — weight loss or gain unrelated to dieting, trouble sleeping or sleeping too much, loss of energy or increased fatigue, slowed movements and/or speech, increase in purposeless activity (pacing, for example), feeling worthless, hopeless or guilty, difficulty thinking, concentrating or making decisions, and thoughts of death or suicide. These symptoms must persist for two weeks for a depression diagnosis. Other medical conditions that mimic depression should be ruled out by a doctor.

May is Mental Health Month. Help stamp out the stigma of mental illness. Check out the National Alliance on Mental Health website at nami.org for more information about depression and other mental illnesses. They have numerous resources. In a mental health crisis, call 800-950-NAMI (6264).

— By Kelly O’Toole, Tribune community columnist

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