Going Mental: Depression or Distress?
Issue Eleven
I’m a terminology nut.
The accurate association of words to items is foundational to how we navigate the world. Much of it is picked up in the first few years of our lives, although there remain certain areas—and important ones—in which a proper and agreed-upon terminological structure remains a work in progress.
Mental health is one of these areas, and that’s understandable. It was only relatively recently that we considered mental illness to be a medical condition requiring dedicated pathology and targeted treatment, so it goes without saying that some of the terms we use in describing mental illnesses are not quite scientific and definitely not universal.
This issue’s feature article examines this problem, and without judgement. It’s an important topic, because, as the author explains, without proper terminology the seriously ill risk being overlooked while day-to-day distresses are medicalized. And that blows.
Let’s go mental.
In the Media
I’m not feeling particularly talkative, so I’m going to link to the article, “What we’re getting wrong in the conversation about mental health,” by Lucy Foulkes, without too much of an explanation. So, please, read the article. It’s one of the best ones I’ve come across regarding this topic.
In short, Ms. Foulkes describes a conversation with a friend in which he describes a mental state that she quickly determines to be clinical depression. She is then taken aback when her friend completely recovers in a matter of weeks without medical intervention.
Her friend, she goes on to say, had recently gone through a difficult break-up. In the end, he wasn’t clinically depressed at all—he wasn’t clinically “anything”—but rather seriously distressed. She then realizes that, in diagnosing him, she had done a disservice to chronic sufferers. She doesn’t lessen the importance and impact of distress—indeed, event-caused distress can certainly spiral into a condition requiring treatment—but rather highlights the reality that depressed people can fall through the cracks when distress is labelled incorrectly.
As she puts it:
It also doesn’t help the people who actually do have depression: a devastating disorder that hijacks body and mind, leaving people unable to live the life they want or, in some cases, any life at all. When you call all low moods “depression”, the term loses any meaning. Back in 2001, the psyhiatrist Derek Summerfield wrote, “To conflate normality and pathology devalues the currency of true illness”. There was barely even a public discussion about mental health back then. His point is more important now than ever.
Excerpt—So Old a Pain: Depression in Fragments
At the bottom of a small, wooden box in which I keep bank notes and coins from Asia, Central America and pre-Eurozone Europe, I found a poem. It was at the very bottom of the box, where it must have looked up at the face of His Excellency, Count Ioannis Antonios Kapodistriasxl for 16 years or more before I found it. At least, that’s about how old I date it. The neat, intentional handwriting suggests it was first scribbled on a piece of notepaper, likely at a café, before being copied and arranged into three stanzas, the first two with numbered lines, 10-9-9-8-10, the syllables of each line.
It's a poem that I wrote when I wrote a lot of poems, that anxious activity of youth, many of them awful and embarrassing, not only the poems themselves, but also the thoughts that brought them to the page. This one isn’t any better than the rest, although I must have valued it and the thoughts that brought it to the page, I saved it after all, preserving it on top of coins from China, Thailand, Mexico, Dominican Republic, Italy, Greece, Great Britain, The Netherlands and Turkey, and beneath notes from the same places, as well as Burma (now Myanmar) and Hong Kong, the bottom note worth 500 drachmas. The handwriting is neat, but the lines filled with nonsense to achieve the syllabic goal, I was obsessed with syllables. Still, there are two lines that give me goosebumps, not because the lines have any literary value, but because they seem to foretell something, they are prophecy.
“It’s fit that my reward should be disguised,
Appear to only eyes whose gaze may pierce the past.”
I have departed from the 10-9-9-8-10, and indeed there is a stroke through one of the nines. My “reward” is clearly “happiness,” or at least tolerable living, I was absolutely miserable when I wrote the poem, a wreck, and my state would worsen over two more years, careening towards a nervous breakdown, just before which it could have gone either way. “Disguised” I think is what I would now call “distorted,” a peering into a thickening mist, memories of memories, unattainable. I can’t see it, I admit as much in the next line, “only eyes” are clearly not “my eyes,” although I wish they were, and perhaps I still hope, at the time of writing, that my vision will improve or the mist, the disguise, will disintegrate. “Pierce the past,” well, that’s my obsession, isn’t it, as if in the past I’ll find the hidden thing, the “reward,” perhaps in that primordial soup, the original pool, the embryonic liquid that we, like fish, flopping on the shore, awkwardly and pathetically twitch toward, our lives depending on it. The thing is, I wasn’t thinking these thoughts back then, about 16 years ago, it was simply an anxious poem, it just came out, likely on a piece of notepaper at a café, later copied, a prophecy, although not a self-fulfilling one, I must have quickly placed the page at the bottom of the box, I only found it now because I was looking for something else.
The text is rich with meaning, even if the writing of it wasn’t. But then, that’s true of many texts. What I find eery about this one is that, encode-decode, I’ve composed an open text to myself, a text that was meant to be found, but not until now.
Mindful
I mentioned in a previous section that I’m not feeling particularly talkative. For about a month I’ve just felt like I have nothing to say. Simple as that.
Of course, it’s not that simple.
I have not been feeling well. At all. I’m also in the process of changing psychiatrists, and the idea of retelling my story to someone yet again is not something I’m looking forward to.
Regarding this newsletter, I’m going to keep at it. But, similar to this issue, it may arrive in your inboxes randomly for the next little while, until I have the energy to put it back on a consistent schedule. So bear with me!
I do hope you’re all well.
Links
Signs and symptoms of depression in men
Young people hit hardest by loneliness and depression during COVID-19
How to help a depressed spouse
