6 Ways to Deal With Stigma


ECT depressionHad depression not killed my godmother–my mom’s sister–and had it not made a pretty good attempt at ending my life, I doubt I would admit to anyone that I pack my suitcase full of the old-people container of meds. It’s hard enough to list them all at the doctor’s office with a straight face, much less speak openly online and offline about my ongoing struggles with anxiety and depression.

We all make fun of Tom Cruise for his beliefs that you can cure depression with exercise alone, but my guess—based on the reactions I get and the conversations I have when I throw out the D word—is that most people share his philosophy … that those chronic worriers and criers among us haven’t learned how to cope with life’s blows, give into needless thoughts and feelings, and—with a little yoga and tofu—might toughen up and get off the couch.

What do we do about it? How do we possibly stand a chance at fighting such an uninformed but common mindset?

1. Don’t Take It Personally

If someone says something stupid, the worst thing you can do is react defensively because a defensive response empowers the other person’s words. It presumes you are threatened by the response, which suggests there is some truth in it. And the more defensive you get, the more confident (and stupid) the other person becomes. If you were raised in a dysfunctional home—and the last time I checked, all of us were—you know well this dynamic. I try to keep in mind Don Miguel Ruiz’s second agreement (from his classic book, “The Four Agreements”) whenever I end up in an infuriating conversation:

Even when a situation seems so personal, even if others insult you directly, it has nothing to do with you. What they say, what they do, and the opinions they give are according to the agreements they have in their own minds…Taking things personally makes you easy prey for these predators, the black magicians. They can hook you easily with one little opinion and feed you whatever poison they want, and because you take it personally, you eat it up…. But if you do not take it personally, you are immune in the middle of hell. Immunity in the middle of hell is the gift of this agreement.

2. Tell Your Story

Your story is the only one you own. You don’t possess Brooke Shields’ or Catherine Zeta-Jones’ or Lindsay Lohan’s. Thank God for the latter. You can try to comment on how each of them descended into depression’s inferno, but your guess is going to be as good as US Weekly’s, which is, well … You CAN, however, describe the exact thoughts that kept you locked inside your bedroom for three days. And if you merely tell the story without any expectation of understanding (difficult but possible), then you are merely telling a narrative about a life event. They can’t disagree, because it’s your story and you own it.

3. Stick to Science

Nothing combats stupidity—and speaks more directly and clearly about the physiological nature of depression–than neurobiology. All those scientific terms will make you look smart, sound convincing, and take the naysayer off-guard, like he’s talking to the president of the kick-butt debate team. I love commenting on the different regions of the brain affected by depression—like the amygdala and hippocampus—and the cell shrinkage and death that the poor guys experience, as well as the diminished capability for nerve generation, because most opinionated people ironically have no opinions about their hippocampus and how it’s doing on any particular hour. I like to quote renowned psychiatrist, Peter Kramer, perhaps the most knowledgeable man alive with regard to depression. He believes that to work with depression is to “combat a disease that harms patients’ nerve pathways day by day,” that “depression is the most devastating disease known to mankind.”

4. Talk About Genetics

Whenever I begin to doubt the physiological nature of depression and get a case of the pathetics, I remind myself of the genetics of mood disorders, and the specific genes that predispose people to this mysterious illness. There is a reason that both my twin sister and I suffer from anxiety. She lives a few states a way and lives a completely different life, but we experience similar symptoms because we share so many genes. Researchers have confirmed a role for the gene G72/G30, located on chromosome 13q, in some families with bipolar disorder, and also evidence for susceptibility genes on chromosome 18q and 22q. Most recently, with genetic studies on families with major depression disorder, psychiatric geneticists like James Potash, M.D. have been able to mark a narrow area on chromosome 15 as having a tie to depression. If you can remember to mention “chromosome 15,” you’ll put an end to the tofu conversation pretty quickly.

5. Throw Out Some Stats

Whenever I give a talk on depression, I start with these statistics that paint an alarming but real picture:

  • One million die from suicide around the globe. Over 350 million people worldwide suffer from depression.
  • Suicide takes more lives than traffic accidents, lung disease, and AIDs.
  • Depression is the leading cause of disability in the U.S. for ages 15-44.
  • 90 percent of people won’t get adequate treatment.
  • 80 percent would rather live with pain than do something about it.

I usually end with the fact that if there had been some more education about mood disorders, my godmother might be alive.

6. Walk Away

If you’re so frustrated you can’t get any of this out, then walk away. And try to repeat number one.

Published originally on “Sanity Break” on Everyday Health.

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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9 Responses
  1. John R. Atkins

    I wish more bloggers on depression would emphasize the science behind its diagnosis and treatment as you have noted above. I have struggled off and on with depression for much of my life, but until about a year ago I had enjoyed a relatively lengthy period of good mental health. Noting that my overall mood and physical health were beginning to deteriorate again I got back rather quickly into my research mode and was, I will use the word disappointed, at how few new treatments seem to have entered the market since the early part of the last decade. My therapist, who I see monthly, readily agreed, though he has seen some progress in patients in his own practice with the trans-cranial procedure.

    I can read that there is important work going on in research into depression, but I am not sure that I sense the same passion and urgency in the scientific efforts surrounding mental health that I see in current work with cancers and heart disease. This may be nothing more than my perception, unrealistic expectations and a testament to the complexities of neurobiology, but giving the growing incidence of depression here and around the world, I am surprised at the lack of fundamental progress. Sufficiently so that I have written to my Congressman, Senator, and state legislators on several occasions recently seeking simply to raise awareness that depression should enjoy the same status in the tax-funded research community (NIH, NIMH and at the large public universities) as heart disease, diabetes, asthma and other chronic conditions. I am not at all convinced it does.

    I do appreciate your forays into the science behind depression treatments and hope you will continue to share your readings in these important areas with us.

  2. Reblogged this on the little things and commented:
    I know, here I am reblogging two times in a row. But this post contains so much of my truth–of the truth–about a lifetime of dealing with depression and PTSD and the stigma I have faced. I know that by speaking openly about it, and writing about it, I expose myself to nasty, smug, judgemental folk who assume that if I just “pulled myself up by my bootstraps” I could beat the depression.
    Depression is a biological illness. And I have fought–am fighting–back. I’m sitting in front of my light box (Seasonal Affective Disorder) at this very moment. I take an antidepressant. I see a therapist and a psychiatrist. And, thanks to the grace of God, lots of caring and supportive family and friends, and the miracle of modern medicine, I am conquering my illness. But I always remember that I am one of the lucky ones. THAT is why I share my story with anyone who will listen, and to hell with the stigma.

  3. Becca Huston

    Is the first statistic under #5 correct? Surely more than 30,000 people worldwide experience depression? Or am I misreading it? In any case, I love the article and plan to bookmark this page.

  4. I certainly agree there is much science that supports the biological and genetic component of depression. However, there is also as much science that doesn’t support that view. When it comes to the genetics, that only means that those of us who have that in our history have a “tendency” to become depressed more easily. But it doesn’t mean we are “destined” to become depressed. As far as the chromosone theory, that’s all it is.

    Now for the biology. There is no research that proves that a chemical imbalance causes depression. Only that a chemical balance is present in the person suffering depression. But it is not know what came first. Did the chemical imbalance cause the depression or did the depression cause the chemical imbalance. Unless we were able to dissect the brain of a living person suffering depression, we couldn’t possibly know what came first.

    For all you who are now upset with me, you need to know that I am a fellow sufferer as well. Dealing with some anxiety issue even tonight.

  5. Apparently my computer has a mind of it’s own.I just want to conclude by saying that every book I’ve read (and there have been hundreds), nowhere to I read that we don’t have some personal cupabilitiy in our depression. Medication is only part of the answer and I don’t know of any doctor or psychiatrist who suggests otherwise. For me, I had to face some of my own issues before I got better and yes, I was diagnosed with true clinical depression and had recurring episodes for years until I got real with myself.
    I’m not suggesting Theresa is wrong, only that there are other studies that have produced different conclusions. As a former research anaylist I know how statistics can be skewed.

    Anyway, hope no one is ready to hang me out to dry. Just wanted to get in on the discussion and present a different view.

    1. Rebecca,
      I appreciate your viewpoint, but I go with psychiatrist Peter Kramer when he says that depression is not a perspective. It’s a disease. He goes on to explain that Primo Levi survived the holocaust but then under depression’s weight, committed suicide. I realize personal issues need to be dealt with in therapy, etc. But I believe that you can also have dealt with all your issues and be plagued by clinical depression.

  6. Thank you for this information, as I, too, suffer from depression along with a long list of other chronic illnesses and diseases. Very helpful insight to the I call depression .
    Tammy 🙂