NZ Herald Column Kyle MacDonald

When is ‘depression’ really depression?

This is my column this week in the New Zealand Herald, which is published in the digital edition every Thursday.
“A few people I know say they’re depressed, but what they’re going through is not the same.” Confused

It may be an urban myth, but I’ve heard it said that the Native people of Artic Canada have 200 words to describe snow, because, as the parable goes, being surrounded by it makes you notice the many subtle variations beyond just “snow” and “sleet”.

Psychotherapists have at least two hundred words for human misery, and many of them differentiate between the different kinds of depression people experience.

To start with are the official categories, because there isn’t actually a diagnosis of “depression”. It’s a bit more complicated than that.

Dysthymic Disorder is a long lasting chronic low mood that is debilitating but usually people can function, even though they may be quite miserable or hampered by their symptoms.

Then there is Major Depressive Disorder, deep dark crippling depression that can leave people unable to get out of bed, function, eat or sleep. If this sort of depression lasts, or keeps reoccurring, then we call that “Major Depressive Disorder.”

Miserable after having a baby? Post Natal Depression.

And then there’s Bipolar Disorder, which is depression with periods of feeling like your mood is unnaturally elevated, to a level that causes problems or, more severely, makes you lose touch with reality.

Of course if your low mood is in response to something really obvious, then we could call that Adjustment Disorder. Or it could be due to substance abuse, or a medical condition.

So many ways to be miserable.

Diagnosis has its place, but sometimes I think the human fascination with cataloguing things is merely a way to try and feel a sense of control over the ephemeral. If we can label it we can also create the illusion of certainty and understanding.

The uncomfortable reality is many aspects of depression remain a mystery. While some will vehemently tell you it’s a brain disease and we just need to fix people’s serotonin levels, medication doesn’t work for as many people as it does, and we don’t really know why.

However one thing that does help is hearing other people talk openly about their experiences, and what depression looks, tastes and smells like.

At the bottom of a deep well, where you can still see the light, but it’s out of reach. When it comes to capturing the experiences of depression, metaphor, images and stories capture it best.

It’s one of the many reasons why it’s important that we keep talking as a society and make space to listen to people’s experiences.

Because being in the dark is scary, but being alone in the dark is always worse.

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