Seeing depression differently

‘Depression’ has not always existed. The wide variety of experiences and behaviours that is today called ‘depression’ has had many different forms and labels over the centuries – and still does in some non-western cultures.

Social construction of depression as an illness

Depression is now widely seen as a medical illness. Experiences that we might call ‘depression’ today used to be seen as a form of ‘madness’. Only since the 1930s has depression been categorised as an ‘illness’ in western medical diagnostic manuals. And only much more recently has it achieved more widespread social legitimacy as an illness.

Benefits of seeing depression as an illness

What is gained by viewing depression from a medical perspective, as an illness?

  • A person experiencing depression has the relief of knowing they are ill, rather than just seeing themselves as a ‘failure’ or bearing the stigma of ‘madness’.
  • Medical and other healthcare professionals have developed expertise in treating depression and people can go to them for help.
  • Medical research has found out more about the biology of depression, so people can be prescribed more and more effective medications to address the biological factors contributing to depression.

Side effects of seeing depression as an illness

These are very powerful benefits. At the same time, it could be argued that there are powerful benefits for those who sell medications and services to ‘treat’ the illness.

Depression medication is very important to the profits of several global drug companies, and these companies actively seek to establish new diagnoses for which antidepressant medications can be prescribed.

On a smaller scale, the livelihoods of doctors and therapists specialising in depression depend on their presentation of depression as illness for which they can offer effective treatments – reducing their incentive for presenting other ways of seeing depression.

Drawbacks of seeing depression as an illness

Are there any drawbacks to seeing depression from a medical perspective?

  • As a non-contagious illness, depression is seen as an individual affliction – social and cultural factors causing the human distress which has been labelled in this way are given less recognition.
  • Depression is seen as a problem to be addressed only by professionals, and responsibility for action is not taken up by wider society or those around the designated ‘ill’ person. Wishing to avoid the perceived stigma of an ‘illness’ label, some may avoid seeking help.
  • Help for depression tends to focus on medical and/or psychological factors. Social factors are often ignored, and the holistic overview of the experiences labelled as ‘illness’ can be lost.

Recognising these limitations is not to suggest an either-or argument about whether depression is or is not an illness. There is clearly much to be gained from the illness model. Equally there is much to be gained from recognising that there are other perspectives to take.

Other perspectives

What are some of the other ways of labelling the human distress we now tend to call “depression”?

Inner wisdom

Some people have looked back on the coming of depression as painful but important signal to themselves to take stock and re-evaluate their lifestyle, values and assumptions.

They later tell a life story which celebrates their ability to listen to the warnings carried in the distress they felt at the time and to take steps to address issues and move forward to a happier, more meaningful life (see also ‘Depression and the meaning of life’).

Oppression

Sometimes the label of depression is now attached to what could be called ‘oppression’ – understandable human distress at socially sanctioned bad treatment, injustice, or prejudice. For example, a group of people distressed and stressed at finding themselves forced to work for very low wages and subject to chronic institutional bullying and threat of job loss would arguably be much better served mobilising action or help to address the unfair treatment than taking pills to cure their ‘illness’.

Appropriate reliance on others

In some cultures, a woman who has just given birth is expected to remain secluded, mainly in bed, and not to engage in any social interactions nor take up domestic responsibilities for a substantial period of time after the birth. Others in the family and community take responsibility for these things during this time. In western culture, a woman behaving in this way might be diagnosed with post-natal depression.

Other ways to tell your story?

These examples suggest that there is not a uniform ‘right’ way to view depression. Being able to consider different ways of seeing depression might also help to make it less powerful in your life.

Next: The happiness trap

Related

Understanding your depression
Living well
Student stories