The language of Depression

We have made great strides in destigmatizing mental illness. However, there is still a long way to go until we view those people who are living with clinical depression, in the same light as sufferers of purely physical conditions. There are many reasons why this distinction persists. How we speak about depression, in particular, the words we use is one of them. Here, I’d like to take a look at the language we use when talking about depression and how it sometimes serves to perpetuate the “all in your head” myth.

“I’m So Depressed”

When someone is feeling down, or sad about something it is not unusual for them to say they are feeling a bit depressed and the word depression has become synonymous with sadness, unhappiness, and sorrow. actually defines depression as, among other things, “sadness; gloom; or dejection” alongside “in psychiatry. A condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason.”

The general population now use the words depression and depressed in day-to-day conversation in the same way as they would use “unhappy.” Social media feeds are full of people saying they are feeling a “little bit depressed today” or they were “so depressed” in response to a minor event like being late home from work.

Social media feeds aren’t full of people saying they are feeling “a little bit cancerous today” or that they are “so cancered.” Why? Because cancer is universally recognized as a physical disease that has multiple forms. It can be spontaneous or contributed to by the sufferer’s actions. It is curable or fatal, depending on the details and it cannot be shaken off by getting out for a bit of fresh air. We do not belittle the severe effects it has on a sufferer by using the name of the disease in general conversation.

However, although depression is also a disease with many forms that can strike out of the blue or can have roots in a life event or personal actions, is curable in some cases but for others may be a lifelong illness and is, in some cases, fatal the general public still do not view it in the same way.

Depression And Sadness

Just because you or someone you know is experiencing sadness, it does not mean they are or will become depressed. Likewise, just because somebody has been diagnosed with depression, it does not necessarily mean they will be feeling sad.

Sadness is an entirely rational response to stressful life events. It may arise due to the end of a friendship, difficulties at work or any number of another occurrence that is hurtful, disappointing, challenging or difficult. It is a painful emotion but it is either made better by a change in circumstances, or it fades over time as we adjust to whatever it is that is causing us sadness.

Depression is not an emotion but an abnormal emotional state with diverse internal and external causes. It affects the thoughts, feelings, perceptions, and behaviors of a sufferer in a wide variety of ways, it can cause physical pain, and no two people will be affected in precisely the same way.

Unlike sadness, which is a standard emotional response to an event, depression does not need an adverse life event or situation to trigger it. Depression is not an emotion or a reaction to what is happening around you; it is just there in the same way as any other disease may creep up on a person and consume them.

Disease Vs. Illness

Mental illness is a standard phrase used by individuals, organizations and the medical profession when, perhaps, on reflection, that is not the most accurate phrase to use when discussing depression.

An illness is actually a subjective feeling while a disease is a condition that affects the body, or parts of the body, causing them to function incorrectly.

For example, a group of people could all eat a significant amount of food, and one person might feel ill afterward. That person is not suffering from any kind of disease, and there is no need for medical intervention, they just feel rough. Meanwhile, another group member overeats sugar which causes them to suffer a diabetic episode. That person is suffering from a disease that causes their body to function incorrectly.

Evidence to support depression as a systemic disease comes in the form of biological changes that are seen in patients with depression. For example, inflammation, neuroendocrine regulation, platelet activity, autonomic nervous system activity, and skeletal homeostasis can all be influenced by depression.

By using the phrase, “mental illness” are we are unwittingly perpetuating the idea that a depressed mental state is a subjective feeling as opposed to a disease with a physical cause?

Symptoms Vs. Disease

In the same way that a runny nose can be induced by a cold, flu, allergies, hormonal changes, medications or a myriad of other causes, the symptoms of depression can come about for many different reasons.

Irritability, sleep disturbances, and problems with focus can all be signs of depression but they, like sadness, are not diseases themselves. Depression is a disease, and the cause of the symptoms has to be addressed before the sadness, irritability, etc. can be relieved.

This is why telling someone with depression to look on the bright side or cheer up is like saying to a person with flu to stop having a runny nose and bring their temperature down. You can do things to help the symptoms abate, but you cannot just get rid of the cause through sheer willpower.

A person needs to have at least 5 of the following symptoms, for a continuous duration of at least two weeks to be diagnosed with depression. The severity of these symptoms must also be considered, so please use this list as a guideline only and consult a medical professional if you believe you or someone you know may be depressed.

  • Feeling “down” or irritable most of the time.
  • A loss or decrease of pleasure or interest in most activities.
  • Significant changes in weight or appetite.
  • Sleep disturbances including trouble sleeping or sleeping too much.
  • Feeling that your movements are slow or feeling restless most days.
  • Feeling tired, sluggish, and having low energy most days.
  • Having feelings of worthlessness or excessive guilt most days.
  • Problems with thinking, focus, concentration, and the ability to make decisions.
  • Having thoughts of dying or suicide.

Mind And Brain

One reason why it can be challenging to understand depression as a condition with physical roots is our tendency to separate the workings of the mind from the workings of the brain when they are inextricably connected.

The brain is a physical organ, while the mind is a combination of our thoughts and feelings, our consciousness, judgment, language, and memory. Imagine the brain as a book and our mind as the words printed on it. If the book becomes wet, torn or burned then the story is disrupted. In the same way, if the brain is not in an optimum physical state, suddenly the workings of the mind become disrupted.

Another reason why mental health conditions are so difficult to understand for those without experience with them is the belief that we have control over our thoughts and emotions. We can mostly blame the Victorians for this. They believed that humanity could control nature, themselves included and that any mental health issues were a result of a “weak and feeble mind.”

The Verdict

Depression is not an emotion. It is not an illness, and it is not a weakness of mind or personality. By choosing our language more carefully, maybe we can help to shift the perception of depression and the language we use until the world at large sees it for the physically rooted condition it is.