Depression. It Used to Be a Real Bummer.
The social construction of illness (depression more specifically) has become a booming business that has touched many of our lives, even if just on a subliminal level. Currently depression is the number one cause for disability in the United States. How can this be? If we look to human biology, that would say we are all predisposed to being homozygous for a short allele on chromosome 3 single nucleotide polymorphism 3p25-26. Since there are over 800 million different combinations in the human genome, so that no two individuals are remotely the same and homozygosity; denoting for a recessive gene is about one in four, means that it's down -right impossible, that 16 million adults in the United States have this affliction genetically.
What does this say about our society? Is it something in the water that we are drinking? Is technology finally rearing its ugly head, and creating such distance between us that we can no longer have social interaction?
It is human nature to be social. We lived in tribes/groups since the beginning of our days. Primates still live in groups, consistently grooming one another, and gossiping while doing so. We have lost that aspect almost completely.
People watching of the younger generation is mind boggling at the minimum. How can you sit at a table with people, yet everyone is glued to a screen? They are invested in talking to someone else through text or ogling someone else's life on Instagram. We're all guilty of it, including myself. How as a society can we not be depressed, when obsessed with not being ourselves?
This is one angle that the construction of depression as an illness starts. Though we as a society may have not understood that artificial intelligence could create a divide that would so quickly create a decline in social status, it has happened, and it is here to stay.
With the decrease of social interaction, there is a correlation with depression. As technology invades our lives further, the more often you will see the commercials on T.V for antidepressants, or for mood stabilizers to enhance your antidepressants.
There have been studies on the human brain that show when humans are engaged in television or when they are scrolling on their phone, the brain that is "lit up" is the primal or "old" brain. This meaning that we are in our lizard (limbic) brain. There is minimal Pre-frontal Cortex activity, just the amygdala and hippocampus, thus allowing for catecholamines, cortisol, endorphins, serotonin and dopamine, to be released. This can be categorized as being on autopilot or having reliance only on the sympathetic nervous system. This is not how we lived years ago. When living in a cave your sympathetic nervous system would have only been activated if being chased or coming into some immediate danger.
We all know that depression is a chemical imbalance in the brain, that is if you are "truly" a depressed sort. Otherwise theoretically, we just spend too much time alone. I know that I am not the only person that theorizes this issue, but what is sad is that society inevitably sees this and cures it with a pill.
The other angle to look at social construction of depression as an illness is the flippancy with which medication is prescribed. Since the 1940's psychology has gone through fads, where people are diagnosed with symptomatic or asymptomatic issues that fall into a category created by the DSM. In 1950's Schizophrenia Catatonia was diagnosed in the country. This is a form of schizophrenia where your patient is malleable to how you set them. The doctor can move their arm up in a straight position, and the individual literally becomes stuck. You no longer see catatonia diagnosed at the level it was in the 1950's.
You then go into the 70's where Sybil was discovered as having multiple personalities that controlled her life. People stepped forward, famous people at that, saying that they too were suffering from multiple personality disorder. Years later, "Sybil" admitted she had made the whole thing up. We then come into the 2000's and our society has suddenly become riddled with Bipolar Disorder and depression. The issue here is that if you have not had a "serious" bout of mania, the medical society will categorize you as Bipolar II, similar in symptoms with the original diagnosis, but revolves around irritation, and depression. Well who isn't irritated and depressed occasionally? Infact, if you are happy, should that cause alarm to the psychiatric society? Should they finger you as crazy if you're always on the up and up? Because people don't feel bad, there is no diagnosis, no medication, and rare interest in those people.
Depression has become a popular illness. When there is something that we do not understand, or do not like, we choose a name, we choose a treatment, and then...we attempt to fix it. Because of this thought process we put people on medication that may just be situationally depressed, unhappy in the environment that they reside in, or that have a lack in communication that everyone truly needs. Those are all issues that stem from self -awareness, and what one needs, but that would take time, money and serious effort to make the change. So, we take a pill. The pharmaceutical companies deeply understand that people are inherently not going to make a change on their own. If the pharmaceutical companies can capitalize on whatever "weakness" that you may have, they will. This creates a system where doctors who do not have the time, the training, or the will the option to care for their patients in a quick and easy manner.
Pharmaceutical companies are genius. Their tactics of pressure, manipulation, and bombardment of advertising is relentless. As was discussed in class, the issue of Pharm Reps coming into doctor offices and hospital settings and giving so openly of their time, and their money in making a "friend" is preposterous. This is coercion at its best. Besides the blatant manipulation that occurs daily in those types of facilities, you also have the companies advertising to their most popular audience...the psychiatrist. If you have the ability or the chance to bring up the DSM-V online, you are greeted immediately with an advertisement for an antidepressant. The propaganda is everywhere, and regardless of who you are, you will be influenced by it.
Quoting from Elliot's Essay "You Are What You Are Afflicted By":
"In his book Listening to Prozac, Peter Kramer worries about using Prozac for patients that do not meet clinical criteria for depression. One of the worries is that, at least in some cases, Prozac seems to change some of his patients in dramatic ways. Shy people become more outgoing, uptight ones become more easy-going, people with poor self-esteem become more confidant. What might seem as an aspect of a patient's personality seems changeable with the drug. This is a disturbing possibility, or at least it seems so for some observers. If Prozac really does alter a person's personality in important ways the notion of being a "new person" would take on more literal truth." (Elliot, pg. 29)
Elliot's essay suggests that maybe some people are just cursed with self- hatred. It appears in America, we are never satisfied with what we have. We are a society that always demands more. Be more beautiful, more money, more happiness, until we are filled with exhaustion. If you are not as out- going as your friend, take a pill, you'll relax, things won't bother you like they would on a regular basis. This draws on the aspect of authenticity that Elliot discusses in his essay as well. That we seem to be unsure of our true self. The person that you see every day without medication that struggles, that feels anxiety, and stress, you can make them well...sort of disappear.
When antidepressants are given to someone that may not need them it creates an illness, even a state of psychosis. Doctors are aware of these issues that can arise with any individual, but yet there is still ambivalent in whether the patient should or should not be taking medication. When psychosis appears because it is medically induced, there is a diagnosis that usually pertains to something more serious, because in the medical professional's eyes, antidepressants are safe for everyone to try.
As a society we have created a crutch, if you're not feeling well take a pill. Don't deal with the actual problem, take it easy and things will pass, but society moves too fast to let things heal in its proper time frame. Grieving is a process that can take time, months even to become aware of what you have lost. Why shut that down? Why create a path that isn't real, where you don't allow yourself to heal?
We should then be questioning ourselves on "why the self-loathing?" Again, socially constructed by the environment that we live in, there is no way NOT to compare and contrast yourself with the other millions of "beautiful people" that are Facebook happy.
We construct a society that is pushing for mental illness, whether we like to admit it or not. Where commercials tell us "if you're having a hard time, talk to your doctor about Celexa, Lamotragine...or Paxil". In this instance you would think that admitting to depressions would be no big deal, but if the depression is real, and it is serious it gets turned around and a stigma is formed. If you are depressed you are useless, you won't work hard, you won't engage with those that surround you, you are UNEMPLOYABLE. We have created a capitalist society where we work ourselves to death. Where perfection is expected, and time for self- care is put on the back burner. Stress creates all sorts of illnesses, but a major one is depression.
When looking to treatment of those that cannot be diagnosed as "depressed" but are on antidepressants anyway, it seems it does not create a stigma that is so crushing that you are an outcast. As talked about in class, the example that was brought up was a young girl that was put on an SSRI, and there was a comradery within her group of friends because they were all taking one. Why is it now that puberty is supposed to be a pleasant experience? Civilization is about 6,000 years old, and just until recently, puberty was the pits for all of us.
The stigma that used to surround taking SSRI's has suddenly disappeared, or at least deflated, because from what the subliminal messages tell us, we're all a little depressed. What is it that has made society so uncomfortable with how they are feeling? I'm going to blame it on the Kardashians at this point. We live in a world that creates the perfect stage for anxiety and depression. We are sedentary, pressured, confined, and disgruntled. That is not the way of the world until the industrial revolution. Humans are meant to work, to sweat to hunt, and to take time for one's self, but it just isn't possible anymore.
What does this look like for people gaining a stigma when seeking treatment? It's ignored at this point because the pills are like candy. This is true unless you really are ill. Then seeking therapy and medication lays a thick gray blanket over the person that is suffering.
If the treatment of (what I will call fair-weather depression) runs rampant in our society then what happens to those that have a true chemical imbalance? We are continuously medicating everyone. This is true from SSRI's all the way to metformin a medication that is for individuals that are pre-diabetic, it can be used to lower the amount of sugar that is in the liver, as well as help the muscle cells within the body respond better to insulin. The reason that I bring Metformin up, is because much of the what the medication is doing could be regulated by diet. Now, not everyone is going to be able to regulate their liver sugar count on their own, but there are many that could, and they choose to take medicine rather than make a conscience choice to make a life style change, this is the same issue that arises with SSRI's. The next thing that happens is that the medication creates a side effect, let's say high blood pressure, so then another medication is given to counter act the issues of the first one. It's cyclical and endorsed by physicians and big pharma.
The individuals that do have psychosis, or drug induced psychosis, are left behind. Our government started closing mental wards in 1955 releasing those that could not care for themselves into the concrete jungle. As if giving them an impending death sentence. With the government and "we the people" worrying that these patients didn't have the autonomy to make decisions, they released 487,000 people that could not make decisions for themselves, so why should we?
Now we have incidences that create fear or stigma around mental illness that could most certainly be avoided. There is the story of 29 -year –old schizophrenic Adam Goldstein who pushed Kendra Webdale into an oncoming train in the New York subway, plunging her to her death in 1999. Then we have the example that is close to home here in Albuquerque. The story of John Hyde, a paranoid schizophrenic that had been in and out of the hospital who murdered two civilians and two policemen on a whim. Because of these sorts of happenings, people hold a serious fear when it comes to mental illness. This is on the other end of the spectrum from someone whom is having a small bout of depression, but because of the fear that is created, all aspects of psychological issues get treated with stigma and fear, if more serious than a bout of the blues.
I am not one for a great amount of self -disclosure, but I recognize this environment with all too much reality. As a kid I was wild, hung with seedy characters, behaved poorly and some can say that I paid for it dearly by ruining relationships, and spending some time in facilities that had bars and isolation units.
The doctors medicated me, and my behavior improved. Unlike most, I thrived in a militant environment, and excelled with authority, but was it the medication? I wasn't being stigmatized for taking an antidepressant and sharing my feelings that had held me down for so long. I felt safe, I felt structured, and I had a built- in sisterhood. Every aspect that I claimed that society is ruining was there for me by force. The friends, the structure, the guidance and the ability to be myself.
When I was released, I went back to my old ways quickly. I left the medication behind and reveled in alcoholism/drug addiction for twelve years. I know that I hated myself, my inability to appropriate self-control and buckle down which created depression. So, am I clinically depressed? They certainly thought so, they even went on to diagnose me as Bipolar II, because I did not have the typical "manic" episodes that reside along the diagnosis for BPD I.
Psychiatrists come from medical school, they are taught to take the same measures as an emergency room doctor; meaning that they want to label it and cure it. Not all issues merit a medicated response. Occasionally we need a holistic, well rounded response that cares for the feelings that we all have but are not allowed to express.
Now because this takes time no medical doctor/psychiatrist ever stops to say, "this perhaps is induced by alcohol, or drugs." Absolutely not. They play on the safe side and medicate you. I went along with them, because I was young and insecure in who I was. Here someone was creating an identity for me in illness, and somehow, I finally thought that I knew who I was.
I took anti-seizure medications that have awful side-effects, and are abusive to your liver, which was already an issue for me at that time. They are doctors you trust them, as you should because they are trying to help. You trust that they want to enhance your well-being, and that what they are prescribing indeed is needed for the illness that has been bestowed upon you. I took the medication for five years, until my liver hurt, but I had become a success in my career and perhaps in my personal life. I thought that I had made it, that I simply had achieved what no one thought I could with-out a crutch to lean on. For five years I identified myself as someone who had a disabling illness, my family concerned that with -out medication I couldn't survive, that I would become irrational and would go back to my old ways, but I was the one that had the most fear to deal with. I was afraid that I had lost myself, and that without the medication no one would be able to deal with me. My self-esteem was wrapped up within the ten pills that I choked down each night. I had an identity, created through some else's eyes, and I latched on.
The diagnosis for bipolar II followed me for a long time. I would admit to the diagnosis even when not needed, maybe in having other people understand me better than I could myself, or for an excuse for the decision that I would make. It runs in my family to have type A personality disorder. The actual definition is much different than what societal norms imply. We are considered to be obsessed with time, pushy, hostile, and overly driven, with our autonomic/sympathetic nervous system consistently in overdrive. Does that mean that I am bipolar? Absolutely not. It means that mindfulness and Cognitive Behavioral Therapy will be beneficial to me in correcting how uptight I am.
I look back on my life and realize that this sort of information should have been made clear to me, but no one took the time to diagnose something, as small as, a personality trait disorder, rather than dive in and diagnose me with something that is a debilitating illness and allow me to carry the stigma for years. It has been three years since I have taken the medication that was prescribed to me, and I am flourishing as an individual. There is stigma, and there is construction of illness created everywhere, every day. If we take the time as an individual, we can care for our mental health in our own way, and thus have a tiny bit of hope.
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