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Posted by Philip on 9 May 2016, 4:38 pm in , , , , ,

Depression and anxiety — illness not weakness. Or something else?

Last Thursday I attended the Health Promotion Agency's video preview session for its refresh of The National Depression Initiative​ (depression.org.nz). The National Depression Initiative (NDI) "aims to reduce the impact of depression and anxiety on the lives of New Zealanders by aiding early recognition, appropriate treatment, and recovery."

I was there as one of 15 New Zealanders who have shared their stories of living with depression and anxiety. For me, it was living with aggressive and abusive neighbours over two years (2011 and 2012) that created acute anxiety ​​and prompted me to offer to share my story. But, in the course of doing so, I've come to realise that I've experienced both depression and anxiety many times over my lifetime.

Watching the other videos, I was struck by the diversity of people and situations. The commonalities in our experiences, though, was even more remarkable.

Sir John Kirwan, who has been the face of the NDI and the website for many years, was present and spoke a lot about his own experiences​. A catch-phrase he repeated many times was, "It's an illness, not a weakness."

I agree depression and anxiety aren't weaknesses, but are they illnesses? I'm not convinced they always are. Calling them illnesses pathologises people and creates an expectation of cure. And, if you don't respond to "the cure", you are doomed to a lifetime of stigma and "sickness".

As I've written before, I think often the causes of depression and anxiety (and I mean​ ​​often, not always) are social. They are responses to events, relationships, social expectations and structures, circumstances and situations that are depression- and/or anxiety-causing.

In the same way that homosexuality has traversed the social spectrum of crime to illness to lifestyle; and impairment has made the journey from an abnormality to be hidden, masked or lessened, to an awareness the attitudes and environments need to change; so too, I ​believe, depression and anxiety (and even other mental "illnesses") need a "social model."

The circumstances that caused my acute anxiety had nothing to do with me. They were created by bad decisions and exacerbated by systems and processes​ that were inadequate in that they were not only unable to create agile change, but they allowed a second bad decision to be made. Even now, I ​have no guarantee that further bad decisions won't be made in the future — and that leaves me with an ongoing level of mild anxiety.

When I think back to other times in my life I've ​​felt depressed or anxious, it's been social factors — feeling I ​didn't fit in, not having adequate support and being socially isolated or uncomfortable — that have created these so-called "illnesses."

As I said at the NDI video preview event, we live in a depression- and anxiety-causing world. Not only are individuals in personally inadequate circumstances, there are wider issues, the awareness of which are deeply troubling: climate change; the instability of the global economy; ​the insanity of politics (I'll call it ​the "Trump-factor"), the increase in domestic and social violence; the unaffordability of housing and rising prevalence of homelessness; rising unemployment and cost of living; the continuing pressurisation and standardisation of education; and more. Not to mention the ongoing inequalities and inequities of social marginalisation despite decades of civil rights movements.

We need to change the conversation about depression, anxiety and other so-called "mental illnesses," because they are becoming more and more prevalent. Hardly a day goes by when I don't talk to someone who is struggling emotionally with the state of their​​ life or of the world.

These are not "mental illnesses" — they are valid "emotional responses" to a culture in decline. The only thing that is ill is society, not people. People don't need curing, the world does.

What that cure is, I'm not entirely sure.​ I don't think anyone is, although it seems people are constantly wasting time and resources on trying to cure a tiny symptom of the problem, rather than seeing the entirety of the disease, from which we are all suffering.

Maybe the only way a cure will come about is by talking about the causes, not the symptoms, of the mess we're in. Maybe the cure is to stop labelling awareness as illness. And maybe the cure is looking at what's wrong with everything, not what's wrong with ​someone.

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