There is always hope
Robin Williams’ death has triggered a lot of discussion in the media and social media this week about depression and suicide. Blogs, tweets, articles, Youtube posts, memes etc have been hard to avoid. And discussion of these and sharing in social media circles has intensified this.
Has this widespread media coverage and associated discussion been good or bad? Globally it’s hard to tell – there has been some potential positive and some potential not so positive outcomes. But instead I propose we take some time to reflect and ponder on the messages we’ve received and sent over the past week and take from that some thoughts to help us move forward.
On the positive side
This coverage and discussion has been an opportunity to bring depression out in the open and talk about it. Talk about what causes it, what the experience is like, how it is treated, how and when to seek help.
Many personal stories have been shared through cyberspace this past week. I hope sharing their stories has helped people find some healing in feeling heard. And I hope that has shed some light, so to speak, on the darkness that is depression for the rest of us.
Perhaps having a small glimpse can help us understand a little of the pain, loneliness, darkness and despair of depression – and why it can seem so very hard rise out of that space. Perhaps this helps us find a deeper level of empathy and compassion when someone says they are struggling.
Perhaps reading these stories we are now more ready to put our arms around somebody and just be there without judgement. If this has happened – I think that is a good thing.
I hope this conversation has helped bring depression (and other mental illnesses) out from under the cover of secrecy and stigma and contributed somewhat to reducing the shame and fear of seeking help.
I hope this has been helpful to those people struggling in silence – that they have found some courage to seek help – to talk to a friend, to see a doctor. I hope these stories have shown people that recovery is possible and that there is always hope. Because, regardless of what you may think of Robin Williams, if this discussion helps just one more person find some hope and find the courage to seek help – then I think that is a good thing.
Not quite so positive
This discussion has brought more exposure to the ongoing controversy about psychotropic medications such as antidepressants. Words can get heated and use of emotive language can create fear. This is not helpful and can be confusing to some people who may have been prescribed an antidepressant. They may wonder if they should stop taking it and confusion such as this can cause people unneccesary distress.
Unfortunately in the average article or Facebook discussion there is no space to address this. But some key points to keep in mind when thinking about treatment of depression are:
- The controversy is real and issues are complicated.
- The controversy is based on concerns about over-prescribing due to lack of studies of benefits vs risk, particularly in the long term. This is complicated by a body of evidence that shows antidepressants are effective in depression, although it is noted that most studies are funded by pharmaceutical companies and mostly assess treatment in the short term.
- Many people have found antidepressants enormously beneficial, others have had distressing side effects.
- The variation in response, it should be noted, is no different to any other medication.
- Therapies such as cognitive-behavioural therapy (CBT) are effective – but they are expensive and often hard to access. However there are many free online sources of CBT and many people find these useful.
- Many people benefit from a combination of therapy and medication, but it’s not always easy to know in advance who will respond which medication in which dose or which therapy (and therapist) is most suitable. This makes it hard for doctors to always get it right the first time.
- Some people will recover from an episode of depression without treatment using approaches such as exercise, meditation or prayer.
- Treatment of depression is 3 dimensional involving body, mind and soul. As well as therapy and/or medication treatment also includes things such as diet, exercise, sleep, meditation, mindfulness, strengthening support networks and friendships, getting back to work. Some people find praying and strengthening their spiritual lives very beneficial too. But there is no prescribed mix that suits everybody.
- More research needs to be done on defining what the illness is and who will respond best to different treatments.
- People have different preferences and values about using medication or therapy – and the uncertainties allow for this. But it’s always important to understand the risks and benefits of all treatment options, including no treatment, before making decisions.
So given all this it’s clear understanding and respect needs to be provided to people who have found a different path to recovery. Not everyone is the same. There are not always clear answers. So in some respects bringing this confusion out also has some benefits – because on a broader level it triggers the desire for further research. And that too is a good thing.
Turning to the positive side
Where its harder and trickier to find something positive is the discussion of suicide. Talking about suicide is always tricky – it’s important not to glorify or glamorise it in any way – lest vulnerable people act on it (God forbid). Yet it’s also important not to sideline or minimise the pain the person may have been in, and we must be mindful of the effect of our words on the bereaved.
None of us can ever know what lead a person to make such a tragic choice – their internal world will forever be a mystery. So whatever judgements or opinions we have – here I fear we must be silent. Silent because we just don’t know, and it serves no positive purpose to speculate or pronounce.
In humility we acknowledge the tragedy. And then with hope we must turn to the positive.
We must turn our attention to the living. And to the living we say – there is always hope. No matter how bad things seem, there is hope and there is help. So let our words and our actions be a wellspring of hope to all those lives that touch ours.
And this is a mantra for all of us, whether we have depression or not. So whatever challenges and difficult times we face, we need to remember there is always hope.
And if we hang onto hope we’ll be able to face the future with courage, no matter what.
Where to get help
Lifeline 13 11 14 http://www.lifeline.org.au
Suicide Call Back Service 1300 659 467 http://www.suicidecallbackservice.org.au
Kids Helpline 1800 55 1800 http://www.kidshelp.com.au
MensLine Australia 1300 78 99 78 http://www.mensline.org.au