I recently got given the Hyperbole and a Half book. It is the best thing ever.
Hyperbole and a Half is a blog and a book written by Allie Brosch. She is hilarious, talented, sensitive, honest and most importantly completely relatable. The blog, which started several years ago, was doing incredibly well, until Allie developed depression and suddenly disappeared from the internet. She recently returned, and both book and blog share her experiences in heart-wrenching detail.
I have read Adventures in Depression and Depression Part Two countless times, and every time I cry because it feels so fucking familiar. And I know I’m not alone in feeling this way. She recreates the experience so well that it’s impossible to feel alone.
I WANT EVERYONE
I KNOW JUST EVERYONE EVER TO READ THIS BLOG AND BUY THIS BOOK.
For people with depression, it may help you describe what you feel. It may help you feel less lonely. It will hopefully make you laugh until your face hurts.
For people who haven’t suffered from depression – here’s something that can help you understand. If there’s someone in your life who does suffer – and let’s face it, the chances of that are pretty damn high – then reading this will be your gift to them. Because you might be able to get a tiny insight into what they go through.
Ok. *Pause for deep breath and slight topic change.*
In today’s NZ Herald (which I usually avoid reading because most of it makes me catatonic with rage, with segues into hopeless despair), there’s an article about the website depression.org.nz. Chris Miller has already written a really good response to it, talking about the fact that, just as there are many different kinds of depression, there are many different things which may help – but there’s no One Cure.
Let’s start at the beginning, shall we? The headline. “Depression website helps banish the blues.” The blues. The blues. Some days, I can’t get out of bed. I feel like I live in a black hole. I routinely harm myself. I deliberately don’t eat, sometimes I can’t eat. I can’t sleep without medication. Sometimes I can’t leave the house without medication.
If one more person calls my depression the fucking “blues” I swear to god I will make them blue.
And the subheading. “Many who log in to depression website end up no longer feeling miserable.” Many? Is that the mathematical, quantifiable many (which doesn’t exist) or just some random measurement you pulled out of your hat? And feeling miserable is not quite the same as clinical depression – though it might be the same as the blues.
It becomes pretty clear that the numbers throughout the article are poorly represented. Chris has already evaluated this, but they’re skewed statistics and – as a PR person – I’m 99% certain the entire article was driven by the today’s Guest Editor, John Kirwan, who of course is behind the site. If anything, this goes to show how much direct influence the editor of The Herald has on the content.
I’m not saying the site itself is a bad thing. It’s great that it has been a helpful resource for some people. It’s great that the campaign around it has gone some way to raising awareness. But the article is suggesting the website alone presented a cure for a large number of people, which is simply not true. One of the six steps that needs to be completed to be considered “successful” is seeking therapy.
Of the 1.3 million people to visit the site, less than half signed up to do the steps, and only 3% actually completed them. That’s 392 people, out of 1.3 million who visited the site. 392 people, out of 424,204 women, and 295,125 men who experience depression in New Zealand. 719,329 people all up.
392 people out of 719,329 people is 0.0545%. The website “cured” 0.0545% of people experiencing depression in New Zealand. Meanwhile, there were 541 suicides last year.
The article says that “public health officials” are calling this “one of New Zealand’s most successful public health campaigns.” It cost upward of $5 million.
Again, I’m glad the website is there. It’s better than nothing. But an article telling people it’s a cure for depression is inaccurate and harmful. In fact, an article telling people it’s very successful is inaccurate and harmful.
Now is the time for the next step in mental health education and awareness. It goes like this:
Depression can be split into two descriptors (as Chris said) – episodic, and endemic. Endemic depression does not go away. It is not caused by an event. It is caused by a lack of serotonin in your brain. In the same way a diabetic must inject extra insulin because their bodies do not make enough, many people with depression may need to take an anti-depressant that will help regulate their serotonin levels so that they can function.
We need to combat the stigma around medication and therapy, and the glorification of “self-help methods” like exercise and eating well – or completing a website to be “cured.” This is the sort of “pull yourself up by your bootstraps” resilience propaganda that seems to be all too prevalent right now.
Have you ever told a diabetic to stop taking their insulin and just go for a walk? No, you wouldn’t, because that’s life-threatening.
If I stopped taking my medication, that would be life-threatening. My depression is endemic. I will have good days and I will have bad days, and sometimes on my good days I will manage to do things to help myself, like taking a walk or eating a proper meal. I know that these things help me. Exercise has a proven support role in treating depression, for several reasons. But on bad days, these things won’t be possible. I won’t want them to be possible. I’m not surprised at all that only 3% of people managed to complete those six steps and consider themselves “cured.” I would be surprised if any of them had anything other than moderate episodic depression.
I guess in those cases, the campaign worked, because it is aimed exclusively at those people. Kirwan says in the TV advertisement “I got through it – you can too.” This enforces the assumption that all depression is a passing thing, and, if you just try hard enough, you can fix yourself.
Maybe that gives some people hope. Maybe it will work for some people. It just makes me feel like a failure.
I want to acknowledge that just because episodic depression may go away, that does not make it less severe or less painful. And maybe when it happens, it doesn’t feel like you will get through it. I don’t know, because I haven’t experienced it. But I’m not trying to invalidate anyone who has experienced episodic depression. In fact, I am totally amazed by you.
I’m going to wrap this up with a section from Hyperbole and a Half: Depression Part Two.
..that’s the most frustrating thing about depression. It isn’t always something you can fight back against with hope. It isn’t even something — it’s nothing. And you can’t combat nothing. You can’t fill it up. You can’t cover it. It’s just there, pulling the meaning out of everything. That being the case, all the hopeful, proactive solutions start to sound completely insane in contrast to the scope of the problem.
It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared.
I don’t have “the blues.” I have several disorders which can be managed through medication and therapy. My fish are dead. And I really don’t want your bees.
“392 people out of 719,329 people is 0.0545%. The website “cured” 0.0545% of people experiencing depression in New Zealand. Meanwhile, there were 541 suicides last year”.
Thank you, Sarah, for taking the time & energy to put this together. A shame the Herald or Kirwan weren’t able to be so clear. I guess for a spend of $5 mill, it’s a bitter pill..
Very well written and interesting piece! Keep writing. Lots of us enjoy reading your stuff, even if you aren’t aware of us all.
Also, keep trusting that enough of your days will be the good ones and that you can get through the bad ones.
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