Musings of a phenomenologist

Science, psychiatry and random musings

Depression, fad or fact?

Posted by soveda on May 18, 2010

I don’t usually read the Daily Mail’s website but my attention was brought to this article by Janet Street Porter:

Depression-Its-just-new-trendy-illness

Which starts:

There’s a big black cloud hanging over parts of the UK, and it’s not going away. Not volcanic ash – but depression. This relatively new ailment appeared on my radar a couple of years ago, when I discovered that more and more women were claiming they suffered from ‘stress’

Ah yes, depression is terribly new – I believe it was first described in… Mesapotamian texts? or the Old Testament? or possibly Ancient Greece. Practically unknown until recent days as you can see.

Why did I get so annoyed with this article?

Is it because, despite the efforts of psychiatrists to reduce stigma (e.g.: Changing Minds) this sort of article appears to promote that stigma? Probably, at least in part anyway.

To put my cards on the table right at the start – I have experience of depression from both sides of the divide, both in treating others with depression and in being treated for depression myself.

I think it’s a good thing that more people are coming out and saying “I have had depression”, and yes it is going to be the “celebrity class” who do so. Why? Well, because they have publicists, access to the media and are seen as “role models” for better or worse. Now I got especially irate about some of the assertions in the article, lets start with this:

I am not denying that clinical depression is a real mental illness, or that it can be debilitating for sufferers. But let’s take a moment to consider whether depression is common among the poor or the working class?

If you’re a black South African woman growing up in a township, or a mum in a slum favela in Rio, or a supermarket shelf-stacker in Croydon, or one of the band of low-paid female workers who go to work at 3am to clean the offices of the wealthiest and most powerful people in Britain in the City of London, you probably aren’t afflicted by depression. What you’re more likely to be suffering from is poverty, exhaustion and a deficient diet. You will have bills you can’t pay and a struggle to feed and clothe your kids.

Let’s answer that question shall we, is depression common among the poor or working class?

Hell yes, being poor/”working class” is one of the risk factors for depression and has been recognised as such for many years, References:

Inter-generational longitudinal study of social class and depression: a test of social causation and social selection models

Which concludes:

The investigation found no evidence for social selection processes in the relationship of SES to MDD, but robust support for social causation models. These results are consistent with other studies but make a distinct contribution. This contribution stems from our ability to control the familial effect of parental depression in the longitudinal assessment of the relation of parental SES to offspring depression and offspring SES. For over a century, psychiatric epidemiologists have wrestled with the question of whether social adversity is causally related to mental disorders independently or rather is confounded with genetic effects. The present findings indicate that, first, the SES-depression association does not disappear after family history of depression is taken into account, and second, it is social causation rather than social selection that mainly accounts for the SES-depression association. Our findings suggest that in the USA, parental education (and, to a lesser extent, occupation) has important implications for the mental health of offspring, especially among non-MDD parents and parents of males. It will be important for future research to replicate these findings with representative samples from the general population and with provisions for investigating the specific processes and mechanisms involved.

Depression and anxiety in relation to social status

But I will let the following quote speak for itself:

Now, men are jumping on the depression bandwagon – bestselling author Tim Lott wrote a misery memoir The Scent Of Dried Roses. He says that GPs are not trained to spot depression in men, and one of the reasons more men don’t own up to it is because they are routinely expected to be strong, and there’s a massive stigma attached to admitting you can’t cope.

According to Tim, if – as research now indicates – 45 per cent of women earn the same or more than their husbands, then the male ego is under attack, and it’s no wonder that more and more chaps are experiencing feelings of worthlessness and insecurity.

At this point, I’m afraid to say, I laugh out loud. The idea of feeling sorry for a bloke with low self-esteem is, frankly, risible. Let’s just call it karmic revenge for all those years men have been in charge of everything.

Actually no I won’t, Janet dear, you are attacking a lovely easy target – I haven’t seen research into whether there is more depression in men than before but that does not alter the fact that unto 4% of men (as compared to 8% of women) suffer from depression each year, with the prevalence of depressive symptoms being higher.

I know that this article was written in order to get people’s hackles up, I know that I should expect nothing better of the Daily Mail and Janet Street Porter but I can’t help it.

If you know anyone who has depression or if you are concerned about depression have a look at these sites instead:

Changing Minds page on depression

Royal College of Psychiatrists page on depression

MIND

Thank you for putting up with my rant.

Oh and keep an eye on the 21st Floor where I expect there will be a more dispassionate dissection of this charming article.

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3 Responses to “Depression, fad or fact?”

  1. brainduck said

    Thanks, that really annoyed me – not least because mental illness *is* a significant public health issue in the developing world, and I’ve been rambling on at anyone who’ll listen / helping run a charity about it for a few years now.
    Street-Porter’s ‘black South African woman growing up in a township, or a mum in a slum favela in Rio’ is quite likely to be having to deal with mental illness – the cumulative individual and social impacts mean that mental illness can exacerbate and compound poverty-related problems. Grrrr.

    More of my rants on the subject:
    http://brainduck.wordpress.com/2008/04/03/mental-health-poverty-in-the-developing-world/
    http://friendsofantarauk.org/

  2. Graeme said

    They should check their history. Daily Mail favourite Churchill (the PM, not the dog) famously suffered from depression. Obviously he was just putting it on to impress Roosevelt and Stalin.

  3. badsciencemonk said

    Nice post mate. The links on the history of depression were also really useful

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