Asking for help can be difficult. To accept the help given, even more so. When you accept that you are not well and that you need help you also have to confront the stigma around mental illness which ads a whole other dimension to your struggle.
“I’m going to try to get well without antidepressants”
Would that thought even occur to you had you been diagnosed with pneumonia or diabetes?
“I’m going to try to live without my insulin”
Most people would tell you you’re stupid if you say that.
“I’m going to get well without antidepressants”
– Good for you! Brave choice!
What, you kidding me? That is profoundly stupid, you’re sick. …but a lot of people unfortunately don’t agree with me there.
So why do we relate so differently to being diagnosed with depression as opposed to say diabetes? Do we somehow believe that we bring depression on ourselves but diabetes we get through no fault of our own?
Actually diabetes and depression are not that different when you look at it from a medical perspective. The symptoms are of course vastly different. Both depression and diabetes are adverse results to normal circumstances.
Most often depression is a result of psychosocial strain such as stress, loneliness, bereavement, somatic disease etc. Unfortunate but unavoidable circumstances of life. To coap with such circumstances serotonin is released in our brain. Serotonin keeps us emotionally balanced. It’s also involved in sleep regulation and appetite which is why these behaviors are usually affected by depression.
Diabetes is a result of our own immune system attacking and destroying the cells in our pancreas responsible for producing insulin resulting in low or no production at all. We need insulin to break down the sugars in our food. Without it our blood sugar gets too high which leads to a number of negative symptoms on our body.
Hence both depression and diabetes have a physiological cause beyond our conscious control.
Both depression and diabetes have a hereditary factor but we still don’t know exactly why some develop diabetes and some don’t. This is true for depression as well, not everyone going through a hard time in life gets depressed. But just as with depression, well actually everything in life, we are not all the same. We are not all the Simone Biles (e.g. super fantastically awesome) of Serotonin Production. Some run out of it quicker than others. When we deal with difficult circumstances we use more serotonin and when we run low it’s even more difficult for our body to produce it. Which is one of the many reasons why depression is extremely difficult to cure without medicine.
The standard treatment for both depression and diabetes today is to eat right and exercise and to supplement insulin/serotonin as needed. Serotonin is not administered directly as with insulin. The most commonly prescribed medicine and the one with the best results is SSRI medicine, selective serotonin reuptaking inhibitors. What it does is to block the receptors that reabsorb released serotonin from doing just that. This results in serotonin being present in the synaptic cleft longer which means it gets an elongated effect, mitigating the deficiency. Serotonin being present for longer also stimulates the production of new serotonin.
Diabetes can be summed up as an insulin deficiency. Depression can equally be described as a deficiency, a serotonin deficiency. Hence there is no medical or physiological reason for us to feel different about the two. Still one is shameful and viewed as a failure. The stigma surrounding depression and mental illness keeps a lot of people from seeking help early. Suicide is a very real symptom of depression. The longer you wait to seek help the worse it gets and the risk of suicide increases. In Sweden today the number of young people killing themselves are increasing. I don’t know what the statistics look like around the world but I would be surprised if it’s not true in other places as well. This trend needs to change and one way to do that is to start talking about mental illness. We need to erase the stigmaand open up the discussion.