Friday, November 06, 2009

Pain is Pain is Pain

I'd intended to write about something else altogether today, but a couple of things happened that decided a change of topic. I've been on a bit of a Stephen Fry kick - watched Stephen Fry in America earlier this year and absolutely loved it, watched the last episode of Last Chance to See this past weekend and immediately wanted to start again from the beginning the minute I'd finished the series and then moved onto Stephen Fry: The Secret Life of a Manic Depressive (that links to part one on YouTube - you can watch the entire thing there and I highly recommend you do). And yesterday, I watched a momversation entitled Overcoming Depression and really, how much more obvious does it get?

I know a number of people who are depressed. Not just sad or out of sorts because they're having a bad day, but chronically depressed, brain chemistry out of whack kind of depressed. Some of them are on medication and much better than they were, some are on medication and a little bit better than they were and some haven't gotten to the point where they're ready for that yet. And part of the reason that they're not - and part of the reason that some of the people who are taking meds wish they could get off them - is the stigma that comes with it.


Just as a number of physical conditions that are invisible, depression can't be seen. And just as I tend to rant about the suspicions surrounding the experience of pain that can't be seen or can't be tested for, so am I about to do a rant about the stereotypes surrounding mental illness. The stiff upper lip doesn't just apply to being in physical pain, but also to emotional pain - pull up your socks, get a grip, try harder. But no matter how you try, it's not possible to get better with a change of attitude. Watching that five-minute momversation is an incredible education into what depression does to a life. It shows you that even if your life is wonderful on paper, there can be a disconnect making it impossible to escape the sense of "crushing despair".
Mindy described deep depression as "intolerable pain... so unbearable and so excruciating that the only way you can think of to make it stop is to stop living."

Stephen Fry's documentary about manic depression is longer (two hours), but does the same thing. Shows you more effectively than anything else what living with bipolar disorder is like - if I were teaching psychiatry or abnormal psychology, I would make it mandatory to watch this movie. I've read about bipolar disorder, I've known people with bipolar disorder and believed I sort of knew, but I had no idea. I only knew the clinical picture, I had no idea what it was like living with it and even if you just want to learn about depression, you should watch it, too. Yes, there are segments about mania, as well, but in its exploration of the total picture of the disease, the parts about the pain of depression are so eloquent that I feel as if I finally know - as much as I can know, without experiencing chronic depression myself.


And chronic is a really good term, can bridge the gap between the invisible and visible, can draw similarities between depression and say, RA or diabetes. No one expects someone with diabetes to manage their disease without insulin. No one expects me to manage my RA without medications like Humira. Then why is there so much judgment of those who are depressed that so many people end up being miserable all their lives or killing themselves because to ask for help, to take medication is so shameful? I think we should flip it. I think we should start saying in that judge someone because they have a disease, whether physical or mental, is shameful. And maybe if we started using the language of the physical disease and started talking a lot about it, understanding would come, as well. A friend of mine and I talk of flares, of my RA and their depression and it has helped a great deal to normalize our mutual experiences within our relationship. Given us a code to describe to each other how we feel, but also given us a keyword we can use when we notice the other is having a bad time and in this way, we help to remind each other to increase our medication when we flare without judgment. It's normal, it's "just a flare", but it is just between us, because there are risks for my friend should they decide to be honest about the disease. Risks that are I do not face.


Again, the social pressure to silence your experience of pain is not doing anyone any favors. It makes people with RA not ask the doctor for painkillers and it makes people who experience the pain of depression not ask their doctor for medication to manage their pain.


And it makes me wonder all over again why our culture will not allow people to be in pain….

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