We’re always most at ease when our lives follow a clear and meaningful narrative, when we see our future shaped into something romantically tangible as our fates entwined into fortune and favour. When there is valuable and vision to assigning evocative significance to the inexplicable future. Until one day it doesn’t, and the hopeful optimism once held so dearly become lost to unease sanctions and imaginative dissonance. Indeed, it is something that is less often seen as an illness but more so as the failure of one’s will. Merely a self-indulging desire to dwell on the negative, malingering co-dependency of the soul. Simply put, a bad attitude that can be overridden with sufficient simple self-assurance and rationale.
However, reality is often not as simple as logic dictates, and what was described is simply known today as depression. Depression is clinically defined as a severe and deliberating fixation on negative emotions towards oneself that leads to impacts on one’s ability to think, feel and act (Weary & Edwards, 1994). Rightfully, countless psychologist has often described symptoms of depression to include but not limited to feeling of sadness, holding strong nihilistic views, lacking desire in engaging in hobbies, self-imposed social isolation and difficulty in getting out of bed (Costello, 1993). In regards to the final point, it is seemingly trivial to consider that something as benign as feeling lazy to get out of bed could constitute to being an indicator of something severe and pronounced, yet it is one of the most reliable hallmarks of a clinically depressed person (Lane, 2006). Like the primary drive why people engage in vices of life (e.g alcoholism, drug abuse), the reason is the same for depressed people to be unwilling to get out of bed; it is the desire to feel sheltered and not be bothered about other aspects of life (Kanter et al., 2008). Like a caterpillar to a cocoon, the act of “getting out and about” seems so intensely heavy and foreboding that it is just so much to deal with that they rather not deal with it at all despite knowing full well that all that ever achieves is by delaying an inevitable pitfall.
Personally, I think that depression is more than merely being a mental illness or “a lack of will”. To those who were unfortunate enough to be afflicted by it, even momentarily, it is often described as feeling devoid of life’s sensation, a looming lull ever present on an unending horizon. So intense that even the rational power of the mind cannot escape its constant gloom and instead shapes and twists one’s view into something darker and terrible as lightless night (Miller & Seligman, 1973). To me it is more accurate to view depression as being an ailment of one’s soul, for depression does not require any specific preconditions to one’s psychical, financial, social and economical well-being. It strikes when one least expects and often times, to the unexpected ones who “ought to not be stricken by it”. In medieval times when scholars and holy men struggle to define this unseeing, unfeeling, unknowing phenomenon that has mystified reasoning for centuries, one description stood out to me above all others, with poem written by a 16th century Spanish priest called John of the Cross. In it, he aptly describes depression through a poem titled “Dark Night of the Soul” (Durà-Vilà, 2017). While the original context and meaning likely denotes a more religious connotation to Catholic beliefs, I believe that it is important to understand that the “dark night” referred in these writings give a symbolic identity to the feelings and negative thoughts one goes through while in a depressive state. It is therefore important that as therapists, counsellors, psychologists or even merely being a humble friend in need that we appreciate and realize this “dark night” of the soul as it afflicts and transforms those it lay its cold embrace on while being able to assess the severity of demoralisation and despair these troubled souls may go through, as the implications for troubled behaviours such as substance abuse and suicidality grows the longer and stronger it afflicts.
Another example that hints to a global understanding of depression being something more than a simple disease of the mind or lack of will is the Japanese word for depression, being “utsubyou” (commonly used today in clinical diagnosis in Japan) or in ancient times “yuutsu”. Both words when translated into English, loosely translates to “blocked spirit/sickness” (Schulz, 2004; Kitanaka, 2012), which indicates that there’s similar conclusions developed independently throughout the ages and in differentiating cultures to come to view depression as being the illness of the soul. In fact, in Japan it has been proven as an effective yet comprehensible concept to educate the public about what is depression and the importance of actively seeking remedies for it when in the mid-20th century, pharmaceutical companies and doctors alike used the phrase “kokoro no kaze”, which literally translate to “cold of the soul” in reference to something minor (common cold) that still needed to be treated because it could potentially kill you (Schulz, 2004). This simple phrase, with a little marketing edge, forever changed how Japanese people view depression, helped advance its societal acceptance of the condition and highlighted the importance of treating it (Watters, 2010). Preventing and treating cold in Japan is commonplace given its weather, how brilliant is it then for doctors, psychologists and businessmen there to come up with a phrase so simple yet so relatable to its people? Today, the phrase “kokoro no kaze” is so ingrained in Japan’s society that simply speaking it automatically resonates with any person who grew up in Japan.
In Malaysia, we need something similar to this to better educate and treat those of us who are stricken with this ailment of the soul. Perhaps the psychologists, psychiatrists, doctors and educators of our nation should consider rephrasing its lessons on depression, as there’s nothing more frustrating for the depressed as to have someone blithely tell them that things aren’t as bad as they seem. So infuriating as listening to advice from people eager to see you “snap out” of your despair, as if depression could be cleared up with the proper hobby, with a better diet, by getting out more or with a simple pill.
Underlying the advice in many cases kindles embers of antagonistic annoyance; “why can’t these people get their lives together like the rest of us?”. The reply is just as frustrating to outsiders as the question is to the depressed: because they simply can’t. The logic of everyday life does not apply, which is exactly why it is a concept difficult to grasp. The depressed are often not able rid themselves of their despair any more than a person can “snap out” of a heart disease. And only when we as a society recognize depression as a disease that afflicts, not as a moral or social failure, can we begin to talk about a solution.
Adrian Chan
Reference
Costello, C. G. (1993). Symptoms of depression. John Wiley & Sons.
Durà-Vilà, G. (2017). Sadness, depression, and the dark night of the soul: Transcending the medicalisation of sadness. Jessica Kingsley Publishers.
Lane, C. (2006). How shyness became illness: A brief history of social phobia. Common Knowledge, 12(3), 388- 409.
Miller, W. R., & Seligman, M. E. (1973). Depression and the perception of reinforcement. Journal of Abnormal Psychology, 82(1), 62.
Kanter, J. W., Busch, A. M., Weeks, C. E., & Landes, S. J. (2008). The nature of clinical depression: Symptoms, syndromes, and behavior analysis. The Behavior Analyst, 31(1), 1-21.
Kitanaka, J. (2012). Depression in Japan: Psychiatric cures for a society in distress. New Jersey: Princeton University Press.
Schulz, K. (2004). Culture and the definition of mental illness: Did antidepressants depress Japan? Pp. 74-80 in J. The Sociology of Mental Illness: A Comprehensive Reader, edited by McLeod and E. Wright. New York: Oxford Press.
Watters, E. (2010). Crazy like us: The globalization of the American psyche. New York: Free Press.
Weary, G., & Edwards, J. A. (1994). Anxiety, Depression, and the. Handbook of Social Cognition: Applications, 1, 289.