We Need to Have Empathy for Those With Depression. It is an Illness

Posted on Jan 30, 2013 | 108 comments


Somebody commented that in 2013 I have done a lot more personal posts than usual.

Depression - Van GoghI didn’t set out that way. It just happened. Lots of tragedies in the past couple of months.

Aaron Schwartz. Sandy Hook. Now Jody Sherman.

And my friend Brad Feld & his wife had written a book on the importance of personal relationships which made me want to weigh in on that. And my wife weighed in, too.

I guess it’s been a heavy year. I’ll be back to business topics by the next post. But I hope you’ll indulge me one last personal post.

It’s now in the press that Jody committed suicide. I knew that but didn’t want to speak the unspeakable. How to say it? Mutter those words.

But it was reported compassionately by Christina Allen in this moving piece on Pando Daily.

And it got me thinking a bit.

I started out this year writing about how much I hate December. That’s the mood I was in. I absolutely love January. I always have. So I wanted to start the year off talking about putting December behind me.

As an aside, I was blown away by just how many people told me they felt the exact same way about December but never wanted to say it publicly. Who knew?

In that post I started off on a tangent.  Actually, it’s a bit eerie for me.

“You’d imagine your favorite founder, VC, blogger, political figure, billionaire, whatever has a stress free life pontificating about how to build the next really cool, society-altering product or changing a city, state or country. But of course life isn’t like this. We all face demons and stress.

Never was that more clear than in this short, but tear-inducing post from 2007 by Aaron Swartz, who you probably know took his life last week at the full-life-in-front-of-him-but-didn’t-feel-that-way age of 26. As a society it’s clear that we need to de-stigmatize depression, treat it and be aware of our colleagues & family who may be experiencing it.”

We need to de-stigmatize depression, treat it and be aware of our colleagues & family who may be experiencing it.

I wrote that on January 13th. I don’t know the details surrounding Jody’s death except that it was officially ruled as a suicide. I have some experience with people I have known in my life committing suicide and with others who have tried and failed. I can’t imagine suicide coming without some deep sense of depression and/or despondency. But I’m certainly no expert.

Suicide is the 10th leading cause of death globally. That seems too high.

Deep depression bordering on despondency. So bad that no alternative seems possible. I can’t process that. It doesn’t register in my brain. Probably doesn’t with almost all of you, as well.

But the thing is – it doesn’t process precisely because I believe that people with clinical depression that becomes too severe to handle have brains that are chemically wired differently than “healthy” brain chemistries. That it is an illness and one that needs to be treated both emotionally and chemically.

At a minimum we need to recognize the signs. As a society. Nobody that I’ve spoke with who had seen Jody recently has even an inkling of a idea. So I’m not even talking about that. But surely you know people in your circles that struggle with depression. What can we do about that?

What I hadn’t told anybody was that I had actually written a much more detailed post on January 13th. I was so moved by Aaron Swartz’s suicide that I couldn’t stop reading about it. Wondering why somebody with so much intelligence, with so much potential and with so many friends couldn’t see beyond his short-term fog.

I took the longer piece out because it seemed too focused on depression inspired by reading about Aaron Swartz and not enough on the positives of January that I was feeling.

I cut-and-paste the text and saved it to my Trello board where I store blog ideas. I thought I might some day dust it off and try to deal with it in a blog post.

And now it has struck so close to home that I haven’t well slept in 2 days. And it’s too soon to be dusting it off.

So here is what I wrote just 2 weeks ago thinking about Aaron. Not that it would have made even 1% of a difference. But in light of what happened I felt the need to push this post – unedited as I had written it – and move on.

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“I am lucky that my brain isn’t chemically wired for depression but I’m all too aware that it is a disease and clinical condition that needs to be de-stigmatized. I have had friendships with too many people in my lifetime who had depression not to know this.

And if you are one of the lucky ones like me not prone to depression you need to have more compassion for people whose minds are wired differently. I remember living in the stiff-upper-lip environs of London where the common refrain to depressions was, “pull your socks up, mate! Life isn’t that bad. You have nothing to be depressed about!”

I used to think that about people who were depressed. I no longer do. I came to realize through reading about it that it’s a condition. It’s a wiring the brain. It’s not something that one can just “shake off.”

So I have come to explain it thus:

Imagine a spectrum of mental health

Now imagine the right hand side of the line as a perfect, normal, happy, cogent and functional brain.

Imagine the left side as schizophrenia. I know you’d all acknowledge that as a mental condition worthy of treatment and accept that this person is chemically wired differently than a healthy human brain. And this person is worthy of treatment, help, empathy and compassion.

Move over the spectrum to Alzheimer’s – a condition in which the brain loses its ability to remember people or circumstanced. It often comes later in life and certainly society understands that as disease worthy of treatment and compassion.

And slightly along the spectrum you run into bi-polar disorder. If you’ve ever experienced somebody with true bi-polar disorder you understand that some chemical condition takes over the brain and an other-wordly human being emerges for a painful period of time. I have been very close to 2 people with this condition and it is shocking to digest when you first experience an episode of mania. I can only say if you haven’t seen bi-polar disorder up close the nearest I can explain is the film Blue Sky, in which Jessica Lange won the Oscar for best actress in her portrayal of a military wife (husband Tommy Lee Jones) with bi-polar disorder. It was so accurate that it sent shivers down my spine watching it.

So we’ve acknowledged that mental conditions exist in which we can’t simply say, “come on, mate, pull up your socks and remember who your daughter is – you raised her! Stop being so difficult!” That would be mindless.

I believe depression is simply along the mental continuum. I have a close friend who takes medicine for depression. He spent his childhood depressed. He didn’t realize how much his life had changed on medication until he once spent a long weekend and forgot his medicine. He told me his entire drive home from his weekend was filled with thoughts of suicide.

Well. I didn’t start out this post thinking I would talk about depression but I was so moved this weekend by reading blog posts, eulogies, watching videos of Aaron Swartz and then the gut-wrenching post from 2007 where he acknowledges his demons that I thought it warranted a side-bar. And as somebody sent out on Twitter, the need for those of us who don’t suffer from this terrible disease to know the warning signs and engage others with whom we are concerned. And to never downplay or stigmatize those feeling depressed. It is a disease with treatments.”

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I know it’s a strange topic to talk about. But maybe that’s just it. Maybe we as the tech community need to be more open about it. And watch out for our friends.

Now back to my regularly scheduled programming. Thank you for indulging me.

  • Brenda

    Thank You Mark. William T. McKinney, MD. and I built The Northwestern University Medical School Asher Center for the Study and Treatment of Depressive Disorders together, from the endowment up. Dr. McKinney spent his career working toward destigmatization of mental illnesses–frequently comparing mental illness to diabetes–something that needs to be regulated both medically and environmentally. I am saddened that we as a society tend to shame those with mental illness –frequently causing those afflicted to retreat further–by suggesting that they can and should simply “pull themselves up by their bootstraps”. Depression a medical problem, and it needs to be treated as one. Good on you for speaking out on this very important topic. Too many brilliant, “awesome” deep feelers are lost to this illness. Let’s keep this discussion-and the people behind it–alive.

  • Stefan

    Thank you for publishing this blogpost and provide a means for people to share and discuss this important and neglected subject. Seeing this discussion gets me a little bit optimistic that we can get a more open and accepting environment so that it is possible to talk about this kind of diseases.

    Yes, people actually seem to care, not just about their loved ones but also about total strangers. This is consistent with my experience, when I have taken the currage to talk about it with some well choosen people they actually care. This is a very good thing and something that everyone in this kind of battle should take to their hearts.

    Regarding me, yes I have the help and support I need. This horrible disease have cost me way too many years of my life but enough is enough… Thank you for caring! :)

    Totally relevant xkcd: http://www.xkcd.com/1163/

  • http://twitter.com/parkercloud Rick Parker

    Most people can’t imagine or understand, severe depression is vicious brutally painful. It is self attacking self

  • Zak

    Mark, I’ve read your blog for a long time, and I love that you approached this topic. I’ve been surrounded with depression in family and relationships–Valerie’s story resonates because my mother did in fact retire out to the wilderness to dissociate from society–but I’ve known just as many deniers.

    Because of this I learned early on that just as the workings of the brain are so beautiful and so much more complex than the workings of the mechanical structures of the body, so too are the diseases and disorders of the brain that much more complex. It is far easier to understand a failure of a bone or ligament than it is a disorder of the brain. The brain remains the last frontier of medicine, and I think we’re far from real medical solutions. In the meantime, these tragedies if nothing else can hopefully increase awareness and understanding among the rest of us, so that we can remain together.

  • Pat

    I suffer from depression too. Unfortunately, I can’t take meds because if I do then I can’t get health insurance. One of the questions on the health insurance form is “Have you taken anti-depressants in the last 3 years?”

    So if I take them – I can’t get health insurance. If I don’t take them then I am depressed

  • http://bothsider.com/ Mark Gavagan

    Lisa,

    You make many insightful comments – thank you.

    However, I think there’s an important distinction between feeling terribly sad and depressed by difficult events, as you describe in the second half of paragraph 2, and clinical depression.

  • https://plus.google.com/u/0/b/114718778524214371963/114718778524214371963/posts kidmercury

    i used to be a deeply depressed person with frequent thoughts of suicide. not so much anymore, now i can snap myself out of such thinking pretty quickly. because of my experiences i think depression is overhyped and poorly understood.

    eat right, get some exercise, surround yourself with quality BFFs, and live in an economy that isn’t broken. that last one is key. japan has the highest suicide rates in the world. also the highest debt/GDP ratio in the world. i promise you this is not a coincidence.

  • http://www.facebook.com/bryan.neuberg Bryan Neuberg

    Mark,

    The entrepreneurial community doesn’t know about “soft bipolar.” It’s a critical piece to understanding why so many entrepreneurs are super successful… some of who are privately suffering.

    I just wrote a piece for PandoDaily abt this topic with one of the nation’s leading doctor’s on the link between moods, mood swings, and entrepreneurship.

    I would love for you to read it, and if possible, ReTweet it. The community needs exposure to this unknown and vital perspective…

    “Why Many Entrepreneurs Are Privately Suffering, and
    What to Do About It” by @NeubergBryan: bit.ly/1351vzT via @PandoDaily

    http://pandodaily.com/2013/02/20/why-many-entrepreneurs-are-privately-suffering-and-what-to-do-about-it/