The Moody Blues

by Maria on November 5, 2003

Why is it that people with ‘real’ illnesses like heart disease, cancer or ‘flu can receive unqualified sympathy and support, while those suffering from an equally organic illness like depression are so often told to ‘just snap out of it’?

I’ve just started reading Andrew Solomon’s extraordinary book ‘The Noonday Demon; an Atlas of Depression’, which has the most striking opening sentence and paragraph I think I’ve ever read. Last night, I read Solomon’s horrifying account of a visit to an emergency room after he’d dislocated his shoulder. He was terrified that the pain and trauma of a relatively uncomplicated injury would lead to a breakdown, and explained his history of severe, psychotic depression. He first asked calmly, then begged, for adequate pain relief and a psychiatric consultation. The response from the emergency doctors was ignorant and curt – ‘pull yourself together’ – and a severe depressive episode did indeed ensue.

This morning, the Guardian publishes an affecting story about a football player called Nic Colley who was too ashamed to admit to depression, and told team-mates he had cancer instead. When the lie was found out, the Tamworth FC, who had fully supported Colley when he was a cancer patient, turfed him out. To some, Colley’s actions seem unpardonable, especially as he allowed fund-raising efforts on his behalf. But it’s easy to see why he thought a sportsman with a mental illness would be, in his own words, ‘slaughtered’. Frank Bruno, former heaveyweight champion of the world, was admitted to a mental hospital in September, to the memorable Sun headline ‘Bonkers Bruno locked up’.

So why do we find it so damn hard to offer heartfelt sympathy and support to people with mental illness? Because we think that these diseases are in some way not ‘real’, and that the people who suffer from them have somehow invited them in or allowed them to stay. It seems to me that the people who vehemently exhort those with depression or a range of illnesses that are equally stigmatised* to ‘snap out of it’ are speaking not from judgement but in fear. How terrifying is it to think that you might wake up one day and be one of those people who literally cry with despair at the prospect of having to get washed and dressed? Or to realise one spring, perhaps months after a bout of winter ‘flu, that your health has disappeared for no apparent reason and may never be coming back? How horrifying might it be to inexplicably find yourself in a state where your mind or your body has simply forgotten how to be well?

It’s simply too awful to think this kind of thing could ‘just happen’, and much easier to blame the people it happens to.

*And I’m thinking here of chronic fatigue syndrome.



Realish 11.05.03 at 10:22 am

So why do we find it so damn hard to offer heartfelt sympathy and support to people with mental illness?

Because we have not yet fully accepted and internalized the fact that mental life is a physical, biological phenomenon.


SKapusniak 11.05.03 at 10:30 am

Oh, chronic depression and chronic fatigue syndrome. Yep I had years struggling with those. I’m not 100% convinced that the doctors diagnosed me right, but that was basically what they said, and I confess I didn’t really exist in the world for a loooong time.

Since I was pretty young when I fell completely apart, I’ve only every been on the receiving end of the ‘snap out of it’ line, rather than on the inflicting end…

…personally I think it’s usually utter frustration that causes otherwise well meaning people to throw out that sort of line. Being trapped in depression causes you react to people and situations in a very abnormal manner that’s frankly both irritating and incovenient others, causing everyone else lots of extra work. That’s what the sole external manifestation is. There isn’t anything else that can be seen.

What do people normally do when someone is acting in manner that causes us all sorts of problems? They tell them to stop doing it of course! Sometimes it even works ;)

If it doesn’t work then it’s usually taken as evidence that the someone in question is by nature an inconsiderate asshole. Hence ‘snap out of it’. Repeatedly. At ever increasing levels of frustration as they try not to file you in that asshole category, in deference to your condition, and fail because you don’t snap out as instructed.

Also, I think, there’s a fundamental philosophical problem, or at least a disconnect with how most people think about the nature of self, with ‘diseases of thought’ like depression, that confuses everyone.

Since this is partly a philosophy blog I shall try in a completely amateurish way try to expand upon in my next comment…


SKapusniak 11.05.03 at 11:29 am

Okay onto the philosophical problem! At least it seemed a philosophical problem to me at the time :)

What depression taught me, in a very concrete way — in the bones so to speak — is that some assumptions I had about the self just don’t work very well.

Looking at someone else I tended to think of ‘them’ as a first approximation, as being their acts, how they behave, what they say etc. Looking at myself I tended to think of myself, again at first approximation, as being my internal life, my thoughts, my feelings and so on. Actions were epiphenomena so to speak.

…and here’s the big, horribly naive philosophical error, there was an ‘I’ a ‘myself’ the conscious bit which directed my thoughts, which subsequently directed my actions. Or at least attempted to with some tho’ not total success (obviously ‘I’ needed to master the controls better) Tada!

Of course I didn’t really think about it that concretely, it was more of a hidden assumption.

What depression taught me was that an ‘I’ in that strong naive sense, a little homonculus at the controls of the great machine, was utter nonsense. I had mistaken consciousness, that which can see the self, for control, the ability to direct the self. Because there was no control over the depressive thoughts and feelings, or indeed anything else really, to be had anywhere at least accesible to consciouness. All ran its own course.

The ‘snap of out of it’ solution rather assumes that the homunculus is in residence somewhere and can push the buttons and pull the levers to reassert control over the machine run amok.

So what actually directs the self? The conclusion that works best for me, practically, is that the whole of the self directs the self so to speak. Thoughts, acts, emotions, behaviour, imaging, happen as they happen together generating the next versions of themselves, consciousness weaving in and out every which way doing it’s watching stuff. Everything continually unfolding, and thus getting dangeriously mystical ;)

A wider bigger version of ‘I’ set to match the whole dimensions of the self.

I will also mention that because of all this discussions of ‘free-will’ look rather different to me now.

End of rambling!


Keith M Ellis 11.05.03 at 1:23 pm

“The ‘snap of out of it’ solution rather assumes that the homunculus is in residence somewhere and can push the buttons and pull the levers to reassert control over the machine run amok.”

Yes, I’m as hostile to what Dennet calls “Descarte’s Theater” as anyone.

I’ve suffered from lifelong chronic, severe unipolar depression. Effective antidepressants seem to raise me to a “sufficient, but below-average” level of functioning. Without them I can’t do much, except sleep and be in crisis. I also find that I have problems with irritability and anger without meds.

Anyway, my point is that early on I learned to control the irritability and anger without medication. And the way I did that was suddenly realizing one day that the feelings I was experiencing were _not_ essentially me…they were feelings that I was _experiencing_. Now, since I am not a dualist, in a sense those feelings—well, any and all feelings—are as essentially “me” as any other cognitive activity. But the problem I was having was that those feelings sort of possessed me, they created their own logic and worldview with their own demands. The realization that the irritation/anger was something that could have, in a sense, an “external” cause enabled me to have a sufficient dissociated perspective in order to more rationally evaluate my and control my behavior.

I have had much less luck comprehending deressive feelings this way, however.


pathos 11.05.03 at 2:17 pm

I think the problem may just be the word “depression.”

Personally, I’m depressed lots of the time (following a death in the family, or when my sports team loses, or what have you), but I don’t “have depression,” which appears to be something else entirely that can require treatment or medication.

Consider, if you will, two opposite (and real) psychological disorders. One causes you to eat too little, causing severe health effects. One causes you to eat too much, causing severe health effects.

Disorder A is called Anorexia. There is lots of sympathy for the anorexic. Medical plans almost all will pay for anorexia treatments.

Disorder B doesn’t really have a name. “Overeating disorder,” maybe. But lots of us overeat all the time, but we don’t have any real disorder. We know we are just failing to use our self control. So many health plans do no cover this disorder, even those that do cover anorexia.

We tell the overeater, “Just stop eating already!” But we don’t tell the anorexic, “Just start eating!” We as a society recognize that disease.

One the one hand, we may be less likely to sympathize with people who just have more severe versions of what normal people have (say, depression or overeating). It may be enough to change the name. Create a diagnosis of “Doofhoffer’s Syndrome” that matches depression, but doesn’t strike us as something that we all have to some degree anyway.

On the other hand, it may be a deeper issue of self-control. More of us are overweight than underweight, so we see the anorexic as sick, before their problem is in the opposite of our “natural inclinations.”


Neel Krishnaswami 11.05.03 at 2:33 pm

I don’t think you need to invoke the Cartesian self in order to explain this.

Any level of sympathy and support beyond mere words has costs for the people being sympathetic, and of course has benefits for the people being sympathised with. So naturally there will be hypochondriacs, who try to fake some sort of illness in order to win sympathy, and the people who they deceive will naturally be angry. Since the outward symptons of a mental illness like depression are easier to fake than, say, cutting off a leg to become an amputee. So people may be more reluctant to show sympathy to someone with mental illness for fear of being fooled.

Of course, this state of affairs sucks ass for people who are genuinely mentally ill, since they get sick and don’t get the social support they need. But I don’t know what can be done about that, short of forcing people to wear little miniature MRI machines on their foreheads, which constantly display their brain state.


E. Naeher 11.05.03 at 3:50 pm

Cancer is pretty unambiguous — you have it or you don’t. Depression can be easily faked and exists in varying forms ranging from normal emotional response to external events to pathology. These varieties are not as easily distinguished as the DSM would lead you to believe.

Depression is also ridiculously overdiagnosed; I was diagnosed with dysthymia and, IIRC, other forms of depression repeatedly for several years. SSRIs and countless therapists didn’t help; a change in external life circumstances did, immeasurably. So while I suppose it’s inaccurate to say that it was “all in my head,” it certainly wasn’t the medical condition that the psychologists and psychiatrists wanted to convince me it was.


zizka 11.05.03 at 4:14 pm

I think it’s because there are times when you don’t feel good that it’s possible to make yourself feel better by changes your pattern of activities, exercising, doing a little hobby or craft stuff, etc. And in those cases, if you don’t do those things and dwell on your bad feeling, you get worse.

So people are extrapolating from one thing (either mild depression, or something that isn’t really depression at all) onto a completely different thing which is much more serious.

A physical example is tendinitis, which I had a few years ago. It’s not just a “pain”. I’ve had lots of pains, including severe injuries such as broken bones. It IS possible to be stoical about these pains. But tendinitis is an utterly crippling pain. I went around for five days without mob\ving my right elbow more than an inch from my hip. I just couldn’t.

Philosophically (or sociologically), “mental illness” is an illness, but it’s an illness that changes who you are. A stigma. Someone who’s mentally ill will be condescended to and everything he does will be devalued and treated as a symptom at the drop of a hat. (Medical professionals are among the worst.) Being mentally ill is far worse than being diabetic or having high blood pressure.

There’s actually a whole ethno-medicine — epilepsy is sort of like mental illness, cancer has a stigma because it’s supposedly inevitably fatal, AIDS is both fatal and “immoral”, hepatitis is like AIDS. There are likewise different stigmas for retardation, autism, learning disabilities, etc.

Asking someone to “snap out of it” probably is related to the stigma — sort of like saying, “If you keep this up, I’ll have to put you in the less-than-human ‘mentally ill’ category”.

Medicalization of behavioral and emotional problems is kinder than criminalization, demonization, or ridicule, but from the point of view of the sufferer it’s still very harsh, since everything you do is devalued.


Barbara 11.05.03 at 6:03 pm

To add to Zizka’s comments: Mental illness “changes you” but the “changes” are often more likely to be perceived by those around you rather than yourself. You may simply view them as a normal state of being, with “changes” having gradually accreted as your illness progresses. Indeed, denial is a hallmark of many types of mental illness (probably including severe depression at times), so that when a suffer is asked by his or her non-medical acquaintances what’s wrong, the answer usually comes back as “nothing,” and neither of them may perceive what is happening as a “medical” event or state. This can be true even when behavior is truly bizarre (which would not generally be the case with a depressed person). I haven’t suffered from clinical depression, but my dad and my sister have had major psychoses. I have concluded from my dealings with them that it is difficult for many mentally ill people to gain real insight into their illness because although they may be engaging in behavior that seems bizarre to others, it makes perfect sense to them, or they never manage to link it to their illness (rather than as something they did for no apparent reason).


E. Naeher 11.05.03 at 6:08 pm

Zizka writes:

“So people are extrapolating from one thing (either mild depression, or something that isn’t really depression at all) onto a completely different thing which is much more serious.”

I don’t think it’s that people are extrapolating, I think it’s that many people who think they have a real illness don’t. Those surrounding them realize this.


Michael C 11.05.03 at 6:32 pm

I’ve written a little bit on philosophical issues surrounding depression and suicide, and I sense that people’s inability to be sympathetic toward mental illnesses like depression arises from the way in which depression undermines expectations about responsiveness and reciprocation among those who care about one another. When you care about someone who’s depressed, your love doesn’t reach them. An apsect of the condition is that ordinary signs of affection, love, etc., are often rebuffed because the depressed individual is often angry , insecure, and suspicious of others’ loving them, and so has difficulty trusting our attempts to understand or help them. Simultanesouly, depressed people have trouble loving back. This dynamic often generates a sense of helplessness among the friends and loved ones of the depressed, culminating in a desire to just leave the depressed person to her own devices. Hence, just snap out of it.


laura 11.05.03 at 6:54 pm

I’ve been thinking a lot lately about depression because after years of understanding myself as someone with a tendency to depression — a couple pretty bad episodes and a lingering feeling that I was always on the edge — I was diagnosed with celiac disease, or gluten-sensitivity. Completely unexpectedly, cutting almost all of the gluten from my diet made me no longer anywhere close to depressive. It took me several months to figure out the cause and effect, but nearly a year on, it’s indisputable.

I’m not remotely trying to imply that depression is a simple physical thing, or that everyone who tends toward it should just stop eating gluten. Rather, I’m newly aware of depression as illness. In my relatively minor case, it was a result of nutrient malabsorption, an inadequate immune system, and perhaps other mechanisms I don’t fully understand. My body was not operating at 100%, but you would never have looked at me and decided I was sick. And yet it had incredible mental/emotional ramifications, it shaped my sense of self from the age of 16 and even when I had a fine life and wonderful friends, I could never escape it. From my own experience, and from watching friends with much more serious cases of depression, it is one of the diseases I most fear. Every day I’m thankful that that fear is no longer a visceral thing.


sidereal 11.05.03 at 8:21 pm

I think claims about fear of faking and the slippery slope of depression from mood to illness are misplaced. If that explanation were true, it wouldn’t apply to peoples’ perception of their own depression, since they’d know they were faking, and most people who are legitimately chemically depressed (like laura) have no idea that it’s a physical phenomenon.

True, the overlap between mood and illness can exacerbate the problem, but the underlying cause is definitely our fetishizing of the mind/body duality. The Machine gets sick, but the Ghost doesn’t. If the Ghost could get sick, there’d have to be an inner ghost that was aware of its Ghost being sick, and so on ad infinitum. Acknowledging that the very thing that apprehends sickness can be sick is a flanking maneuver on a conception that many people hold very dear.


Jonathan Ichikawa 11.05.03 at 8:36 pm

I think this is very much right on. The answer is, I think, mostly false beliefs about depression, and what’s likely to help.

I’d probably go around telling cancer patients to “snap out of it” too, if I thought they might follow my advice.


Neel Krishnaswami 11.05.03 at 9:06 pm

zizka: don’t all illnesses change who we are? If I were (say) to come down with AIDS, then my personality would change pretty radically, even if I were a pure homo economicus. I would no longer have a reasonable expectation that I will live another half-century, and that would change the level of other risks and enterprises that I would think worth undertaking. And in the real world there are all sorts of physical changes that go along with that, too, which have their own impact.

sidereal: In my comments about faking, I was specifically addressing the question of why healthy people don’t give the mentally ill as much sympathy and support as they deserve. Of course someone who is mentally ill often won’t recognize it — their sickness is harming their ability to make decisions! If it didn’t, it wouldn’t be a mental illness.


Stephen H. 11.05.03 at 9:14 pm

Why is it that people with ‘real’ illnesses like heart disease, cancer or ‘flu can receive unqualified sympathy and support, while those suffering from an equally organic illness like depression are so often told to ‘just snap out of it’?

It’s all about symptomology and society. Society doesn’t necessarily feel sympathy toward the outwardly ill, but prefers that the outwardly ill go in hiding, so as not to be contagious. The melancholiac has no apparent outward physical symptoms, but appears as somehow not conforming to certain social norms. We can all adopt at some time or another the attitude of the nurse and care for the outwardly sick, but what can one do to the melancholiac? Dressing a bleeding wound is easy, upsetting and even disgusting perhaps, but easy. Healing the melancholiac is not so easy. In fact, it’s downright frustrating.


Keith M Ellis 11.05.03 at 9:44 pm

“I’d probably go around telling cancer patients to ‘snap out of it’ too, if I thought they might follow my advice.”

That’s a good point, nicely made.

For my part, it wasn’t until I was about 25 that I recognized my depression for what it is. Until then, I had taken it to be situational and/or maladaptive, something I could “snap out of”. But at that point I happened to be in a life situation where all the factors I had previously thought responsible for the depression weren’t there. I was “happy”, or I should have been, yet I was unable to function and I was self-destructing. What I had thought made sense, didn’t. Something else was going on.

A big part of why things like depression aren’t accepted by many non-sufferers as legitimate physical illnesses is because it can be very ambiguous and difficult for the _sufferer_ to accept. Regardless of whether my depression was biochemical or not, I had a lifetime of habituation to it around which I molded my entire sense of self and behavior. The first year or so of being on antidepressants was, for me, a pretty confusing time while I struggled for a clear sense of who I really was. At first, the medicated “me” felt false—and this is something many, many people experience on antidepressants.

But I had an epiphany one day. I was walking beside a school playground, and I stopped to watch the kids. Watching them made me very happy. And suddenly I realized that this was essentially how I viewed life, that I thought life was wonderful. I thought about my values, my humanism, and realized that in some deep way I’m an optimist. The mental picture of self abruptly shifted; the depression was a distortion imposed upon me—it wasn’t me.

And yet, in a sense it was, because I had learned to live, as best I could, with that distorted self; and I had acquired many habits of thought and behaviors that persisted (less so these days) beyond the biochemical imperative of depression.

Or, let’s use a different, non-controversial example. As I’ve mentioned before (haven’t I?), I suffer from a genetic disorder involving collagen formation that has resulted in severe, progressive osteoarthritis at a young age. At this time, I can still walk without aids; but I need both hips replaced (and at least one shoulder), walking and other activity is limited, and I live with chronic pain always. I suffer from an indisputably severe physical disability. And yet, there are things that I could be doing to help myself that I am not. Specifically, the strength of the relevant muscles is important because they take some of the load off the joint. I _need_ to exercise, somehow, in a way that doesn’t adversely affect my joints—but it’s so very hard when, dammit, it _hurts_ to do anything. My point here is that even with indisputable organic illnesses, there’s still a lot that remains within the realm of willpower and responsibility to self.

However, the insidious nature of depression and other mental illnesses is that they directly interfere with one’s ability to be responsible for oneself in this way.

In fact, while society and most people around me see my bone disease as my “real” disability, I feel and believe, without a doubt, that my depression has been more disabling and hurtful to me than the bone disease ever has, or ever will.

Sorry if this was too long.


zizka 11.05.03 at 11:41 pm

E. Naeher’s comment was extraordinarily obtuse. What I said was that people who fail to be sympathetic to someone who is genuinely depressed (the mental illness) are mistaking the mental illness from something they have experienced themselves, also called depression by many, which is NOT a mental illness (or is a much milder form of it).

This does not exclude the possibility that a.) some people are faking it (malingering), or that b.) some confused, unhappy people think they’re suffering clinical depression when they’re not.

As far as I can tell, the purport of Naeher’s comment is that there is no such thing as clinical depression (the Szasz position). Szasz’s book was provocative 30 years ago, but I don’t think that it has weathered well on the whole. (It may be that Naeher has come to his conclusions without Szasz’s help, but that doesn’t make his position any stronger).


zizka 11.05.03 at 11:54 pm

Neel — as I wrote I realized that all diseases change who you are. For example, a crippling knee injury makes whole categories of activities impossible and cuts you off from people you know through those activities.

I was thinking especially of the fact that some diseases invalidate you as a person (agent) in the eyes of others, whereas diabetes or hypertension or osteoporosis really doesn’t. (In athletic circles, a knee injury probably would, but not elsewhere.) But mental illness tends to put a stigma on everything you do, for everyone. (I’m also thinking of diagnoses like alcoholism and, formerly, homosexuality).


Maynard Handley 11.06.03 at 1:43 am

E. Naeher’s comment was extraordinarily obtuse. What I said was that people who fail to be sympathetic to someone who is genuinely depressed (the mental illness) are mistaking the mental illness from something they have experienced themselves, also called depression by many, which is NOT a mental illness (or is a much milder form of it).

Come on. You are the one being obtuse.
More generally, I find the very fact that Maria posed the question seriously, and that so many people cannot give her a straight answer, to be emblematic of so many problems of the left and do-gooders in general.
First of all, let me make it clear that I am, philosophically, on the side of the left and do-gooders. I want the wretched of the earth to have better lives; I have no problem with taxing the superwealthy very aggressively; and so on.
However I am well aware of what many leftists take pains to deny, that the world is full of bums, malingerers and general social parasites.

So what does this have to do with the question?
Of COURSE there are people who whine and moan about every minor thing, who believe that no-one else in the world has ever suffered the way they are suffering. They are a staple of movies and sitcoms. We laugh at Adrian Mole and Georgia Nicholson, not just because their teenage angst coupled with massive egos and lack of empathy are funny, but because we recognize our own teenage selves in them.
So when we see others complaining about how unbearable their lives are, we remember our own unpleasant experiences — the string of rejections by girls, the unpleasant breakup, the terror of doing badly in college, the difficulty getting a job — and we ALSO remember that we survived those experiences just fine and did, indeed, snap out of it.

Now it is perfectly valid to say that depression as an illness is NOT the same thing. That is something we all agree on, not least because of the experiences like that of Laura.
But that’s not the question. The question is: why don’t people take depression seriously, and the answer is not because they have no experience of it, on the contrary it is because they have ALL had experiences of being unhappy, have, a priori, no reason to believe that the case in question is anything other than that, AND have all had experience with social parasites who exaggerate for sympathy and more. If you don’t believe in social parasites, well, email me privately and I’ll let you know about a little deal I have going involving the fortune of the late Saddam Hussein — all I need is a little seed money you can lend me, and we’ll soon both be rich.


Kragen Sitaker 11.06.03 at 2:11 am

We are discussing two things here: physical illnesses that alter your mental state, and mental states that are described, in what seems to me a kind of metaphor, as “illness”. It’s hard to distinguish between the two externally, but I think it’s important; it’s possible for two people with the same physical illness to have very different mental states as a result, or even the same person at different times.

When you treat the mental state itself (rather than physical states that may produce it, such as schizophrenia or gluten intolerance) as an “illness,” the metaphor suggests a host of unhelpful or marginally helpful related concepts: drugs, hospitalization, diagnosis, symptoms, surgery, abnormality, and an opposite state of “health”. Likewise, the metaphor dismisses the mental, emotional, and subjective aspects of the situation as secondary, and often treat the mental states resulting from the illness as being somehow invalid, not “real.” This is perhaps the most destructive aspect of the medicalization of emotional suffering — the way its believers often dismiss the suffering and mental struggle itself as meaningless.

I think most people realize that this conflation of mental states and physical illnesses is misleading, but make the mistake of rejecting the medical aspect of the situation completely.


zizka 11.06.03 at 2:26 am

Maynard, you said nothing. What I said (Between my two posts) is that some people ARE malingerers and that some people DO pity themselves too much, but that there IS a disease called depression which is much more serious than the normal bad feelings lots of people have. Then I gave a bunch of reasons why people with the disease of depression don’t get the sympathy than people with physical diseases normally get. (I.E., I discussed the question asked).

I can’t even tell whether you disagree with me or not. Because you admit that clinical depression is different from all the normal unhappy feelings we all have, which seems to support my point that one the reasons for the common lack of sympathy for people with clinical depression is mistaking it for something else (quite different and much milder) which is ALSO called depression.

But to explain why people don’t have sympathy for people with clinical depression, you go off on these tangents about how you really are a leftist and that there are a lot of malingerers in the world. If I were an editor I would send your post back for a rewrite.

P.S. If I had read Naeher’s first and second comments together, my response above would have been much less harsh.


Keith M Ellis 11.06.03 at 2:29 am

“the answer is not because they have no experience of it, on the contrary it is because they have ALL had experiences of being unhappy, have, a priori, no reason to believe that the case in question is anything other than that, AND have all had experience with social parasites who exaggerate for sympathy and more.”

This strongly reminds me of the rationale for discriminating rape victims from regular crime victims. However, numerous studies and, for example, the FBI’s own estimates, show that rape is not falsely reported any more than other crimes.

This view of depression and the social reaction to it is built around the same assumption of a distinctively high-rate of false claims. This assumption is also intuitive, but could be just as false.

You may not believe that my depression is a serious physical illness. But no matter. Because if it were or if it weren’t, my example undermines your claim. I almost never claim (and then only to closest friends and family) that I am unable to do something because I was depressed, even though it would quite often be true. Such a claim carries no weight. For it to work as an excuse, it needs to, you know, be accepted as an excuse. Your argument is that people won’t accept it as an excuse because it’s accepted as an excuse.

This was a big point of my previous post. I can barely freaking walk. X-rays of my joints look like disaster areas. Yet I can tell you that my bone disease hasn’t and doesn’t disable me as much as depression does. But I rarely make that claim (this is a huge exception) because I don’t expect anyone to either believe or understand that it’s so.

And as someone who was formerly in the highest marginal tax bracket (by a wide margin), I don’t think I can be called a “social malingerer”.

Your explanation is off-base, the other much more moderate ones are better: depression as a part of the normal human emotional spectrum and depression as an illness are both quite real but not nearly as distinct as we might like. Just as, I might mention, _physical_ pain is both normal and a serious illness. If we lived a hundred years ago and there was no known etiology for what is wrong with my joints, then “it hurts to move” would sufficiently describe my condition. But, you know, for normal people, it sometimes hurts to move as they get older, it hurts to move a day after vigorous excersize, etc. Moving in spite of pain is something that we all must learn to do to some degree. Lots of people have joint pains or mild arthritis. Because of this, if I describe my condition as “arthritis”, they tend to underestimate its severity, particularly because there’s few outward signs of illness. (And because I’m only 39.) This is the effect involved in the discounting of depression, as other people have said.


zizka 11.06.03 at 4:30 am

Far from malingerers, I’ve read stories of intensely depressed people who functioned successfully and productively for years, unbeknownst to friends and family, before their depression incapacitated them. Often they kept up a cheerful front for the benefit of others.

Jim Capozzola of Rittenhouse Review has written about his own depression.

Dangling participle above. Shoot me now.


Andy 11.06.03 at 6:11 am

>>after years of understanding myself as someone with a tendency to depression — a couple pretty bad episodes and a lingering feeling that I was always on the edge — I was diagnosed with celiac disease, or gluten-sensitivity. Completely unexpectedly, cutting almost all of the gluten from my diet made me no longer anywhere close to depressive. It took me several months to figure out the cause and effect, but nearly a year on, it’s indisputable.

Ever unexpectedly read something that causes the lightbulb to go on in such a profound way that it is a potentially life-changing experience? This just happened to me. I would describe myself as very similar to Laura – prone to depression, with not very much needed to send me into very severe episodes of complete alienation and withdrawal. And yes, I got the “snap out of it” response from those around me, also.

This past spring, I read an article about a finding that celiac disease/gluten intolerance is very much more common than previously thought. The article mentioned physical discomforts associated with the condition that sounded familiar to me – so I went off gluten in June just to see what would pysically happen. Coincidentally, for that past 2-3 months or so, my overall mood has considerably brightened, but knowing my history, it was always like waiting for the other shoe to drop, so I just assumed that it was a temporary situation while waiting for the inevitable bleakness to return. I *never* associated mood with gluten, and I never associated the mood change with the lack of gluten. I never even considered that it might be something organic that might be changed with diet – just that being prone to depression and having my life framed by that was a permanent part of me that I was rather helpless to affect without severe medication.


Not that it automatically follows that my experience is necessarily similar to Laura’s, but for the first time in a very long time I have a new perspective and hope about myself just from being here tonight. THANK YOU, Laura, for your post – it opened up a whole new avenue of thought for me to pursue. And THANK YOU, Jim, for mentioning this discussion to me – I’d never been here before – serendipity! And I guess THANK YOU Maria for hosting this forum. I know I’m not, in fact, technically adding to your discussion topic, but … WOW! THANK YOU all so much!


Barry 11.06.03 at 11:44 am

Laura, gluten can cause a wide variety of problems in those with celiac disease.

Have you seen a gastroenterologist about this? How long have you been on a gluten-free diet? Are you with a support group?


Cobb 11.06.03 at 6:11 pm

Because the international human understanding of work is that it is physical, not intellective. Things that give people headaches and disturb their ability to do monk-like white collar bourgie work is nothing compared to things that physically weaken their bodies and disrupt their ability to carry water from the well to their home.


laura 11.06.03 at 7:45 pm


A gastroenterologist diagnosed me (the second time I was hospitalized and referred to her) — I’ve had the blood tests and endoscopy and all. I’m not in a support group, but I’ve got a number of books, product lists, and cookbooks etc. And I have found more benefits to the diet than I could list.


georgem 11.06.03 at 8:16 pm
I fractured my skull over my left eye at age 5 or so when I fell from a moving car. My left eye has very poor vision.
I started drinking at age 15, did some drugs, left a military career because of the drinking (not recommended for re-enlistment), was at times a violent drunk… I never felt good unless I drank or smoked.
My wife and running kept me straight for a while, but the anger and self-hatred kept boiling over, sometimes onto my kids.
I’m 53 and on Zoloft now and am no longer plagued by anger and self-hatred. When I make a mistake, it’s just a mistake, not proof that I am stupid or useless.
If I try to cut back on the meds, the feelings return, so there is definitely something broken.


julia 11.08.03 at 9:02 am

I don’t think people say “snap out of it” because they expect anyone to snap out of it. I think people say “snap out of it” because it sends a clear signal that they are not going to be drawn one inch closer to whatever that creepy stuff is that’s making this person so damn inconvenient to deal with.

I think people are afraid if they get too close to crazy they’ll fall in, and I think that’s how people see you if you can’t “snap out of it”


sagesource 11.10.03 at 1:07 pm

However I am well aware of what many leftists take pains to deny, that the world is full of bums, malingerers and general social parasites.

Now you have to explain why those people choose to be bums, malingerers, and general social parasites. And, if they really are, how to get them out of it.

Hint: calling them names, or punishing them, is very little use, except perhaps to your own ego.


monica 02.07.04 at 7:15 pm

So very well said, Maria.

I’d like to mention another type of illness that gets even more stigma than depression and even more of the typical blaming-the-sufferer reaction. What about food disorders? Anorexia, bulimia, etc. Often, the reaction from people who have no clue is to assume the person was too stupid and brainwashed by some fashion magazine or ad with a thin supermodel in it, and out of the blue decided to start inflicting this torture on themselves. Sadly, some feminists (even if this does not affect women alone) have contributed to this train of thought, by pointing the finger at advertising and models of beauty that rely on being thin. When in reality, anyone who has a friend or family member suffering from such a disorder will tell you a completely different story. It’s got nothing to do with ads or fashion. It’s always about something at the emotional level, and family history, personal experiences, and even predisposition to depression or addiction. Probably even genetic factors. But no. Especially because it’s something more widespread among girls than boys, it’s got to be cos they’re stoopid and superficial. Alternatively, it’s all-the-parents-fault. There’s really a lot of ignorance. And yes, fear.

Maria, you really hit the nail on its head there. Mental illness and psychological disorders are just not accepted as easily (relatively so, at least) as purely physical illnesses, because they betray the illusion that we are masters of our destiny all the time, and we can control all of our behaviour all the time, and set things straight, only by sheer *willpower*.

The existence of depression, panic attacks, behavioural disorders is like a stain on this grand myth that we have full control over our own minds, actions, and emotions.

And then, the need to explain everything. So often, there is really no single explanation as to why one person develops depression or anorexia or chronic fatigue. It’s scary, to be left without a reason. It’s human to want to know why. And to “place the blame” somewhere.

It’s when that tendency is turned into sanctimonious judgement, scorn, or exploited for commercial or sensationalist reasons, that it gets annoying.

Paradoxically, I think that the overabundance of self-help books and success stories of “how I overcame my depression” reinforces that myth, rather than increasing sympathy and understanding of the realities of those illnesses.

On the plus side, there’s a lot more attention to these problems than just a few decades ago, but outside of the specialist area, at mass media level, it’s not often the kind of attention that’s useful.


monica 02.07.04 at 7:51 pm

“The ‘snap of out of it’ solution rather assumes that the homunculus is in residence somewhere and can push the buttons and pull the levers to reassert control over the machine run amok.”

Heh, exactly what I meant. The homunculus… It all changes one’s perspective of life indeed.

I have to add, having also been on the receiving end more often than the giving end of the “snap out of it” classic, I too understand that reaction at a personal level, from friends, family, etc. From people who care, that phrase can also be said with love and sympathy. And frustration too, oh yes. Sometimes you just drive people insane, when you’re screwed up. They don’t get it, cos they can’t. You don’t get it yourself. And you can get very selfish, nasty, and vindictive, when you’re screwed up. When you’re not kind to yourself first of all, you’re not exactly going to get cheers and smiles all round…

But no one ever “fakes it”. Faking depression? what the hell for? it’s not like it’s fun. If anyone somehow should feel this odd desire to fake depression, well, it means they’re really just as screwed up as if they had it for real.

I remember reading, always in the Guardian, on the debate about self-inflicted cutting among teenagers. The fakers/real sufferers debate there is very interesting. My own idea is, there’s no fakers. There can’t be. If a kid feels that cutting themselves is “cool” and they like to show it off, then it means they do have a problem, and do need some help. It doesn’t matter if they go about it in such offputting ways, doesn’t matter if they make it into a fashion statement, the very fact they’re doing it speaks a lot about their state of mind. No one reasonably happy with themselves would ever “fake” something as complicated as depression or even something as tangible as self-mutilation just to attract attention. There’s simpler, healthier ways to attract attention, like, dye your hair red or wear see-through shirts…

On depression as medical condition vs. depression as ordinary, temporary part of everybody’s life. It is different. Ordinary depression and sadness is an emotion like any other. Depression as a condition is entirely different. Has a lot of mental and physical consequences as well. Again, no one can be seriously faking that.

I don’t think that the “sympathy” that needs to be given to these illnesses is the total opposite of the “snap out of it” – sympathy is not a pat on the back, that’d be indifference. I think absence of moral judgement would be enough. Separating moralistic assumptions from understanding of psychological problems, that’s what would be really nice. If only people (sufferers first of all) could suspend the need to place the blame at all costs.

Also, I think frustration with people who do not seem to be *willing* to recover at all is totally understandable. Patience can only be stretched so far, and these illnesses take their toll on friendships, relationships, family, etc. Everyone needs some support, but, they got to be inclined to at least help themselves a little as well. It’s a two-way process, obviously.

However, I think the issue here is not reactions at a personal level, but at the wider, social level, in general. General attitudes and mentalities about it, not reactions of people directly involved.


monica 02.07.04 at 8:24 pm

Ps – not to sound too full of contradictions, I just want to clarify that “willing to help themselves” is not in the sense of “recovery achieved by superhuman willpower as you can read about in my exclusive biography, now selling for only $29.99”.

It’s meant in the basic sense of being willing to first of all accept one’s illness, that it’s not one’s fault, that there’s no such thing as perfection, and that life is not a matter of success vs. failure but enjoyment on one’s own terms, and recovery is not a matter of “going back to how things used to be before”… (the catastrophe that one inevitably thinks provoked the depression), but of acceptance, openness to change, and realistic expectations. I think that’s the only effort required of people suffering from depression or similar. It’s the exact opposite of that idea of willpower or control in the “efficiency” sense.

So, it does require acceptance and sympathy and support. Otherwise, like the examples in the article, people just won’t even dare talking to anybody about their problems. The main thing that makes therapy work is just that, someone listening without judging.

I remember my mother telling me (in one of the frustrated moments) that if I’d had to work 12 hours a day in a factory like my grandma did and then raise 7 kids, I wouldn’t have time to be depressed. That it was a luxury, a thing for the rich and spoilt, and there was this idea beneath it all, that therapy was only a self-indulgent thing. Then I found out my grandma suffered from depression too, and so my mother, and they never “snapped out of it” either, so… there goes the whole working class cure to depression… Just a lot of self-indulgent bollocks ;-)

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