Diane, who has been suffering from depression for more than eleven years, is one of those who are willing to talk about her illness. She says, "Most people are still very much surprised that I admit and am willing to talk openly about my depression. There is still a stigma associated with the disease. People still don't understand." For this reason, we won't use real names in this article although the people who shared their stories are very real.
Incidences of this illness are staggering. An estimated 10-14 million Americans suffer from depression, according to a recent article in the Alliance for the Mentally Ill publication. Other estimates range as high as 35-40 million.
No one is immune from an attack of depression. Keep in mind that everyone feels "down" or "blue" at times. That's normal. But it's been estimated that 26 out of 100 women and 12 out of every 100 men will have a major depressive episode at least once in their lives. For creative individuals the estimate increases to 38 out of 100.
Statistics can be deceiving and any attempt to quantify this disease could be challenged. Particularly since, according to the Alliance for Mentally Ill, we're talking about those who are only now beginning to and seek help -- 80 % of those suffering from depression never seek treatment and suffer needlessly.
DuPage County is not immune. In fact, Dr. Martin Russo, a physician working with Central DuPage Hospital with offices in Bloomingdale, reports that easily forty to fifty percent of his patients are suffering from depression. Social workers and doctors throughout the county report similar statistics.
For this article only the most conservative numbers will be used. The indication, then, is that at least 150 out of every thousand suffer from this debilitating disease. In DuPage County, Illinois that translates to more than of 132,000 -- in Elmhurst, approximately 6,300 people -- live with some level of depression.
The Human Factor
Sondra Dodds at Family Service DuPage in Wheaton, IL says that those who are depressed often feel isolated and alone, different and unusual, misunderstood by family and friends, powerless and defeated. Many also feel the need to hide their real feelings, even from those they love. Those who are more willing to share their experiences share many common experiences although each case is dramatically different.
They share a common bond. They live in a no-man's land that's sapping the community of its most valuable resource...competent contributing citizens. They don't choose to live there. And they can't will to get out of there without help.
An insidious disease, depression is multi-faceted. The onset and the symptoms of depression are not always the same. Frequently depression is an outward manifestation of undetected physical illnesses such as cancer.
For some the disease can be traced to low self esteem; for others to excessive drain on their physical health and energy or chronic illnesses; for others to abnormally high levels of stress-related life experiences; for others realization that life is passing them by and their goals will never be reached.
In all instances the illness points to imbalances: physical, mental and spiritual. A depressive illness is a "whole-body" illness involving your body, mood, thoughts and behavior. It's not just a passing bout with "the blues". You cannot "will" or "wish" it away.
Rose had frightening bouts with burning sensation in all parts of her body. It was as if her stomach, head, nerves were all "aflame". Katherine began to withdraw from friends and acquaintances.
One Elmhurst resident tells of his experiences, "I felt helpless and unable to cope with every day stresses. I saw myself as worthless as a part of the community I worked for. Frequently I entertained thoughts that my family would be better off if I just disappeared or died. I knew I was on a self destruct kick...ignoring my health, setting myself up for failure in my job and getting myself in no- win situations. The harder I tried, the worse things got in my life. I saw myself reacting to even the simplest setbacks with uncontrollable rage."
Anna, who has been treated both in and out of the hospital for depression said, "Over the years, I've seen a big change in the people who are suffering depression. They're getting much younger now and they are filled with anger."
Some deal with the constant sensation that they are "not connected with the rest of the world" and "unimportant". For yet others, the illness may just hover at the point where there's a gnawing stomach ache and the constant knowledge that "something just isn't right". Nearly all report that their level of productivity fell dramatically. Many find that they just "can't attend to the task at hand". In the worst case scenario, suicide seems to offer the only way out.
The bad news is depression renders a person unable to cope adequately with life events and, frequently, it goes undiagnosed for months -- even years -- because the victim generally blames him or herself for uncontrollable problems and their inability to function in a reasonable manner. It's a vicious downward spiral that sucks its victim into a hopeless pit of despair.
Impact on the Community
While many manage to function at some level of competence, their difficulties "connecting" and "attending to task" often limit them to minimum-wage positions although they may, under normal circumstances, be highly competent workers.
Heddi reports that her income dropped from nearly $3,000 per month to less than $800 a month while she was working much longer hours. A significant number of others have found themselves homeless. Evidence of this can be seen at the DuPage PADS site, where a striking number of clients are middle-management professionals who have lost their jobs.
The June 1995 county reports indicate that there are just over 884,000 people in DuPage County. Of those, the Labor force in DuPage numbers 492,169. If we calculate just 15% of those and figured that 73,800 people lost just $10,000 in earnings during the course of a year due to depression we're talking about the kind of losses that would be considered intolerable in business.
It's a vicious cycle. Stress, illness or financial difficulties strike sapping the individual and breeding a sense of hopelessness which aggravates the situation. Meanwhile, the sufferer must cope with others who are frequently equally depressed and stressed with their own problems. At the same time they have to deal with others who haven't the foggiest clue about what severe depression does to a person. In all cases misunderstanding and the inability to communicate the real pain lead to further hopelessness.
Stress continues to build in today's society where people dealing with stressful situations attempt to find solutions. When people dealing with any kind of stress or depression try to resolve difficulties or get answers to problems and get trapped into voice mail and mechanical phone menus or are put on waiting lists. When they feel treated like number, taken advantage of or overwhelmed constantly by circumstances they can't change, depression mounts.
In a society where both parents in a dual income family may hold down two or more jobs just to keep the bills paid, a person's value is equated with how much money they bring into the household rather than unconditional love and appreciation. One, or both, can slip easily into depression. The situation is much worse for single heads of households.
Barbara Hayes, a Family Service DuPage Licensed Clinical Social Worker, believes that "role strain" is a major contributing factor in the higher incidence of depression in women. Not only are women parenting or grandparenting a younger generation, while, frequently caring for elderly parents; but, they are also required to cope with the challenges of maintaining a certain level of career growth in an uncertain economy -- frequently as sole support of their entire family structure. To meet the demands of each of these roles, a woman must maintain an exterior facade of strength. For many there is precious little time for attending to personal needs. All too frequently, functioning on far too little sleep and nutritious food, they cave in.
Meanwhile, the media, particularly women's magazines, focus on introspection, self analysis, poise and youthful figures, mounting anxiety, anger and insecurities. At the same time they juxtapose these weaknesses that turn us inward upon ourselves, with idealistic reports of the affluent life that many of the population will never achieve.
It's Not A Case of Buzz Words
Depression is not a new disease of the 20th century. Sufferers are among the elite. Abraham Lincoln, Winston Churchill, Edgar Allen Poe, Mike Wallace, Joan Rivers and Dick Cavett are among the many who have been afflicted.
Indications are that those who are more sensitive, creative and intelligent are more prone to suffering from depression. One study performed in the '80s found that 38% of 47 writers, poets and artists had taken medication, sought psychoanalysis or had been institutionalized for depression and bi-polar disorder. Another study performed in the 80's showed that more creative people suffered from emotional strife synonymous with certain neurosis. (Time-Life Books, 1992)
The Good News
Although the problem appears to be hopeless, there is good news. If you're going to have an illness, you want it to be depression. It's the most easily treatable.
The afflicted needs to work at getting back in balance. Professional counseling, support groups and the medical profession are learning to work together to speed recovery.
The medication is a critical aspect of treatment. The new drugs are marvelous even with the occasional discomfort of side effects. They work to re-balance the synapses that are responsible for the transmission of brain impulses.
Social workers and psychiatrists, too are much more skilled at identifying symptoms today than ever. Group counseling, support groups and crisis lines are more accessible. There's help and information out there for those who have the courage and determination to find it.
Much of the work, says Barbara Hayes, a licensed clinical social worker who oversees a 12-session group that's been running throughout the summer at Family Service DuPage, focuses on teaching cognitive reasoning techniques. Those who participate in this therapy learn to evaluate the validity of their thought processes and to recognize distorted thinking patterns. Then they learn to restructure their thought processes more positively and realistically. It's a sort of de-programming that allows individuals to discover that there are other ways to look at one's life experiences. Hayes has found this kind of therapy most productive when participants have the appropriate medical support. She assures her patients that "using medication is not wimping out." Trying to pull yourself out of depression without the proper medical attention just doesn't work, she says. It's like a diabetic telling his pancreas to shoot insulin into his system, she says.
Unfortunately current health care programs, both private insurance and public aid, put unrealistic limits on treatment. All too often they cut short coverage long before the patient is able to cope without the medication and psychological support. When this happens they "hamstring the health care providers," said Rose. It's not at all uncommon for these programs to cut off the payment for medication and counseling sessions just about the time a patient starts to show some progress and before the patient is sufficiently recovered. The only recourse in cases like that, short of going "cold turkey", is to get on a waiting list for services that are offered on a sliding scale fee. All too often the patient is not financially able to handle that.
Fortunately it's the patient who does the real work of recovery. Those who discover that they control of their own destiny have the greatest hope of recovery. They can then learn how to maintain balance in their lives and their habits. They practice being less compulsive nurturers. They begin to trust themselves and be a bit more open with others. They learn to maintain a childlike attitude of gratitude and wonderment. And, they learn to be less sensitive to outside turmoil.
One of the key ingredients to healing lies in getting away from introspection and self-centeredness and to reach out to others. Those who have been afflicted and have made the most progress typically have found ways to give of themselves to others less fortunate or to share their unique talents with the community...the challenge being that a person who is severely depressed has great difficulty breaking through his/her feelings of isolation.
One group of women developed a phone network that they said was particularly helpful. One of the women is dealing with a pregnant teenager, another with a financial problems, a third with the death of a mother and a fourth with an overbearing aging mother. These women discovered that being able to pick up the phone and connect with someone who they knew would understand helped to speed recovery. In short order, often a matter of minutes, they managed to break the downward spiral of day-to-day crises. These calls provided the ladies a life-line that they turn to before the crisis could escalate. Most often within a very few minutes, they found they could put the experience into perspective and they'd find themselves laughing. And therein they found a cure, because you simply can't be depressed and laugh at the same time.
Dr. Russo's findings confirm that depression is indeed a multi-factorial disease that encompasses genetic, biological and environmental factors. He voices the concerns of many when he says, "The reason that depression is so pervasive is that society is losing its sense of security and moral fiber in both the family and in the community. As it's losing its fiber we're losing our sense of purpose and personal value. At the same time we need to look at the spiritual component that gives us a sense of wholeness and peace when looking for solutions."
Those who understand depression agree, with Heddi, "I need people, but I need people that I can be myself with. And, I need to find a way to make sense out of the madness I face every day I walk out my front door. When things get off balance, I need to make some changes. Alone I can't do it."
NOTE: Although most of the quotes here are those of women, the situation is far from a woman's problem. Women are simply more susceptible to depression. "Role strain is a factor, according to Barbara Hayes. "We are more aware of depression than we were in the past, but there are more stresses in society today for women to fulfill multiple roles. They make very heavy demands upon themselves. Women traditionally are the nurturers and very often in the process of nurturing others they forget to nurture themselves....as a result, at some point, people just start caving in."
The experts tell us that women today suffer twice as much depression as men. While one in four women can expect to develop depression during their lifetime, one in eight men can, too.