We hate being “sick.” When we have a cold or the flu it feels horrible. We often have low energy, feel the need to sleep a great deal and lose our appetite. It’s much more difficult to concentrate or to enjoy the things that usually bring us pleasure. Even doing basic tasks such as showering can feel burdensome. We certainly don’t want to see or talk with anyone. In fact, often it feels like everything hurts and we just want to curl up in a ball and wait for the sickness to pass.
Yet, however unpleasant it may be, sickness is actually the coordinated effort of our immune system to heal us from the effects of an infection or virus. In theory, the various behavioral and emotional symptoms of sickness help prevent us from exerting ourselves so that our body and mind can put energy into healing. Many of us have tried to push ourselves when we are sick by continuing to work, exercise and socialize only to find that we feel worse. And often, when we try to push through it, it only prolongs the period of time that we are sick. So, hopefully, we’ve all learned the lesson that we need to take it easy and let our immune system do its job.
Accordingly, as a society, we seem to acknowledge that when someone is sick, they need certain accommodations. Businesses often provide “sick days” for people to have the opportunity to heal. Family and friends are accommodating when their loved ones can’t engage in social or household activities and need to stay in bed as they recover. People who are sick may even receive extra care and concern to let them know that they are loved in the hopes that they feel a bit better during this tough time.
And equally important, when someone is sick, we generally don’t criticize, mock or judge them. There is a basic recognition that everyone gets sick and that asking someone to resume typical activities during that time would be counterproductive and detrimental to their well-being. Further, when people are sick, we do not challenge the fundamental notion of who they are or what their potential is as a person. There is an understanding that they need some time to heal, then afterwards will return to pursuing their purpose in the life they have developed for themselves. In fact, letting people know that it is OK to be sick, and that their support system rallies during tough times is one of the experiences that can build trust and loyalty.
Interestingly, when we look at the symptoms of being sick, many often overlap with symptoms of depression. Depression is often called the “common cold” of mental illness because of its prevalence. But perhaps there is a deeper connection to the “sickness’ response to fighting a virus or infection. Depressed individuals often have the same loss of pleasure (anhedonia), increased sleep, reduced eating, low energy, poor concentration and reduced life functioning. And similar to being sick, being depressed is a painful and unpleasant experience, resulting in severe suffering and disability.
And perhaps relatedly, from an evolutionary perspective, depression may have the same healing effect on emotional stressors as sickness has on an infection or virus. The general hypothesis is that the symptoms of depression such as loss of enjoyment and low energy force us to pull back and not engage in activities such as work or socializing that would take us away from focusing on and solving the stressful issue. As an example, the “depressive realism” hypothesis suggests that depressed individuals are actually better able to accurately process information, which would help in speeding up problem solving. And the “Analytical Rumination Hypothesis” posits that the rumination – or repetitive thinking—that often occurs during depression creates an intense focus on problem solving that increases the speed at which issues are resolved.
And yet our response to people who struggle with mental illness such as depression seems to be quite different than our reaction to “sick” people. There is a stigma of mental illness whereby people are met with judgment and condemnation rather than empathy and compassion. Depression is seen not as a potentially useful state but rather as an indication of weakness or a character flaw. We often encourage people to “snap out of it” rather than use depression as an opportunity to reflect. This may be particularly problematic as this approach is in direct opposition to the proposed adaptive response of depression that requires taking time to rest and focus on difficult issues. Imagine we forced people who were fighting an infection to work, socialize and engage in regular household activities. The energy needed for fighting the infection would be placed elsewhere, thus risking prolonging the infection’s effect on our bodies. And yet people who struggle with depression are often expected to go on with their daily lives regardless of how they feel.
I have been thinking about this topic quite a bit since interviewing Hip Hop artist Hopsin, who has been outspoken about his struggle with depression and suicidal thoughts. And in his new song “Alone With Me” he chronicles his own thought process of addressing his life issues. So, if depression is an opportunity for us to heal, how can we maximize the utility of our depression to address the issues that we face?
First and foremost, we must challenge the stigma of mental illness that leads us to judge and criticize people who struggle with depression. Just as we give people who experience sickness care and compassion so they can heal, we need to consider depression to be part of a larger coping process that allows someone to address whatever issues they are facing. This could include anything from simply not criticizing a depressed individual, all the way to helping them clear away work, social and household duties and making them as comfortable as possible in order to address whatever issues they may face. And just as we would not force a sick person to socialize or work to make them feel better, we should not push depressed people into these activities before they are ready. Similarly, we must fight the temptation to stigmatize ourselves for depression and show ourselves this same compassion by letting ourselves heal.
Second, we need to encourage people to see depression as an opportunity for healing. In the case of depression, that means helping an individual directly address whatever may have triggered the depression. That could include being willing and available to talk someone who is depressed about what they are going through or helping them seek out treatment of some kind. Depending on the hypothesis of what is causing the depression, this might include counseling or it may include medication to address biological issues that are perpetuating the depression.
Finally, we must resist the strong temptation to think that depression disconnects people from their identity. When we are depressed, we often feel like a different person, completely disconnected from our purpose in life and the roles we play. But if we can see depression as an opportunity to recognize that there is something that is occurring in our lives that is interfering with our achieving those goals, we can reinterpret our depression as our mind and body’s way of telling us we need to tend to that issue. From this perspective, taking care of ourselves when we are depressed is something we do to assert who we are and what we want in life, rather than something that represents weakness and a retreat from our goals and purpose.
To be sure, depression causes tremendous suffering for the depressed individual and the people who care about that individual. Viewing depression as an opportunity to heal should not in any way minimize or trivialize the pain that depressed people feel. But out of respect for that pain and suffering, it is crucial that we stop stigmatizing depression and depressed individuals and treat depression as an opportunity to heal rather than an excuse to judge. In doing so we give depressed people the best opportunity to address the issues they face that may be perpetuating depression and retain the respect and dignity they deserve.
