Shawn Colvin is paying it forward. The Grammy award-winning singer is telling the world about her struggle with depression so that others can benefit from her experience. In contrast to her beautiful and uplifting songs such as “Sunny Came Home,” Shawn’s experience with depression has been anything but pretty. And that’s precisely what makes her willingness to step forward and share her personal story all the more powerful. Like many people who suffer from depression, Shawn at one point felt isolated and hopeless about anyone understanding or getting better. Hearing stories of depression from prominent and successful people like writer William Styron made her feel less isolated and more hopeful that recovery is possible. Now she is bravely sharing her experience as a message so that those also afflicted with depression can come out of the shadows.
Despite the documentation of depression as a DSM-5 mental disorder, many people still think of depression as a “sad mood.” But Shawn’s experience, like millions of others who suffer from depression, has been very different. Shawn told me, “It’s an illness. It’s a clinical, biological illness.” In fact, depression goes far beyond a sad mood; depressed individuals often can experience no pleasure, have no energy, can’t concentrate, and cannot sleep or eat. Shawn said, “It’s this hideous psychic pain. And there’s no pleasure or lightness.” More, the typical remedies that might improve a sad mood don’t work for depression. “The worst thing you could do is tell them to snap out of it. People say, go see a funny movie, your life is so good. Think of your spouse, your child, your job. And it just doesn’t work like that. Sunny days made it worse. Happy songs made it worse. Funny movies made it worse.”
Further, when people are depressed, they often can’t function in even the most basic tasks. Shawn recently told the Huffington Post, “To get from the bed to the bathtub is sometimes an impossible feat.” In fact, depression is now considered the second leading cause of disability worldwide, with many people experiencing severe dysfunction, particularly at work. Unfortunately, during depressive episodes, Shawn was often not able to complete the basic tasks of her job. The damage that depression can do to one’s career came into sharp focus when she received feedback from an annual festival at which she had routinely performed. “I was told I wasn’t really very good and I didn’t interact with anyone. I wasn’t asked back for years.” This may be a surprise to many, as we often assume that a negative mood fuels creativity. For Shawn, it was the opposite: “I wasn’t creative when I was depressed. When my depression got treated, I was creative again.”
It was after she was not invited back to this festival that Shawn began to recognize the stigma of depression and how, in our society, mental illness is treated differently than physical illness. She said: “I finally became really angry because if I’d had cancer and been ill and then got better — which I have — I’d be welcomed with open arms. I would have been celebrated.” Her perceptions are unfortunately consistent with research suggesting that many depressed people perceive that they will be discriminated against in a variety of circumstances such as work. And to an extent, the perceptions of depressed people reflect a reality: Stigma and discrimination against people with mental health issues is prevalent and widespread. In fact, evidence suggests that health-care providers and even some mental-health professionals hold stereotypes of people with mental illness.
This stigma has serious negative consequences. For many people, this stigma can interfere with seeking out care. In 1999, the U.S. Surgeon General labeled stigma as perhaps the biggest barrier to mental-health care. Research suggests that perception of stigma is significantly related to depressed people avoiding seeking care. Further, as people begin to experience depression, stigma may cause some people to try to avoid, separate from or suppress these feelings, all of which have been linked to the worsening of depression. That was definitely Shawn’s experience at first. She described herself as being in “denial” about her symptoms. She said, “It creeps up so subtlety and you just don’t want to believe it.”
But as her symptoms grew, the need to escape also became extreme. She initially sought escape with alcohol: “I medicated my depression with alcohol for many years.” Eventually things got so bad that she, like many people who suffer from depression, contemplated suicide. For Shawn, the desire for suicide was not necessarily linked to a negative event. She said, “It’s a natural response when you are depressed to look for reasons. But that’s not the case with me.” Rather, for her, it was simply the intense pain associated with depression and the fear that she would never recover that triggered suicidality. She said, “You do want out. If this is the way it’s going to be, I have to stop this. I’ve said all of these things: ‘I don’t want to be in this anymore.’ ‘I don’t think I can do this anymore.’ It’s unbearable pain.” She even went as far as to begin plans for her suicide. “I told my ex-husband, the father of my daughter, that if anything happened to me, that they should move into my house. I was making plans.”
One of the things that helped her have hope was realizing that others were struggling with similar issues. “I read books about people like William Styron who had been in the depths. It helped me feel less alone.” It seemed that people who had been through depression were in a better position to understand and to give strong advice. This caused her to actively seek out people who might be able to help. “Some people go into a hole and never come out. I just couldn’t suffer alone. And I was lucky I found good people.” Shawn’s experience is confirmed by clinical research. Meta-analytic reviews show that both depression peer-support groups and group therapy for depression are efficacious at reducing depressive symptoms. And based on her experiences, Shawn encourages others who may not seek help because they think they may be a burden or are embarrassed of their condition to also seek out help. “Would you think you were a burden if you were suffering from cancer? No, you’d be grateful for the support and do anything you could to treat it.”
This included finding good mental-health providers. You might think that the person who sang, “Please no more therapy, mother, take care of me,” on her song “Polaroids” would have an antagonistic view of mental-health care. And it took some time trying different practitioners and treatments. “After a few hard falls, I knew it could be treated and that it was just a matter of riding it out — as excruciating as it was. I knew I could get better.” But after finding the right mental-health-care provider and right combination of medication and therapy, Shawn is now a strong advocate of getting treatment. In this sense, her experience is common. Research suggests that the combination of medication and psychotherapy is the optimal treatment for people with more chronic or severe depression. And she is thrilled with the results. “I thought this is what it’s supposed to be like? This is what people walk around feeling? And I wasn’t euphoric, I was just balanced.”
As depression is chronic for many people, Shawn encourages people with chronic depression to approach treatment as one would any other chronic physical illness. “Everybody wants medication to be temporary. It’s not temporary for me. If I had diabetes would I think insulin is only temporary for me? It’s a lifelong thing for me.” But in accepting that depression can be chronic, one can then treat themselves as they would if they had other chronic issues. And her message is similar for others. “You’re sick. Treat yourself like a sick person. And that allowed me to forgive myself. Even though people don’t get it, you are sick. That provided me with comfort.” And accordingly, she encourages people to seek care the way they would for any other physical illness. “You can’t talk someone out of being diabetic. You need to give them hope, tell them there’s treatment and then give them that treatment.”
The World Health Organization estimates 350 million people worldwide suffer from some form of depression. And it’s time that we stop thinking of depression as simply a bad mood gone awry but rather, as Shawn says, “a brutal fatal disease. It’s that serious.” We never say to people with heart disease, cancer or diabetes, “You have such as great life, why do you have heart disease?” We need to start thinking of depression in the same way and to start treating people with depression with the same respect.
And for Shawn, if we take that approach, there is a message of hope: “Whatever it takes, tear down the stigma. It’s an illness. It can be treated. People get better.”
Image source: Michael Wilson, courtesy of Nonesuch Records
