The Cedar Lounge Revolution

John Waters, depression and sadness: Reactionary times… August 20, 2007

Another week, another column from John Waters [sub req’d]. Now, I don’t intend to make a habit of parsing his thoughts. I’ve got a few of my own on a range of other issues, from the bizarre introduction by Ed Moloney to the biography of Ruairí Ó Brádaigh to puritanism on the Left. But today’s is well worth at least a slight consideration.

Under the heading “Depressing new take on sadness” John, for it is he, steps fearlessly into debates on depression…

An Australian psychiatrist, writing in the British Medical Journal , has said something many of us think but are nervous about expressing out loud.. .

‘Nervous’? Surely not. And who is this ‘us’?

Prof Gordon Parker believes that the concept of “depression” has got out of hand. Doctors are diagnosing as depressed people who are merely “unhappy”. A low threshold for diagnosing clinical depression risks treating normal emotional states as “illness”, he argued. Prof Parker was challenged in the same edition of the publication by a fellow Australian, Prof Hickie, who said that diagnosis and treatment of depression had led to a reduction in suicides.

Okay.

But it must be obvious to most 10-year-olds that Prof Parker is talking sense and Prof Hickie talking through his hat. The number of prescriptions issued for anti-depressants is growing in the UK at the rate of about 6 per cent per annum, while suicide rates have remained static at a high level for at least a decade. The same is undoubtedly true of this country.

Unfortunately, this very day, figures released show that it is not true of this country. In a disturbing article in the Irish Times new research suggests that the suicide rate is probably higher than hitherto thought due to methodologies used in categorising them, and that:

These latest figures show suicide rates in the State have risen from nine per 100,000 people in the five-year period 1980- 1984, to 15 per 100,000 in the five years 2000-2004.

and that:

The researchers found that in 30 of the 47 cases the victim had experienced depression at some time in their lives. And fewer than half of suicide deaths could be attributed to alcohol.

In any case, there is, to my mind, something a tad distasteful about making a judgement on ‘depression’ from the suicide figures. The pressures and dynamics involved in suicide are radically different – albeit parallel on some axis – to depression in the population. This doesn’t deter Waters, and as we shall see arguing from the extreme to make a point about the general society is a tack he will take again…

Virtually every newspaper report about suicide nowadays cites depression as a major cause, implying that those who take their own lives do so because they suffer from some perhaps unrecognised clinical condition.

Some years ago, the leading Irish psychiatrist and then chairman of Aware, Dr Patrick McKeon, spoke about the nature of what is called depression. “Human beings, to live with themselves,” he said, “actually have a natural infusion of positive perspectives on things, and that enables us to keep going in life. When that’s taken away, that’s actually called depression . . . if anyone is really involved in life they are going to get depressed at some stage or other in their life. To anybody who says they don’t get depressed . . . I say, are you really that switched off.”

But McKeon is not saying that there is no such thing as depression. He’s saying that people do get depressed and that people must expect that in a life. And if one is willing to accept the likelihood of depression then one must also be open to the idea that there are means through counseling or medication that can alleviate that depression. What Waters is doing is subtly different as he continues…

Life can be tough. Bad things happen. We feel let down, sad. Sometimes we feel sad for no apparent reason. St Thomas Aquinas defined sadness as “the desire for an absent good”. In a society that persistently seeks to deny a higher meaning, it is not surprising that more people feel more and more sad, but we dispose of the evidence of our vacuity by defining them as “depressed”.

Waters is saying that depression isn’t depression, it’s merely sadness.

This is astounding stuff. Waters appears to be trying now to diminish depression as an aspect of our society and rework it as ‘sadness’, and a sadness which is the result of not having a ‘higher meaning’. And those who eschew ‘higher meaning’ are… the guru has spoken… vacuous. Look, I’m all for politics, but it’s not for everyone. Most people prefer to knock along doing their thing, and while that may put the project back I’m not given to whinging about their fecklessness.

Problem is that there is such a thing as clinical depression. To be honest I suspect much larger numbers of people are prey to it than the statistics demonstrate. I’m not really surprised. It’s not that ‘life can be tough’, it is that life is tough. It’s a struggle in this society or any society.

(Incidentally, on a slight tangent, the evidence seems to lean towards those who have convictions – whether atheistic, or theistic – as being those who, for example when facing death are best capable of dealing with it. Those like myself in the agnostic, not entirely sure, mode, are the ones who get it worst – natch)

But, as so often in the discourse presented by our centre right media the point is not the supposed primary issue of depression or the treatment of same, but instead a means of getting a good lash in against…why post-modernism of course!

There may be a moral dimension also, which again I require to cite an expert in order to outline. In The Frivolity of Evil, one of the superb essays in his collection, Our Culture? What’s Left of It, Theodore Dalrymple addressed the matter of what our societies term depression, which he argues has eliminated “the word and even the concept of unhappiness from modern life”. Dr Dalrymple worked for 14 years as a psychiatrist in British prisons and mental institutions, retiring in 2004.

“Of the thousands of patients I have seen,” he wrote, “only two or three have ever claimed to be unhappy: all the rest have said they were depressed.”

Get out of here! They’re in prison and they ‘claim’ to be depressed? Who knew?

This semantic shift is deeply significant, for it implies that dissatisfaction with life is itself pathological, a medical condition, which it is the responsibility of the doctor to alleviate by medical means. Everyone has a right to health; depression is unhealthy; therefore everyone has a right to be happy (the opposite of being depressed). This idea in turn implies that one’s state of mind, or one’s mood, is or should be independent of the way one lives one’s life, a belief that must deprive human existence of all meaning, radically disconnecting reward from conduct.

Okay, even noting that Dr. Dalrymple worked ‘as psychiatrist in British prisons and mental institutions’ it seems to me that that environment might not necessarily give the most complete picture of depression as it relates to the broader society, nor might the environment lead one to be – shall we say – as sympathetic as one might otherwise be.

Moreover, the semantic shift is irrelevant. If a patient presents saying that they are ‘unhappy’, or ‘depressed’ the function of the doctor isn’t to beat them rhetorically around the head for their temerity in not accepting that life is a vale of tears and in this instance most specifically a corrective institution, but instead to determine the severity of the depression and whether the person is suffering from clinical depression, a recognised disorder or from a more transitory depression of mood and do something about it. These are real and potentially serious conditions and disorders that blight lives.

And incidentally, for anyone who has any actual – as distinct from rhetorical – experience of depression of either flavour or those who have had depression it will be well known that the goal is not actually to be ‘happy’ but to achieve some balance where by ‘unhappiness’ doesn’t flood the day to day experience. That balance may not actually include ‘happiness’ to any significant degree. This has nothing to do with a ‘right to be happy’, nor is it about being the ‘opposite’ of depressed. There are many intermediate stops on that journey. But hey, why allow the complexity of the situation spoil the reality?

It gets worse.

He wrote about one patient, a woman who had lived a life of, to any objective assessment, outright misery. Having been raped as a child by her mother’s boyfriend “with the mother’s full knowledge”, she had herself chosen as lovers a succession of highly violent men, who had left her with three children. As a psychiatrist, he met many such women, who had chosen men “who had their evil written all over them, sometimes quite literally in the form of tattoos saying F*** Off or Mad Dog”.

So… these are ‘choices’ made as easily as I go into the canteen at work and choose between the Innocent smoothie or the unpleasant “Summer fruit” fizzy juice drink?

The woman is most likely in a prison or mental institution, John. That suggests that her problems are greater than the question of whether we concern ourselves if the unhappiness/depression she experiences is unhappiness or depression.

Incidentally, there are a host of potential reasons why a woman in such a position might indeed be attracted to an individual who was seemingly ‘strong’ or ‘impervious’. I know it’s a bad choice, but it is an understandable one. And I want to move onto a different aspect of this because Water’s argument flies very very close to the idea that those within abusive relationships are somehow to ‘blame’.

There is a glibness here that is quite – well reactionary actually.

Such horrors, according to Dalrymple, are the inevitable consequence of a culture of ideas in which the notion of personal responsibility has been eliminated. An “unholy alliance” between left-wing liberals and right-wing free-marketeers has made “a long march though the minds of the young”, elevating non-judgmentalism to the highest value and dispensing with ideas of personal responsibility in favour of total “freedom to choose”. When the individual chooses badly and encounters unhappiness, we decide she has become ill. Dalrymple’s only cause for optimism “has been the fact that my patients, with a few exceptions, can be brought to see the truth of what I say: they are not depressed; they are unhappy and they are unhappy because they have chosen to live in a way that they ought not to live, and in which it is impossible to be happy”.

So, by examining the extreme – a prison population – it is possible to build up a seamless theory of the broader society? Doesn’t seem like the best way to move forward – as well consider that the human dynamics in the Apollo 13 capsule as it fought its way back from the moon give a good insight into school organisation

And one has to ask, what is this ‘culture of ideas’? Where is this non-judgementalism? If any thing I see much the opposite. Unlike some around here I’m no fan of Big Brother. But one thing that it appears to promote, apart from a nebulous infantilism, is a sense that there are indeed red lines of personal responsibilities, that one must try to get along, not to upset others, etc, etc. Big Brother is explicitly judgemental when it comes to those who criticise core attributes of individuals, such as gender, race or sexuality. It just so happens that Waters doesn’t want to recognise that judgementalism may not be his judgementalism. And that’s at, as it were, one end of the market.

Yet again the straw man of non-judgementalism is dragged kicking and screaming out of the place where straw men are kept. One can ask, with all due respect, what on earth is Dalrymple talking about when he suggests that ‘they are not depressed; they are unhappy and they are unhappy because they have chosen to live in a way that they ought not to live, and in which it is impossible to be happy’ ? Without context such a statement is essentially meaningless. Taking the woman who was attracted to violent men. The social linkages created by the children would be such as to permanently embed her within a matrix that would make movement beyond it difficult, if not impossible. Educational, social and other issues would also impact. And she is, I reiterate, most likely in a prison or mental institution.

Of course she’s made bad choices, and of course it is broadly speaking impossible to be ‘happy’ in such a context, although institutionalisation brings for some a degree of acceptance, in itself a serious problem. But what on earth has that to do with people outside prison whose life choices have been circumscribed by many other factors which have left them depressed? What relevance does this column have to them? Because one very significant distinction between someone in prison and having their life experience and someone outside of it who has suffered catastrophic distress comes down to ‘meaning’.

For those who commit crimes the possibility of prison is at least an element of their mental horizon. But for someone in the broader society where ‘life is tough’ events can unfold with appalling rapidity, events that are entirely beyond personal control. Yeah, that might just lead to depression above and beyond how “they have chosen to live in a way they ought not to live”… But then we’d need a whole different column, making entirely different points and coming to a significantly different conclusion.

And here the argument is almost a mirror image of something that Michael Shermer of Scientific American has noted in a recent column on self-help manual The Secret by Rhonda Byrne. The Secret is, as Shermer writes:

… the so-called law of attraction. Like attracts like. Positive thoughts sally forth from your body as magnetic energy, then return in the form of whatever it was you were thinking about. Such as money. “The only reason any person does not have enough money is because they are blocking money from coming to them with their thoughts,” we are told. Damn those poor Kenyans. If only they weren’t such pessimistic sourpusses. The film’s promotional trailer is filled with such vainglorious money mantras as “Everything I touch turns to gold,” “I am a money magnet,” and, my favorite, “There is more money being printed for me right now.” Where? Kinko’s?

The advocates of the Secret argue that:

“Thoughts are sending out that magnetic signal that is drawing the parallel back to you.” But in magnets, opposites attract–positive is attracted to negative. “Every thought has a frequency…. If you are thinking that thought over and over again you are emitting that frequency.”

But as Shermer points out:

The brain does produce electrical activity from the ion currents flowing among neurons during synaptic transmission, and in accordance with Maxwell’s equations any electric current produces a magnetic field…The brain’s magnetic field… quickly dissipates from the skull and is promptly swamped by other magnetic sources, not to mention the earth’s magnetic field … which overpowers it by 10 orders of magnitude!

And Shermer notes that:

Ceteris paribus, it is undoubtedly better to think positive thoughts than negative ones. But in the real world, all other things are never equal, no matter how sanguine your outlook. Just ask the survivors of Auschwitz. If the law of attraction is true, then the Jews–along with the butchered Turkish-Armenians, the raped Nanking Chinese, the massacred Native Americans and the enslaved African-Americans–had it coming.

And they didn’t have it coming, anymore than someone who is suffering from depression, or clinical depression or whatever has it coming – even for the sake of a newspaper article.

So what’s the difference? Self-help gurus suggesting that positive thoughts will get you everything your heart desires or journalists suggesting that depression is really ‘sadness’ because that slots neatly into a discourse about responsibility and how those who say they’re depressed are really unhappy because of some existential angst caused by lack of responsibility and the inability to judge.

There is no real difference because each is built upon an avoidance of fact or knowledge in favour of ‘something many of us think ‘.

Think again.