A Society Despondent Over the Blues

If the Democrats have their way on Nov. 8, it’s a safe bet that George Bush will wake up feeling depressed on Nov. 9. Are we now to understand that this will make him not only a loser but a psychological cripple (read: invalid) as well? Should he view himself as fatally flawed, weak, or, perhaps worst of all, un-American if his mood takes a nose dive in the aftermath of an electoral defeat and he finds himself feeling (gasp) despondent?

Surely not, you say? Yet these are the precise implications of the recent flap over mean-spirited rumors that Michael Dukakis had experienced depression and had sought professional treatment for it.

Today’s malevolent rumormongers seem to know that merely using the word depression in the same sentence as a candidate’s name can arouse suspicion, fear and doubt in the public’s pliant mind. This suppleness exists when the public remains largely uninformed about the nature of mood disorders and of the important differences between psychiatric treatment, which is aimed at diagnoses of mental illness, and psychological help, which is designed to assist in swift resolutions of problems that quite “normal” people encounter as they go about the business of everyday living.

We Americans are intolerant of people (including ourselves) who are sensitive to emotional pain. We reject such qualities in our leaders--despite the fact that it is precisely such emotional sensitivity that also makes leaders passionate and compassionate.

This fact has important implications for every individual regardless of whether he or she ever aspires to high office or even cares much one way or another about November’s election outcome. And the issue has critical implications for mental-health professionals concerned with the prevention of depressive illness--America’s No. 1 mental-health problem.

What we find so intolerable in our leaders we find similarly unacceptable in ourselves. When we feel depressed, then, we criticize ourselves for being weak, inadequate and inferior to others. In short, we get down on ourselves for feeling down. The result is a deflation of self-esteem, inflation of guilt and exaggeration of depression’s hallmarks: helplessness and hopelessness. In turn, the very problem we seek to resist paradoxically persists.

As the self-flagellation is heaped on, the low mood is compounded. Attacks on self-esteem and self-worth are escalated until a vicious cycle is firmly entrenched. With the additional “stigma” of seeing headlines about seeking professional psychological treatment, the sufferer is faced with a no-win choice: Either she or he shuns the help of a professional, in which case the symptomatic sensations of hopelessness and helplessness are exacerbated; or he or she seeks help and adds to the litany of self-contempt the brand of “invalid.”

Either way, this is wrong and dangerous thinking. It is the person who suffers in silence who runs the risk of severe mental illness.

One need not be psychiatrically or severely depressed to identify with the syndrome of self-blame, self-criticism and low moods. Major depression, though highly prevalent as compared with other forms of serious mental illness, still only affects a minority of the population--an estimated 15% of American women at any point in time and about half as many men. But even severe depressions, as well as moderate and milder forms, almost always begin with a sad, low or blue mood.

And just about everybody gets the blues. In a recent Gallup survey that I designed and analyzed of 1,000 working women nationwide for a book on the subject, fully 93% admitted that, with varying frequency, they “feel depressed, have the blues, or get down.” Almost half the sample indicated that they struggle with low moods once a month or more often. Recent research indicates that negative, irrational and self-flagellating thinking can turn an otherwise benign bout of the blues into a more prolonged, serious and even debilitating episode of depressive illness.

Mental-health statistics portray women as two to two-and-one-half times as likely to suffer from depression as men. Why this may be true has not been adequately explained, although one compelling reason may be how women, as compared to men, respond to the onset of a blue mood. Women respond to sensations of sadness and depression by becoming physically inactive and engaging in self-blaming rumination; men, on the other hand, generally respond by engaging in physical activity and distracting themselves through work or other endeavors.

Also, women are particularly vulnerable to physicians’ tendencies to overdiagnose depression in females and therefore to overprescribe medication to induce mood elevation and tranquilize anxiety. As a consequence, women rely on a “solution in a pill bottle”instead of developing drug-free behavioral and mental activities that will counteract depression and give them an enhanced sense of control.

Stressful life events are part of living; and occasional mood slumps, the blues or other common forms of depression are natural responses. Without the lows we wouldn’t experience the highs. Perhaps the country might be better off with a more compassionate President instead of one who is laughing all the time.