Depression: A Conversation That High-Society Needs
When she was in her mid-20s, Sasha (not her real name; other details have been changed to protect her privacy) tried to jump from the 28th floor of the condo she was staying in. We heard it was a maid’s timely intervention that kept Sasha from killing herself. Due to the nature of the incident, only a few of us friends of Sasha were allowed to visit her at the famous, swanky tertiary hospital where she was confined afterwards. This would not be the only time she would try to self-terminate.
“All in all, in the maybe 5 or 6 years of that period, I probably made suicide attempts at an average of twice a year,” Sasha now tells me, many years after that incident. Sasha is from a prominent family with a name and pedigree that is easily recognizable—and so she’ll remain unidentified in this story. Now in her late30s, Sasha is still uncomfortable about talking to others about her condition: she’s been diagnosed as having Bipolar Mood Disorder Type 1.
Bipolar condition used to be known as “manic-depression”. This means that her moods can go down to debilitating lows that can, as what happened in her 20s, become a near-fatal, suicidal bout of depression. Or, her moods may also go into the opposite direction and she could become extremely happy, loud, talkative, and a bouncy ball of energy. Usually, Sasha has no problem when she’s in her “up” or “manic” phase. It’s the depression phase that she has more difficulty with.
Depression, as a mental illness, has become a hot topic this year after the death of Hollywood star Robin Williams from suicide. Suicide is too often the fatal result of untreated depressive illness. Sasha, however, has a mixed reaction to the worldwide attention given to depression due to Williams’ death.
“Sure, there’s more awareness about depression as a disease. Awareness, yes. But understanding? The reason why I don’t like talking about depression and bipolar illness is that so many people have wrong ideas about it. It’s frustrating. I don’t have the energy to keep on correcting them.
“My main beef with people when it comes to depression is this: they always think that when you’re depressed, you’re sad. They just don’t get it that depression is not sadness. It’s something much worse,” she said.
What is depression, exactly?
It’s very common for people to think that depression is all about feeling sad. And yes, sadness can be one of the symptoms of depression—but it’s just part of it, and it may not even be the most significant or problematic aspect. “Depression” in the context of this article, is a medical term that refers to a mental illness or a mood disorder. People who have depression, contrary to what some may think, are not “crazy” in the usual sense that we use the word.
And while suicide is a very real risk for those suffering from depression, medical science has come a long way in making depression treatable and manageable so that the risk of suicide among depressives is significantly reduced. However, widespread stigma and misunderstanding of depression are serious obstacles that are keeping many people with depression from receiving proper medical care and social support.
The World Health Organization defines depression this way: “Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Suicide results in an estimated 1 million deaths every year.”
Depression symptoms are not so easy to recognize because it’s easy to think that they’re due to fatigue, exhaustion, stress, or “laziness”. The Natasha Goulbourn Foundation, a non-profit organization dedicated to promoting the correct understanding of depression and helping depressed and suicidal persons, lists the following symptoms of depression on its website:
- Low mood or “down” feeling
- Lack of appetite or eating disorder and weight loss
- Fatigue or loss of energy and restlessness
- Intense Anxiety, agitation and inner tension
- Withdrawal from normal company (family, friends and co-workers)
- Depressed or low mood
- Loss of interest and enjoyment of ordinary activities of daily life.
- Reduced energy, being easily fatigued, diminished activity
- Marked tiredness on slight effort
- Reduced concentration and attention on a task
- Reduced confidence and self-esteem
- Feeling of guilt and unworthiness
- Bleak and pessimistic views of the future
- Ideas or acts of self-destruction or suicide
- Disturbed sleep
- Diminished appetite and libido
- Unexplained physical symptoms
Stigma and recovery
Sasha remembers a trip to Europe that her family took, where they were joined by some friends, including the matriarch of another wealthy, prominent family. Off-handedly, Sasha mentioned to the woman something about being depressed. The matriarch looked at her in disbelief.
“She looked absolutely bewildered, like I had said something that was out of this world. Then she told me, ‘What the hell could you possibly be depressed about?!’ Now, Ramil, do you understand why I don’t like to talk about depression with members of so-called ‘high society’?” she said.
The matriarch’s question was reasonable. After all, if one has been born to wealth and privilege, with all of one’s needs being met without a hitch, with trips to Europe and designer clothes, and luxuries denied mere mortals—what right does one have to be depressed?
The answer to that, of course, as Sasha and those with mood disorders know, is that one cannot control the symptoms of depression simply by “cheering up” or by exercising willpower. The problem is rooted in an imbalance of chemicals and neurons in the brain: a biological, physiological cause that does not respect one’s bank account or social status. As the case of Robin Williams proves, even a Hollywood A-Lister is not protected from the fatal effects of depression.
“The truth is, Ramil, a lot of people from high-society are uncomfortable about mental illness. It’s not because they’re conservative but because they are so under-informed. This is why I don’t even talk to my parents about my condition anymore. They just don’t understand. Also, whenever this topic comes up, my parents become confused. They don’t know what to do. I end up feeling guilty over having them go through that kind of discomfort. So most of the time, I just keep my symptoms to myself and only ask help from a few friends who know and are able to understand. And really, unless you have this condition, unless you have gone through depression, you will never know what it is truly like to have it,” she said.
On top of managing her symptoms, Sasha is also dealing with the break-up of her 10-year marriage.” I’ve kept the break-up a secret. Because I didn’t want people talking about it. What I did, after we broke up, was go to the States for a few months. Then I got back here and thought about what else to do with my life,” she said.
I had to ask what the effect of the break-up was on her symptoms. “Well, as expected, I was depressed for a while but then the break-up also made me realize that my life, my happiness really depends on me and not on any other person. It’s really a choice: do I let this disease, this destroyed marriage break me or do I get up, move on, and live? I choose to live.”
Nowadays, Sasha copes by making sure to see her psychiatrist as often as she needs to. She takes her medications, which include Seroquel and Rivotril, and also receives Cognitive Behavioral Therapy. She accepts that her condition is chronic and may last for many years to come.
“I’m a very practical person. When I was diagnosed with bipolar, I just told myself, ‘Okay, so I have this. What do I do next? How do I deal with this?’ I always have my medications with me, so I can take them as needed. I’ve given a few friends the phone number of my doctor, so that in case something happens, they have the authority to call my doctor up for help.
‘The most difficult thing for me is the exhaustion. It’s exhausting to deal with these symptoms and also deal with external problems involving work and relationships. As you know, the difficulties in life can become double for people like us, who have to deal with both internal and external challenges,” she said.
Then there’s the stigma about mental illness that she has to worry about. “I know this lawyer who was seeing a psychiatrist. He wasn’t crazy. He just needed that kind of medical help. But you know what? Someone complained to the IBP (Integrated Bar of the Philippines) and questioned this lawyer’s fitness to practice law. And that lawyer was disbarred! So it’s really risky when you come out has having depression or bipolar because your competence in performing your profession or running your business can be questioned.”
Very few members of high society are willing to come out and admit to having depression, bipolarism, or other mental illness. There’s simply so much at stake for them to risk their reputations. Admirably, people like Patis Tesoro and Peque Gallaga have both come out and revealed their own struggles with depression. Tesoro and Gallaga have put their experiences with depression on record in the book “Down To One” published by Anvil Publishing, Inc.
As for Sasha and others like her, it’s simply better for them to manage their conditions and move on with their lives quietly. However, as a society, staying silent about depression and other mental illnesses will only increase stigma and force those with the condition to stay hidden and endure worsening symptoms—one cannot help but remember what happened to fashion model Helena Belmonte, who kept her condition secret, enduring her symptoms until she reached the breaking point and reportedly jumped to her death.
Now is the time to have real, honest-to-goodness conversations about depression and mental illness, whether in high society or not. This will help those suffering from depression and other mental illnesses to overcome the shame and the stigma and seek help. Ultimately, this will save lives.
RAMIL DIGAL GULLE's writing career has spanned journalism for print, TV, and online news; PR, marketing, and literary arts. He is a Palanca awarded poet, a past nominee for the National Book Award, and has published four books of poetry. Gulle's latest book, "Poisonostalgia", was recently published by UP Press. He is also an arts and culture columnist for an online news website. He is invited to panel in various literary workshops and conferences. He teaches writing courses for journalism, poetry, fiction, and creative writing. He became a mental health advocate after being diagnosed with Bipolar Type 2.
To know more about depression, suicide, and where to get help, go to the Natasha Goulbourn Foundation website at www.ngf-hope.com
If you are (or if someone you know is) thinking about suicide or self-harm, please remember that help is a phone call away. In the Philippines, please call suicide prevention hotline numbers at the Natasha Goulbourn Foundation: 02-804-4673 (HOPE), or 0917-558-4673 (HOPE). You may also call the Manila Lifeline Centre at 02-896-9191, or 0917-854-9191. In the U.S., please call 1-800-273-8255 (TALK). #suicideprevention #suicidepreventionhotline