marie claire Shines A Light On Depression

When Fiona Sawyer first experienced depression at 19, she felt so worthless, exhausted and fragile she spent days hiding in bed feeling downcast or hysterical. "I was filled with self-loathing and repeatedly told myself: 'you are a hopeless,' 'no-one loves you', 'you're not worth anything'," recalls the 36 year old events manager from NSW.

On her darkest days, Sawyer thought about taking her hands off the wheel while driving. Only years later in counseling did she realise her malaise was due to generalised anxiety disorder triggered by moving out of home and starting university.

"Some friends tried to help though many didn't know what to say or do," she explains. "Other people saw me as a 'drama queen' or attention seeker. It was incredibly hurtful and made me feel so alone, because I felt no-one understood."

The comments were Fiona's first experience of the hard slap of depression's stigma. "Many people judged me as weak, self-indulgent and wallowing in self-pity and self-made problems," Fiona recalls. "It made me shut up about my emotional pain. But I didn't need anyone to get down on me -I was so hard on myself. I felt so ashamed because I couldn't cope." Thankfully a combination of counselling and antidepressants helped her find her way out of the dark tunnel.

Mental illness is such a serious problem that by 2020, depression will be the second biggest killer, after heart disease, says the World Health Organisation. In Australia more than three million people experience mental illness each year and one in five women and one in eight men will experience depression in their lifetime, according to beyondblue, the national depression initiative. The take home message? Each one of us could one day find ourselves facing the stigma of depression or at the very least, will know someone affected by it. Studies show that once a person has suffered one period of depression they are twice as likely to experience another, although they may go for years before another episode.

"Just before I became pregnant with my first child, now aged one, I came off medication and my depression returned with a sudden, frightening intensity," Sawyer explains. "It was terrifying to feel myself sinking back into that black hole, Thankfully, this time I received a new repertoire of coping strategies from my counsellor. But the fear of being stigmatised still remains. I was fearful I might lose my husband after he saw for the first time the severe effects that depression has on me. I thought he might stop loving me even though we had been together for over six years. Thankfully, he has been incredibly supportive, just like my family."

From puberty onwards women are twice as likely as men to experience depression, says beyondblue. "Major life events such as pregnancy, motherhood and menopause are often triggers," says Nicole Highet, beyondblue's Deputy CEO. Yet despite countless media campaigns aiming to demystify and de-stigmatise depression, Australian attitudes seem to be caught in a Jane Austenesque time warp. In many quarters it seems men who cry are still derided as weak and women who suffer depression are characterised as hysterical and self-indulgent. In short, we still blame the sufferer for their condition."

"This is particularly true if the depression is not caused by an obvious trigger like a loss or relationship break-up," says Helen Christensen, Executive Director of Sydney's Black Dog Institute, an organisation involved in mood disorders treatment, education and research.

The problem concerns and frustrates Kathy Griffiths, Deputy Director of the Centre for Mental Health Research at the Australian National University who points out that depression has profound impacts on brain chemistry and physical as well as emotional health. "Imagine if you had a heart attack or breast cancer or diabetes and it was treated as though your illness was just in your head," Griffiths says. "Imagine being told, and telling yourself, that you were weak and that you should just snap out of this illness. Imagine if you were unable to access the treatment and services that could fix your life threatening illness and had no job or nowhere to live because of this illness. Sadly, this is what is happening to people with depression every day."

Of course there have been improvements. In the noughties we are more open about admitting to depression as evidenced by celebrities like Gwyneth Paltrow, Ashley Judd, Uma Thurman, Catherine Zeta Jones and Beyonce, who have spoken publicly about their conditions. Yet you only have to scratch below the surface to find detractors, as Brooke Shields discovered when publicly chastised by Tom Cruise for admitting that antidepressants helped her overcome her post-natal depression.

Organisations like Black Dog Institute have been doing their best to overturn unhelpful stereotypes that paint people with depression as weak and wallowing. Despite the enormous amount of money being thrown at the problem, the stigma still remains. But the reality is that this problem can't just be dealt with by the government.

At a grass roots level, in our homes and our hearts, Australians need to make-over their attitude towards depression. "It would greatly help if we acknowledged that surviving depression requires toughness and resilience," says Barbara Hocking, CEO of SANE, a national charity that educates people with mental illness and advocates on their behalf. "There is a real strength in reaching out for help when you’re depressed."

Recent research by SANE has found that three out of four people with mental illness experience stigma and discrimination. The stigma spills over into every aspect of life. A recent beyondblue survey has found that between 45 and 67% of people with mental illness have problems getting income protection insurance. "This kind of prejudice is often as debilitating as the symptoms of depression," says Hocking. "People with mental illness are often regarded as violent, incompetent and unpredictable, which makes them fear ridicule and rejection. This stigma can alter how they see themselves."

Unsurprisingly, depression is often hushed up to try to protect the person affected from being labelled as unbalanced and unreliable, particularly in the workplace. "One in five Australian people say they would not like to work closely with someone who suffers from depression while one in five also say they wouldn't employ someone with the condition," Griffiths explains.

When applying for a job there is no legal requirement for people with depression to reveal they have a mental illness, unless it prevents them from fulfilling their job description. However, if you suffer depression and need some work flexibility, the condition is a recognised disability under the 1992 Disability Discrimination Act. Each year in Australia undiagnosed depression costs $4.3 billion in loss of productivity due to things like absence.

"Whether it is helpful to disclose depression really depends on the individual's circumstance and their work culture," says Nicole Highet from beyondblue, which is trying to educate employers with its national workplace program that has thus far been run in more than 400 organisations.

For Ally Kearney, a 31 records co-ordinator for local government in Melbourne, the fear of being stigmatised as silly, navel-gazing, weak or crazy meant she made three doctor's appointments at the age of 21 before she managed to talk about the depression which had affected her since the age of 16. At age 29 her diagnoses was changed to bipolar disorder. It was an enormous relief because it finally explained the periods of depression, where she withdrew and felt disconnected and periods of mania, where she would stay out socializing every night and take on too many projects.

In her last job of three and a half years, Kearney's employer knew of her mental health issues and was supportive, particularly two years into the job when she experienced an episode of depression and was voluntarily hospitalised for a month. On her return, her co-workers clearly wanted to help but some presumed her depression meant she couldn't handle any stress. She was also told someone in middle management had now lost all faith in her as promotion material. "It made me feel I had to work twice as hard as anyone else to prove my abilities," she explains. As a result Kearney has only just told several colleagues in her new job of eight months that she suffers from depression. "When you reveal you suffer depression it can be a very vulnerable place," she says. "Some people clearly feel afraid of you. Some steer clear. Or they blame you. What really helps is when you get that rare person who doesn't treat you like a child or a whinger but says – tell me what it's like to be depressed and if there is anything I can do to help you."

Depression is often the elephant in the room. "People find conversations of support very hard to start so they say nothing or say something very unhelpful such as 'life can't be that bad'", observes Griffiths. Concerning beyondblue research shows that 45% of people believe it best to 'keep out of someone's way and giving them space' when they are depressed while 34% think that telling the person with depression about their own problems would help them put things in perspective. In fact both these responses make the situation worse.

"When you're depressed you don't want anyone to fix you or to tell you someone is far worse off as this makes you feel ashamed," agrees Jen Ward, a 37 year old communications manager from Sydney who suffered post-natal depression twice after the birth of each of her two sons, now aged two and seven. "I shared my feelings with close long-term friends but clearly I worried about stigma. I didn't tell the women at mother’s group that I had PND because I thought I should have been coping better. Often all you need is someone to listen and believe you so you don't feel so alone."