We need to talk about depression and ways to jump off the building

caption (image above): A photograph from Alphonse Bertillon’s photo album from his exhibition at the 1893 World’s Columbian Exposition in Chicago.

Mental Illness and depression, in particular, have been the talk of the month, given that the confinement has sparked new conversations about social interaction, human kindness and wellbeing and, of course, the lack of support (medical, but not exclusively) when it comes to mental illness. The other day I witnessed something that turned into a symbolic event for what I feel is happening within our society. The description of such event won’t be pleasant, but it’s necessary to paint the picture. To sum it up and rip off the bandaid, what happened was I saw a homeless person take a dump in a busy street, in Lisbon, in the middle of a hot summer afternoon. I wasn’t the only one witnessing it, a lot more people did. I agonized over it for a couple of days. I feel this event is symptomatic of how we, as a society, deal with the idea of “the other”. The person who did this has been rejected and marginalized for years, so he “ends up” behaving as a sub-human. Our societies tell us we need to pick up after our dogs, when they poop on the streets, but we keep dehumanizing those who have less conditions than we consider necessary to live a dignified life, thus often reinforcing the ostracization that derives from poverty. Can anyone be mentally healthy in such circumstances?

There’s nothing odd about my familiar, historical or cultural context. I was dealt a good hand. Grew up in the countryside with lots of space to explore and experiment. My parents are both educated. They both struggled, but managed to find each other, start a family and made sure my brother and I had good opportunities, particularly regarding our education. My brother and I did not go to kindergarten. We didn’t have grandparents who cared for us and both our parents worked, so we grew up at home with sitters who cared for us. We were never attached to material stuff and were both very creative regarding our occupations and play. As things would have it, we both turned out to be creative practitioners.

However, I’ve always struggle to identify with others and since I can remember I’ve been a bit of a lonely rider, anti-social, pessimistic and pensive. I’ve suffered from depressive periods since the age of 13. It never ceased. Because I had two major depressions, I also know the difference between both states and how depressive periods evolve into paralyzing conditions. I had my first major depression when I was 24 and the second about 12 years latter. After recovering from the first, I thought I’d never let it come to that again. I thought I’d be able to prevent it, recognize the signs and act accordingly. That wasn’t the case. The first depression was more public. I was younger, more dependent, less responsible and after “walking around” for some months with a paper from a doctor that recommended I’d be hospitalized, I finally caved in and asked to be institutionalized. I spent a month in a hospital and it was good, it saved my life back then. I recovered, but kept repeating the pattern, regarding ways to escape the condition. Fast forward ten years and it was a completely different scenario. Apart from my partner back then and a couple of close friends, no one really knew what was going on. I don’t think those who are closer can ever be faulted for not acting, though that can be difficult to process. Depression and addiction can have a lot of similarities when it comes to the gap between our private and public lives. We tend to hide and pretend. The second time I was older and had a lot more responsibilities, so although I talked about being hospitalized with a psychiatrist and a therapist, I couldn’t organize my life to have that happen. I kept working and maintained the appearance of being highly functional. I didn’t want to make my condition public and being committed to an hospital would obviously have that effect. Because I resisted that and let the stigma affect me, it kept getting worst. Obviously, I survived, with the help of an alternative therapy that changed my life and with the decision to stop all consumption of substances.

Having spent so many years dealing with this, I empathize a lot with people who struggle with mental illness and addiction. The percentage of students that come to us wanting to talk about their depression has been growing, but stigma not only prevails, I actually think it has gotten worst. So, although I agree we need to talk openly about depression, in order to break the stigma, what is really necessary is to act and strengthen the support system. But, at least in Portugal, it will take decades, for the stigma exists in one of the fundamental places where help should spark: the medical community. There’s no time or will to tell about my experiences with doctors thruout the years, but one thing is certain: they’re part of the problem. Both people with mental illnesses and addiction are ostracized by the system. It’s quite incredible to experience and watch. Most doctors will think of cancer as a chronic illness in need of a rapid intervention and a carefully designed treatment, but they’ll see mental illness as something abstract, almost of the order of the imaginary. Addicts suffer from something similar, meaning the idea that “it is your fault”.

Though addictive behaviours regarding conventional drugs are decreasing in newer generations, depression grows like the sort of weed that rises from every crack. Newer generations might have it worst than we did, given that their social environment is fragile and often dependent on virtual interactions. Newer generations also lack autonomy, so they might be less resourceful when it comes to surviving amidst adversary conditions. When students approach us with an idea to create a visual essay about mental illness, 99% of the results are surprisingly traditional and redundant. The idea of “normality” prevails, reinforcing the idea of “the other”.

But what are the criteria for normality? And how does society idealize madness based on what it identifies as pathological? Foucault proposes that we look at the epithet of madness as the negative and virtual reflection of a society that marginalizes everything that comes out of the norm, especially for the potentialities that this deviation announces. The lack of conformity settles in a threat of incompatibility that denounces the fear of disintegration of the Self, through madness. Hence, the problem of the idealization of madness can be summed up in the idea that “our society does not wish to recognize itself in the ill individual whom it rejects or locks up; as it diagnoses the illness, it excludes the patient” (Foucault, Mental Illness and Psychology). In other words, we live in a society that excludes and fables at the same time. Foucault identifies a moment, in the 17th century, when idleness becomes one of the greatest threats that the “mentally ill” represents to society: not being able to participate in the production, circulation and accumulation of goods, the patient is accessed as invalid and then removed from the production scheme, meaning institutionalized. Thus are born the spaces of exclusion that survive until today, although in very different ways. We live in a cynical society which affirms itself negatively, needing to exclude in order to capitalize: “…madness was insered in the system of moral values and repressions. It was enclosed in a punitive system in which the madman, reduced to the status of a minor, was treated in every way as a child, and in which madness was associated with guilt and wrongdoing.” (Foucault, Mental Illness and Psychology)

If mental illness faces stigma, death battles a higher monster: the tabu. My generation idolized suicidal tendencies, projected in the lives of creative genius like Janis Joplin, Jimi Hendrix, Jim Morrison, Kurt Cobain or Jeff Buckley, to name but a few. But these people existed in a far away land – that of the idols. When it got closer and we started to see friends choose death, over life, it was a different matter, or no matter at all, for talking about suicide is still a tabu. There’s the religious background to which our society still bows to, informing us that life is a blessing and we must endure suffering, for its design is of a higher order. I think those who perpetuate this idea have little clue of what depression feels like. Major depressions always come with suicidal tendencies, there’s no beating around the bush. That death drive is so intense that it prevents one from committing to life. Again, regarding this aspect, depression is much like addiction: those in need of help can only be helped when a decision to choose life over death steps in, even if that’s not fully processed on a conscious level

The media perpetuates the tabu of not talking about suicide. The argument remains the talk about the Werther effect, supported by some studies that say talking about suicide and its specifics can trigger copycat behaviour. After many years of different therapies, I finally encountered an alternative therapist willing to talk profoundly about death and ethical ways to die. It was a game changer. After many years of talk therapy, I finally ventured into different approaches and, today, I feel talk therapy (psychoanalysis, psychotherapy and all the cross versions that exist) won’t save someone suffering from depression, nor will prescribed drugs such as anti-depressives. That does not mean it won’t help, it can, but in certain cases it only guarantees the patient maintains his/her survival alive. In general, the system offers strong resistance to everything that is considered alternative (microdosing, regression, xamanic interventions, etc.), but fortunately for some, we do not need the system to tell us what we can and cannot do. Of course, here, as in many other situations, information and money come into play.

Though, for most, jumping off the building sounds like no solution at all, when in great pain, that might feel like the only way out. As most who survive suicidal attempts know well, the act itself is no solution, only the result of the condition, that somehow could not be prevented. From the outside, it’s easy to say it could have. Recently, in this country, a well-known personality committed suicide and the most outrageous thing I’ve heard about it was said on prime time, on national tv, by a journalist, who condemn the act because the person in question would not have thought about his sons and daughters and what would be of them, thus condemning him for being irresponsible and egotistical. The nice way to jump off the building would always be to choose life, over death, but what most experience for months – if not years – before committing suicide or attempts, is excruciating pain and survival modes. In such circumstances (and so many other) living a pleasurable life is fiction.  

The idea that someone suffering from depression or addiction needs only “strong will” to break the cycle is a joke, no other qualification comes to mind. Engagement is the only way out. But suffering from depression or addiction kills any sense of pleasure in life, so seeing the light at the end of the tunnel becomes almost impossible. Talk therapy and pharmaceutical intervention can help achieve some sort of chemical/mental state where the idea of pleasure becomes possible, but there’s no miracle cure that serves all. I’ve recently saw two good documentaries that can shine a light on what major depression feels like, namely: Can Magic Mushrooms CURE Depression?, and Hunting for Hedonia.

In Portugal, a recent event evolving photography and mental illness triggered some controversy, though not an informed debate. Our critical mass is mediocre and often inexistente, so nothing different was to be expected. If you can imagine, a fashion magazine, namely Vogue Portugal, had the ingenious idea to do a “madness issue” and the cover, following that brilliant idea, turned out to be hilarious. Some people were offended and said the magazine attempted to “glamorize mental illness“. Again, a joke. Fashion has been doing that for ages, just think about the straitjacket and the countless times it has been “glamorized” on runway shows. Fashion picks up every societal issue and attempts to turn it into a trend, giving it a “cool look”. Sometimes, people are aware of that and what they consume, but most of the times, they’re not.