A full house was on hand for Wednesday’s (May 2) panel discussion on coping with stress, a “Caring for the Harvard Community” event. Facilitated by Families for Depression Awareness — a nonprofit organization founded by speaker Julie Totten after her brother committed suicide in 1999 — the talk focused on stress and its relationship to depression.
Paul Barreira, a psychiatrist and the director of Harvard’s Department of Behavioral Health and Academic Counseling, started the meeting by presenting some disturbing statistics, including that 60 percent of students consistently report feeling “overwhelmed” and up to 14 percent are diagnosed with depression — though nearly double that number believe their depression has reached clinical levels.
Totten then outlined the symptoms of depression — including anxiety, trouble concentrating, changes in diet and sleeping habits, aches and pains, alcohol or drug abuse, and feeling sad, empty, or irritable — and encouraged audience members to reach out to friends or family they believe might be depressed or even stressed, as there is a high correlation between the two conditions.
Until the past few decades, said Edward M. Hallowell, author of “Crazy Busy: Overstretched, Overbooked, and About to Snap!” (Ballantine Books, 2006) the predominant model for viewing depression was that it stemmed from moral weakness or even satanic possession. “This religious view held like a clamp for thousands of years,” he said. “People were cast into dungeons because they were depressed. ‘Try harder, and if you don’t, we’ll hit you or put you to death.’” Thankfully, he noted, though echoes of this outlook remain today in the condemnation and shame sometimes associated with the disease, the medical model that developed in the past century has done “wonders to free us from the tyranny of the moral/religious model.”
Still, the medical model, he noted, is far from ideal. “It’s all about what’s wrong,” he said, “‘Tell me where it hurts,’ all about pathology.” Hallowell suggested it’s time we adopted instead a new, “strength-based” model. “Most people who suffer from depression are gifted,” he said, “and we need to be much more in the business of unwrapping gifts than we are.” Hallowell gave an example of how to view a psychiatric diagnosis from a position of strength: When he has patients with attention deficit disorder (ADD), he said, he tells them, “You have a racecar brain with Chevrolet brakes,” giving the “upside as headline, and the downside as footnote.”
He tries to avoid telling patients they have a “condition,” he added, “because I don’t want them to be part of this … stigmatized group.”
Stigma is something with which the day’s final speaker, Massachusetts State Sen. Robert Antonioni, was well-acquainted.
Antonioni, too, had a brother who committed suicide, and that event turned out to be a wake-up call for the senator himself. “At that point the illusion went away,” he said, “that somehow in my family we were protected.” When Antonioni began seeing a counselor to deal with the loss of his only brother, he said, “I realized I had a problem too, and had often been moody myself. Things that other people would bounce back from would lay me out. It became clear to me I was depressed. My marriage was struggling, I didn’t have energy, and I wanted to avoid crowds.” In one of the many light touches of his talk, Antonioni added, “needless to say, avoiding crowds didn’t do much for my career as a politician.”
That career, however, also kept him from getting help. First, he was reluctant to seek therapy. For a long time, he avoided medications, afraid his constituents would view antidepressants unfavorably and that a prescription might someday prevent him from becoming a judge. When he did start taking the drugs, he purchased them incognito at a CVS in Acton, Mass. And until recently, he refused to talk about his illness in public. As he went through the stages of accepting his disease, however, he realized “the truth is I want to do the full monty,” setting an example of how to live successfully with depression.
“We wouldn’t have a conference here at Harvard about coping with allergies,” he said, regarding the stigma of mental illness. “It just says something about our society.”
The stigma of which Antonioni spoke is both a cause and a result of the social isolation that often accompanies depression, and all of the speakers emphasized that, as Hallowell put it, in this context, “social isolation is as much a cause of death as cigarette smoking.
“The most powerful intervention is a relationship,” he continued, “a person. Listen to your gut feeling that says this person is in trouble. Most people ignore their gut feeling because they don’t know what to do.” What should friends and family do to help someone who is stressed and may be depressed? “Take it upon yourself not to take ‘no’ for an answer” when reaching out to get that person help. And if you feel yourself becoming depressed or reaching a turning point in your stress load, Barreira added, “create a connected life for yourself. Learn how to say no, not to over-commit. Prioritize. And take back any control you’ve given away.”