IN 1945 Holden Caulfield was clinically depressed. His parents denied it. His friends ignored it. His teachers talked over it. Holden knew it, but the world would not listen. And in 1999 it still won't.
Depression and depressive disorders are not like the normal ups and downs that all of us experience. They are illnesses that affect mood, body, behavior and mind. Though often lumped together by the public under the terms "depressed" or "manic," depressive disorders take many forms.
Dysthemia is chronic, mild depression. According to the National Institute of Mental Health's Web site, people with dysthemia are depressed most of the day -- and more days than not -- for a period of at least two years. Major depression is an intense form of dysthemia, and in both cases, those afflicted often feel a sense of helplessness, hopelessness or despair.
Manic depression is an illness only now entering the public consciousness. It causes mood swings that take people from "manic" states of feeling euphoric and energetic to depressive states of utter despair.
Depressive disorders affect a staggering percentage of the population. According to one study cited by NIMH, 17 percent of Americans will suffer from major depression at some point in their lives, and 6 percent will be afflicted by dysthemia. Overall, more than 19 million Americans will suffer from a depressive illness each year. It is by far the leading cause of disability in established market economies worldwide. According to NIMH, depression costs the nation more than $30 billion each year in direct and indirect costs. And then there is its incalculable effect on people's lives.
All of this suffering is unnecessary. Available medications and psychological treatments can help 80 percent of those with depression. Yet -- and this is the saddest statistic of all -- only one in three depressed people actually seek treatment. There are innumerable reasons for this failure to seek help. The stigma of the term "mental disease" is a culprit. The term conjures up images of Charles Manson, straitjackets and asylums. To seek treatment for depression is to associate oneself with madmen.
Most often, however, people do not realize they are sick. All of us experience life's ups and downs. There are days we just wake up sad, and for some these days turn into weeks, and before long they don't remember what it's like to be happy. Depression becomes the baseline and they don't know to seek help.
Living with or loving someone with depression is often as hard as suffering from the disease itself. The mood swings, the lack of motivation and the generally erratic behavior can be too much to handle. This is compounded by the fact that many people think the emotional symptoms caused by depression are "not real," and that a person should be able to shake off the symptoms if only she tried hard enough. Instead of showing support for the depressed, their loved ones show hostility and contempt.
For too long, society has dismissed such people as melancholy, or as possessing a weak constitution. The people around them, whether employers, neighbors or family, have refused to accept the fact that it is a disease. But it is a disease, as real as a brain tumor and as slowly destructive as cancer.
All of this is especially relevant to the University community, because research shows that in recent decades the onset of depression occurs earlier in life. College is an exciting and odd time in a person's life. It is the transition from adolescence to adulthood. Add this to the constant measuring and pressure of exams and papers and you have a situation ripe for depression. Helplessness, hopelessness and self-doubt often are dismissed as growing pains, when in reality, they are signs of a larger and more serious problem.
So what can be done? For yourself, there are simple ways to maintain mental health. Exercise, keeping a journal, and talking about problems instead of internalizing them all are important keys to a healthy mind. So is avoiding excessive alcohol and drugs. But it doesn't stop with your own health. Don't dismiss your friend's melancholy as waking up on the wrong side of the bed. Don't attribute mood swings to PMS. Be observant, but more importantly be supportive.
Holden Caulfield ended up alone in a mental hospital. Your best friend doesn't have to.
(Sam Waxman's column appears Thursdays in The Cavalier Daily.)
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