Emme Chabalie

Berwyn Moore
Literature and the Healing Arts
16 December 2016
In the Wrong Hands
It is not an immediately identifiable pain, like that of a broken limb. It may
be more accurate to say that despair comes to resemble the diabolical
discomfort of being imprisoned in a fiercely overheated room. And because
no breeze stirs this cauldron... it is entirely natural that the victim begins to
think ceaselessly of oblivion.
-William Styron, 1990

The Definition of Depression

The quote above describes the pain experienced with depression.

Depression is a mental illness that is caused by the inadequate production or
reception of serotonin by neurons in the brain. Depression is very hard to
describe by those who suffer from it because it presents itself differently in
everyone, and causes people to feel different ways. Also, because it is a
mental illness, it is hard for others to understand it since they cannot
physically see the damage caused.

Depression, and mental illness in general, are widely associated with

having a rather large stigma that comes with them as topics of discussion,
and especially when the one discussing has a mental illness like depression.
This stigma is so large that most people that are diagnosed with depression,
while welcomed into a loving and supportive community of others with
mental illness, are not welcomed with the same support by those without. My
hypothesis for this and the basis of my research was that the stigma
surrounding depression that those suffering from it must endure comes from
the treatments for the illness and not the illness itself.

History of Treatments

In the early 1900s through today, Electroshock therapy has been used
on patients with depression. Through the years, the treatment has gotten
more sophisticated, but the media has portrayed this treatment as
something to fear and an inhumane experience that those in mental
hospitals had to suffer through. This is not the case, however, especially
today. Nurses that have worked in the facilities that administer electric shock
therapy have commented on their experiences, saying that they never
knew anybody that suffered any, like-you hear things about fractured limbs
and other injuries, but she said that her main memory was waking up with a
terrible headache and aching all over-that is understandable (Adams, J

2015). Having the perceptions that most do about this treatment, hearing a
first-hand account like this may change the view of the use of the therapy.
Also, understanding how and why the therapy is used is important to
combatting stigma. This particular treatment is only used in extreme cases,
such as when quick results are needed or if the patient is not responding to
any other type of treatment and have extreme depression and or are suicidal
(ECT Benefits and Side Effects). Once this therapy is put into perspective and
is explained, it makes sense to be used on patients with depression, and
decreases the stigma slightly. While this is the most extreme treatment for
depression, other treatments have given the illness a stigma as well.
Using medications for something that is wrong with a person mentally
sounds scary to most people with little to no understanding of mental illness.
While those with mental illness understand, it can be hard for others to wrap
their heads around. Clinical depression is caused by a chemical imbalance in
the brain, so it only makes sense to treat this illness with some sort of
medication that can correct this chemical mishap. The other more popular
treatment is talk therapy, which also gets a stigma from the way it is
portrayed in the media and the way some people explain it. It is simply
talking to a professional about problems that you cannot work out own your
own, and getting help with ways to cope, which includes special approaches
such as Cognitive Behavioral Therapy, which provides specific coping
mechanisms for those suffering from depression (Pilgrim 2011).

Sometimes, the depression can be so severe that the person suffering

from it is a danger to themselves or others, and therefore must be placed in
a special facility or a mental hospital either voluntarily or involuntarily in
order to keep everyone safe and find a way for the person with the illness to
get better. This is very different from how it was in the early through mid to
late 1900s, where people were placed in mental hospitals for any and every
ailment that may have had to do with their mind. Sometimes people were
placed here because their families did not want to deal with whatever
ailment they were suffering from and needed a place to dump the person
or child (Skloot 2010). Today, the stigma surrounding being put into a mental
hospital sticks around because of how mental hospitals used to be treated
and viewed, which makes those suffering with mental illness less likely to get
help. Because of the deep emotional pain caused by depression and the lack
of ability to pinpoint where it is coming from (usually it is seemingly nowhere,
as it is caused by a chemical imbalance) coupled with the stigma the
individual may feel surrounding the idea of seeking psychiatric help, they will
be less likely to seek said help and more likely to be in danger of putting
their lives at risk of isolation and failure in school/work, since depression
causes the sufferer to want to be by themselves and do nothing (Schomerus
et al 2009). They also may be in danger harming themselves in the form of
cutting or any other type of self harm, or at worst suicide. Depression, as
stated earlier, causes a deep, seemingly causeless emotional pain that does

not go away on its own, causing various reactions from the person with the
illness.
The stigmas surrounding depression and its treatments unfortunately
follow those suffering with it everywhere, including college campuses. One
may not peg a college campus for being full of judgement, but stigma is
everywhere and those with depression must deal with the effects of it
wherever they go in life, and college is one of those places for a large
amount of people.

The Stigmas and Effects on Everyday Life

Several of the most common stigmas surrounding depression, as well

as other mental illnesses, as stated above, are seen in college campuses. As
stated in Feeg et al, students in a college were asked to complete a reading
assignments and then were later questioned on whether or not they would
dissociate from a person with a mental illness like depression if they found
out they had the illness. The demographics of this study were very similar to
that of Gannon. It was performed at a small Catholic university in New York.
The results revealed that even after completing the reading, those who had
no experience with mental illness in their lives would be willing to dissociate
from a student if they found out the student had a mental illness. For those
who were familiar with mental illness and experienced the effects in their

everday lives, they were less likely to dissociate from said student. Those
who did have mental illness reported that 74% experienced stigma in the
last year, 16% reported stigma in the workplace; and 13% reported being
affected from staff in the health service. For those who deal with
depression daily, the effects are much harder to deal with. A large stigma of
depression is that people are lazy and are choosing to be that way, when
people who have depression are simply struggling and are unable to focus.
Depression makes you tired, and takes away your energy. Because of these
effects of the illness, another huge demographic for experiencing stigma is in
the workplace. Because of the symptoms of depression, performance at work
may begin to decline seemingly because of the laziness that is perceived by
those outside looking in. Not only do the symptoms affect work performance,
but experiencing stigma in the workplace is proven to decrease productivity
as well. The effect of stigma in the workplace contributes further to the
symptoms of depression. Diminished self-esteem and self-efficacy lead to
the why try effectwhy try to get a job: someone like me is not worthy of
or cannot handle it (Corrigan et al 2012). Having a job and being a
productive member of society is pretty much a given in life. People are
required to have a job to make a living and be able to have the basic needs
that humans require. Facing stigma in college and the workplace as well as
the effects of depression can be detrimental to these abilities, and therefore
further contribute to the depression, causing a severe downward spiral.

Connection to Literature

One of the most well known works of literature that focuses on the
difficulties of dealing with depression is The Bell Jar by Sylvia Plath. The novel
is a kind of autobiography of Sylvias life that is chronicled by her main
character Esther. It describes Sylvias later struggles with depression and
mistreatment in hospitals because of the time period and the fact that she
had a mental illness, not a physical one. Up until recently, it was very hard
for even medical professionals to wrap their heads around they idea that the
mind could be ill in a way that caused behavioral problems that wouldnt be
categorized as insanity and untreatable, so that is how people like Plath were
treated. They were part of the experimental age where doctors were not sure
how to treat mental illnesses, so they tried out various treatments that they
thought might work on patients during this time. The Bell Jar talks about
Plaths ill treatment by psychiatric professionals and reveals this as the
underlying reason she associates to her inability to receive treatment that
works. After a doctor wrongly administers her shock therapy, she no longer
trusts psychiatric health professionals, which is understandable, but because
of her depressed state she also associates psychiatric professionals with
awful feelings and therefore is very reluctant to receive other help (Tsank

2010). The novel reveals the causes of her depression but not how to get
through them. This is one difference that the novel provides between
treatment during this time and the treatment we use today. We are less quick
to use therapies like ECT, and more open to talk therapy and different
psychiatric drugs because they have been proven to work. Plath creates a
stigma in her own mind from her experiences in the psychiatric health
community and this stigma directly correlates to her being reluctant to
receive any further help and therefore entering the downward spiral into her
eventual suicide.

Another piece that directly relates to depression is American

Melancholy by Laura Hirshbein. Published in 2009, this non-fiction piece
explores the history of depression as a diagnosis and what factors contribute
to it. Specifically, the author explores the correlation between the diagnosis
of depression and women. Are women more likely to be depressed, or do

psychiatrists think this and therefore create case studies to model this
outcome? Either way, the author explains, we can glean from the idea that
depression is more common in women that the suffering that women go
through is significant enough to raise questions about this. The novel also
looks at the sociocultural influences on depression as a diagnosis and
essentially the stigma of different walks of life.

My Story
Ive been anxious for as long as I can remember. I was worried about
dying around the age of 8 and on, and things started to get bad around 8th
grade. It was during the hard years of middle school where the drama begins
to unfold with old friendships, new friendships, first boyfriends, etc. I
remember I had my first boyfriend in 8th grade and it lasted until 10th grade,
and throughout that relationship the boy I was dating learned how to break
me down emotionally. He knew what bothered me and he used it. After that
relationship, my self-esteem and self-confidence were at a resounding zero,
and I began to self-harm. I would use the razors for shaving my legs to do it,
just small cuts on my left hip. I think I chose there because it wasnt visible
and Im right handed, so it just made sense to me. Eventually, a new boy I
was dating in the 10th grade found out about the cutting and convinced me
to tell my parents. This began a very long process that Im still going through
today.

I started seeing a therapist and a psychiatrist for the first time. My

mom told me not to tell anyone for fear that I would be bullied in school by
anyone that found out. I went to see this therapist and psychiatrist once a
week, but we didnt mesh well, and I began to get worse from both that and
the medication I was on. I attempted suicide. It was right after Thanksgiving
my junior year of high school. I told my therapist in confidence, and she
intervened, which I didnt know she would. She sent me to a psychiatric
facility close to my house, and my family and I were there for almost 5 hours
getting me checked in. It was the most awful time of my life. I stayed for 24
hours, involuntarily committed to a psychiatric facility. When I got out, I
started seeing a new therapist who decided that Intensive Outpatient
Therapy, or IOP would be a better fit for me than hospitalization. I began
working with my high school so that I could attend this treatment three days
a week and be in school for two days. Again, I was not supposed to tell
anyone. For those who asked and I did not want them to know, I told them I
was in physical therapy because I hurt my back. My parents advised me that
if I told anyone, they would most likely think I was crazy because of the
treatment I was in. They did not put it that way exactly, but thats what I
remember getting out of it, and it was true. There were other people with
emotional problems at my high school that were relatively open about it, and
they were ostracized and deemed the weirdos because they had to go to
therapy and take medicine, and that just was not something that people in
my high school could understand. So I dealt with that, and trying to get all

my assignments done in two AP and the rest honors classes, while also
dealing with medicine changes, meeting new therapists, etc.
After going through IOP and looking back, it was the best experience I
could have asked for. Getting the coping skills I did and meeting other
teenagers that were dealing with what I had and worse really helped me to
deal with my illness and come to terms with it. While it was difficult at the
time, I am so glad my therapist suggested it. Sometimes I even wish I could
go back because it helped that much. I was diagnosed with major depressive
disorder and generalized anxiety which are often coupled. Its not something
I could have prevented, but it is a part of me and something I will have to
deal with the rest of my life. I still attend therapy and have finally found the
medication that works for me. I have good days and bad days with my
depression. Some days feel like the end of the world, and some days are very
easy for me and I can laugh and smile like my normal self.
Depression is an awful illness to deal with. At any age, it takes away
your identity and makes you think that you are a hollow shell of a person
that has no interest, cannot smile or laugh and does not enjoy anything.
Dealing with this illness alone is difficult, but when you add in the stigma of it
that does not allow you to share your struggle with anyone without first
knowing how they would take it makes it even harder. Hopefully someday the
stigma will end, but for now the only option is to educate those that are not
dealing with a mental illness about these illnesses, and what they can do to
help friends and family that are suffering. Keep an open mind and love

everyone you meet, because everyone has a personal struggle that you
cannot see from the outside.

References
Adams, J. (2015). British nurses' attitudes to electroconvulsive therapy,
1945-2000. Journal of Advanced Nursing, 71(10), 2393-2401.
doi:10.1111/jan.12704
Corrigan, P. W., Powell, K. J., & Rsch, N. (2012). How Does Stigma Affect
Work in People With Serious Mental Illnesses? Psychiatric Rehabilitation
Journal, 35(5), 381-384. doi:10.1037/h0094497
Electroconvulsive Therapy (ECT) Benefits & Side Effects. (n.d.). Retrieved
December 31, 2016, from
http://www.webmd.com/depression/guide/electroconvulsive-therapy#23

Feeg, V. D., Prager, L. S., Moylan, L. B., Smith, K. M., & Cullinan, M. (2014).
Predictors of Mental Illness Stigma and Attitudes among College
Students: Using Vignettes from a Campus Common Reading Program.
Issues In Mental Health Nursing, 35(9), 694-703.
doi:10.3109/01612840.2014.892551
Pilgrim, D. (2011). The Hegemony of Cognitive-Behaviour Therapy in Modern
Mental Health Care. Health Sociology Review, 20(2), 120-132.
doi:10.5172/hesr.2011.20.2.120
Ronald C. Kessler, Katherine A. McGonagle Marvin Swartz, Dan G. Blazer, and
Christopher B. Nelson. (1993). Sex and Depression in the National
Comorbidity Survey I: Lifetime prevalence, chronicity and recurrence.
Journal of Affective Disorders, (29), 85-96.
Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2009). The stigma of
psychiatric treatment and help-seeking intentions for depression.
European Archives Of Psychiatry & Clinical Neuroscience, 259(5), 298306. doi:10.1007/s00406-009-0870-y
Tsank, S. (2010, June). The Bell Jar: A Psychological Case Study. Plath Profiles,
3, 166-177.