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Depression, disabling but treatable, comes into the light on TPT

Dr. Craig Bowron

In our worst moments we often view those suffering from depression as being weak-minded. We think, “They could pull themselves up by their emotional bootstraps if they had the gumption. They just need to think happy thoughts and work their way through it.”

That’s the heart of the stigma of depression, seeing it as a personality flaw rather than the medical illness it truly is. And this stigma keeps depression in the shadows. It keeps the suffering from being diagnosed and treated — and people are dying to be treated. Every year, there are twice as many suicides as homicides in this country.

This Wednesday, Twin Cities Public Television (TPT) will air a two-hour special called “Depression: Out of the Shadows.” Produced in conjunction with WGBH in Boston, the program hopes to bring the illness of depression into the light. It is common; it is disabling; it is treatable.

Dr. David Cline has been practicing child, adolescent, and adult psychiatry in Minneapolis since 1968. He previewed “Depression: Out of the Shadows” and thought it was outstanding. To Cline, the personal profiles presented in the film seemed very typical, very authentic, and he admired the honesty with which people spoke about their illness. “They talked about their difficulties without shame,” Cline told me.

That’s a word that comes up frequently in depression: “shame.” Those suffering from depression have two problems: the disease itself, and the guilt of having the disease. Cline thinks that part of the stigma of depression can be traced back to this country’s Puritan roots, the Salem witch trials being an example, where abnormal thoughts or behavior were attributed to the work of the devil.

“In Puritan New England, it [mental illness] was seen as misbehaving,” Cline explained. “It was weakness of willpower, it was weakness of character, and not being strong, or faithful to God, I suppose — so it was a disgrace to blaspheme God by one’s behavior.”

Another major facet of the stigma of depression has to do with how we humans perceive ourselves. “It’s the mind/body split,” Cline explained. “The body could do what it wished and it wasn’t thought of as bad. For example, you get heart disease, a broken leg, vomit up blood, or whatever — the body was not a stigmatized entity.” But the brain is another matter. We see it more as “us,” and so when we admit that it’s not working right, it’s an affront to our personhood. We feel flawed.

Through public education like this TPT special, Cline thinks that the stigma of depression is lighter than when he first began practicing in 1968. Lighter, but not lifted.

“I still have patients who want to leave out of that door,” Cline told me, pointing to a side door in his office, “rather than that door,” pointing to the door back to the reception area, “because they worry they might run into someone in the office who might know them.”

For more than a decade, Tom Mischke has been painting the airwaves at KSTP AM 1500 with an enigmatic style that’s drawn high praise from the likes of James Fallows and Garrison Keillor. Satirist, song writer, searing intellectual wit, giggly Cub Scout humorist, Tom Mischke has a brain that can take listeners anywhere; but it’s also taken him into numerous bouts of depression. He, too, previewed “Depression: Out of the Shadows” and was impressed by the program’s ability to demonstrate the science behind depression, to expose the illness as a true brain disorder rather than a personality flaw or a mood problem. Mischke is aware of the stigma of depression, and he bucks it.

“I am mentally weak. In other words, the weakness is in my brain,” Mischke told me. “So you’re mentally weak. So what? Did you suddenly drop a notch or two in value as a human being?” he asked me. “The diabetic has a weakness, but somehow the stigma seems to be associated with [the idea that] if the weakness is in your brain, then it’s not legitimate as a weakness. Unless you flat-out were born mentally retarded or got stomped on with a sledgehammer later in life, unless you can show some real damage, [people think] ‘Snap out of it.’ The brain wounded is not legitimate. And I think the stigma comes because science has not done a decent job — probably out of ignorance — of teaching us that the brain is every bit a piece of the puzzle as anything else, as any other organ.”

Like Cline, Mischke sees the mind-body connection (or disconnection) as a big part of the problem.

“Why do people say ‘the mind-body connection’? How did the mind just get out of the body?” Mischke asked. “If from the beginning they wouldn’t have ever said, ‘Is it a physical thing or a mental thing?’ If they never would have said that — because it’s all physical — we wouldn’t have the stigma today,” he continued. “But we separate from the neck up and say, ‘That part is a part that each of us has control over and each of us should be able to run on our own.’It should be relatively simple: You take care of from-the-neck-down with eating well and exercising, and from-the-neck-up by being a strong-willed person with good thoughts, good thinking, and good character.’

“But there’s no sense whatsoever of, ‘Can’t it go wrong like anything else? Can’t it go wrong like a heart, a kidney, a pancreas? Can’t it just be some piece of flesh that has as much ability to go haywire as anything else?’ “

Yes it is, and yes it does; and depression is just one example of the trouble that can follow.

“Depression: Out of the Shadows”
Where: TPT TV, Channel 2
When: Wednesday, May 21, 8-10 pm.
Repeats: See broadcast schedule

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