Richie Sadlier: Saying you have depression doesn’t mean you do

It’s tricky to discuss in a climate that promotes compassion, but delusion exists here

 

It’s good to talk, but often it’s not easy. You could be judged, mocked, ignored or not believed.

Few areas are as stigmatised as our emotional wellbeing so there are risks involved in choosing to say a word. It’s been this way for decades, which explains so much of the silence that has oppressed and isolated people who needed support.

There’s been a noticeable shift on this front in recent years, but we’re still figuring out for ourselves how to have the conversation. We’re told to be understanding, compassionate, patient and helpful. It takes courage to come forward, so be respectful and kind. But we also know that people can be deceitful and dishonest, so there must be times when it’s right to call them out. But when is it okay to challenge what someone is saying?

How do you spot a teenager who just wants a lie-in from the one who is genuinely anxious about going to school?

Surely the decent response in all circumstance is to act with compassion? After all, if you reacted any other way you’d be accused of being part of the problem. You’d only be adding to the resistance people feel about speaking up, something I suppose I could be accused of now by writing about this.

How, for example, do you spot a teenager who just wants a lie-in from the one who is genuinely anxious about going to school? Or the employee who fancies a break from work from the one who medically needs it? Sometimes people are genuinely in the dark about the nature of their issues while others will deliberately mislead you for their own personal gain. It’s a tricky topic to discuss in a climate that promotes compassion and understanding, but dishonesty, delusion and deceit exist here too.

Often people are unaware of the nature of their suffering, so they grab the nearest label that seems to fit. Google has a lot to answer for in this area. It’s not done to deliberately mislead anyone, but they come away with an inaccurate sense of what they’re dealing with. It might seem fairly harmless, and in many cases, it is, but it’s hard to find a solution to a problem you misunderstand.

Richie Sadlier: ‘Clients say regular, excessive drinking is the only thing that helps them with their depression’. Photograph: Cyril Byrne
Richie Sadlier: ‘Clients say regular, excessive drinking is the only thing that helps them with their depression’. Photograph: Cyril Byrne

I have friends who have openly admitted to lying about depression to get extended time off work. It’s easily done too. Just convince your GP and she’ll sign you off. Job done. There’s nothing your boss can do about it. But I also know some people, and I’ve had several clients too, that are oblivious to what’s actually affecting them.

Saying you have depression, for example, doesn’t necessarily make it so. Not in therapy anyway. It’s a starting point in the conversation. When clients arrive for a first session with a self-diagnosis, rather than rattle through the clinical symptoms of the condition they believe they have, I want to find out what it’s really like to be in their shoes. I want to understand their inner world and their outer world. And once they openly engage in some honest self-exploration, they often abandon the use of the label they originally came with. Sometimes it’s because they begin to appreciate the impact of recent experiences, but often they’ll realise that it just doesn’t fit anymore.

It’s usually like this when alcohol and drugs are involved.

I remember getting a call from a friend in great distress several years ago. She was concerned about her mate who had just had what she described as a panic attack. They were abroad at a festival somewhere in Europe. No obvious cause, she said. It came from nowhere, she said. She had no history of this before now. She wanted suggestions on what to do and how to help her out. She was determined not to let this lie and get her to see someone when they returned home. She wanted names of therapists who were experts in anxiety because that was obviously the issue.

You can’t get certain answers if you don’t ask specific questions, and you can’t help a person if you don’t have handle on their problem

We spoke for a while, so I learned a little more about how they had spent the previous few days. They hadn’t skipped every meal, but they just weren’t hungry given the amount of drink and cocaine in their systems. Eating is cheating and all that. They were on day three of festivities and had barely slept. I felt confident I had cracked the case of the mysterious panic attack, but I said nothing to my mate at the time about what I was thinking. Some people can’t see the thing that’s staring them in the face.

I’ve had similar experiences with clients who came to therapy looking for help. They describe the daily grind of having a mind that seems to work against them. You wouldn’t want it for a moment but it’s their reality all the time. They say regular, excessive drinking is the only thing that helps them with their depression. Maybe they smoke weed a few days a week to help with stress levels. Maybe they rely on cocaine to reduce their social anxiety when they’re out. They describe drugs and alcohol as their solution without realising it’s their problem, totally oblivious to how it’s impacting their mood and their thinking.

You’d be amazed how many people refuse to consider there’s a link, but you can’t help them if you collude in their denial and their avoidance.

Given the complexities of these issues and the uniqueness of everyone’s mind, there isn’t a sweeping statement to be made about all of this. But you can’t get certain answers if you don’t ask specific questions, and you can’t help a person if you don’t have handle on their problem. And if they don’t acknowledge the issue themselves there’s really not a great deal you can do.

We are living in a culture that embraces intoxication which makes a topic like this difficult to discuss.

It’s good to talk, but it’s even better if you’re talking about the right thing.

– Richie Sadlier is an accredited psychotherapist

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