The Written Word
for June 27, 1999

This column, much edited, appeared recently in Elm Street magazine

This is a personal story of mental illness – and it’s a mental illness suffered by one in four women and one in eight men. They’re the accepted statistics but those who know about these things say it’s one in four for men to except men don’t admit to the problem. Which is a very large part of the problem.

I am clinically depressed and have been for over 10 years. I think it a fair assumption that everyone reading this has clinical depression within the immediate family.

It is also a story of hope. And love. And success.

I come from traditional British stock – one grandmother was born in Salisbury, England, one in Cape Breton Island. One grandfather was born of English parents in Minneapolis the other, in Auckland, New Zealand. I cut my teeth on G.S. Henty’s stirring tales of British Imperialism and, growing up as I did in the Second World War, stories of great courage. Boys didn’t cry in our world, only little girls did that. It was a masculine world where the heroes were Sir Francis Drake, Cecil Rhodes and, of course, Winston Churchill my lifelong hero about which I would later make a most interesting discovery.

In those days the world was divided into the sane and the insane – the latter, if untreatable or dangerous sent, usually for life, to an asylum. The depressed, more often than not with drinking problems, were just "explained away

We like to think we’ve made great advances in the field of mental health and I suppose, if you don’t measure that progress against too strict a standard, we have. But we have a long way to go.

We still talk about "mental health" and have "Mental Health Acts" throughout the country. Why do we make this distinction? Isn’t "health" just "health"? If not, why not?

Because we’re frightened stiff of mental illness we joke about it. We still laugh about people who are "a couple of bricks short of a load" or say "their elevator doesn’t quite go to the top". But we don’t say "he’s one wheelchair too many to be a man" or that "she’s one ‘tit’ removed from a woman." And there’s a reason for this. We’re frightened stiff of mental illness. We don’t say these things because of how devastatingly hurtful they are but we laugh uproariously at references to mental illness. A disc jockey on the radio station I work for once commented that his school was so small that the debating team was one schizophrenic. Ha, ha! Except it’s not funny to those who live with schizophrenia personally or in their family and who well know that the disease has nothing at all to do with "split personality". Society indulges in sort of a gallows humour to cover up its collective insecurity about mental illness.

We have images burned into our subconciousness, which for many are impossible to eradicate. We’re afraid not only of what mentally ill people might do to our loved ones or us we fear that we ourselves might be so afflicted.

Society has always treated mental illness as something very different. At one time we burned them as witches (then in the case of Joan of Arc decided that the "voices" were indeed from God and made her a saint.) We then sent them to asylums not for treatment but in order to isolate them. Our literature is full of grotesque images, often accompanied with a physical impairment in order to deal with two fears at once – the Phantom of the Opera, Quasimodo, Rumplestiltskin, the Wicked Witch of the West and so on.

We have improved since the advent of psychiatry, no doubt about it, but we have a hell of a long way to go. One of the great impediments to progress is that some of the images are true. There are psychopaths who kill for the pleasure of killing. There are dangerous "lunatics" and there are dangerous "sex maniacs" ranging all the way from child molesters and rapists to Clifford Robert Olson. Unfortunately it is into that general group we’ve assigned all who are mentally ill. That’s not only wrong, it hurts both the patient and the community at large. Worst of all, it discourages mentally ill people from seeking help because once what ails you goes into the mental slot instead of the physical slot you are marked as an object of fear. Many are simply afraid through ignorance but many more see themselves in the mirror and are deathly afraid that their problem with coping, if diagnosed by a doctor, might put them across that line of demarcation between the physically and mentally ill. The styigma attached to mental illness is still, by far, the biggest barrier to its cure. Thus because sufferers fear the societal consequences of being diagnosed as depressed, they suffer the even greater consequences of remaining untreated.

What then is depression?

I am not a doctor and do not intend to come close to a medical definition here. I content myself with my own definition, which is simple: "an ongoing inability to cope." It takes many forms and is often part of, or at least associated with, more serious mental illness such as schizophrenia. In my case, about which more in a moment, it is uncontrollable anxiety.

What we’re talking about isn’t the routine sort of depression which accompanies the every day hard knocks of life such as loss of job, the death of a loved one and that sort of thing. I happen to believe that these natural unhappy events can, through a sort of "piling on" process either lead to or aggravate clinical depression but they are not that in themselves. Clinical depression is a chronic ailment, which requires ongoing treatment.

Some cases will require psychotherapy and fairly exotic treatment methods and often there will be the need for the help of a psychiatrist (I’ve seen two) to confirm the diagnosis and work out the appropriate medicine but in the vast majority of cases, clinical depression can be treated by medicine prescribed by a family doctor.

I’ve told my story elsewhere (Canada:Is Anyone Listening. Key Porter, 1998) but here’s a shortened version in the hopes that someone reading my story may see something familiar and get help.

Like everyone else, I’ve borne my share of life’s problems. In my case they include the sudden death of a teenage daughter, a consequent divorce because of my inability to deal with that tragedy, serious financial problems and highly stressful occupations (Lawyer, Cabinet minister, broadcaster.) I woke up one day in March of 1988 with a pain in my right side, which threw me into a panic. I had never experienced this sort of sustained panic before and I concluded that I must be dying of liver cancer, a diagnosis I quickly confirmed by looking under the "Ls" in the Columbia Medical Encyclopedia. Even after seeing my doctor, having ultrasound tests and getting the firm diagnosis that I had gallstones I remained utterly convinced that I was dying of liver cancer and that the doctors were lying to me. It’s hard to explain how this deep anxiety works but it’s devastating. There is an overwhelming feeling of doom and none of the defences we all erect around ourselves is of any help.

As it happened, I was lucky. My doctor was one of a very few GPs in 1988 who both understood depression and recognized the signs. In the midst of me berating him for not telling me the truth about my cancer he asked my how long ago it was that my daughter had been killed. Within minutes and about five questions later, I was in floods of tears. I was, the doctor told me, clinically depressed and my form of depression was anxiety. And there was help.

I was reluctant to accept this at first. After all, we men of sturdy stock didn’t have this sort of thing, did we? Stiff upper lip, Sir Francis Drake, British pluck, Land of Hope and Glory and all that stuff.

I soon learned a new word – seratonin. This is a chemical the absence or shortage of which causes depression. It was really no different from diabetes (I have that too) in that the body doesn’t adequately supply a necessary chemical. Happily, I learned, there are seratonin substitutes readily available, the most prominent of which is Prozac. My doctor prescribed a medicine called elavil, which was particularly effective when because my form of depression – quite common – took the form of anxiety. Within a couple of weeks I had never felt better in my life. For the next nine years, apart from the daily reminder when I took medicine, I gave no thought to depression. Then I made the serious mistake of trying to fix something that wasn’t broken.

I interviewed a prominent American psychiatrist one day and he spoke of a brand new medicine called "serzone" which was all the rage. I got the impression that I was using the "tin lizzie" of anti depressions and that I ought to buy the latest model. Because I had a mildly unpleasant side effect (all depression medicines can have side effects) I broached the subject of changing medicines with my doctor. He wasn’t thrilled with the idea but nevertheless prescribed serzone for me and I switched. It was a serious mistake – I had to withdraw from all medicine for two weeks and only gradually increase the dose of the new one. I went through utter hell and by the time I was used to the new medicine I discovered that it too had side effects, namely a morning hangover which reminded me of college days after a fraternity bash. Since a couple of cans of light beer is now a big night for me not only did I hate the hangover I felt cheated of the party from which they habitually arise. Ten months later I changed back to elavil and all’s well.

Because of radio shows I have done with specialists on depression I’ve that not only am I not a rare case but that depression in Canadian society is epidemic. It by no means always takes the same form as mine but it is there.

It’s there in severe drinking problems and spousal abuse. It’s there in all manner of anti social behaviour. It’s there in the valued employee who suddenly seems to have lost his stuff or the employee of great promise who somehow can’t keep up with the changes taking place. It’s there with kids and most tragically with kids who kill themselves.

I now look back at a father who drank too much and see a man – a wonderful, loving man – who couldn’t cope and used the only medicine then available to him, whisky. I look back at a nephew by marriage who killed himself at 15 and see a youngster who needed help that wasn’t then there. But mostly I look back at myself and see how lucky I was to have a doctor who understood depression.

For here is the sad part. Many doctors don’t understand depression. Many who do, simply refer their patients to a psychiatrist all of whom have waiting periods of 4-6 months or longer. All doctors who wish to help patients with depression problems must sacrifice a lot of unpaid time because medicare won’t pay for the extra time it takes to properly assess and assist the depressed patient. It’s sad, so terribly sad because there are so many that need help. What’s even sadder, help is uncomplicated and in most cases, complete.

When I say complete, here’s what this depressed person did last year – hosted five 2 ½ hour radio shows a week with a prepared editorial each day, wrote three newspaper articles every week, did numerous speaking engagements and guest appearances on radio and TV – and wrote a book. The medication is not a tranquilizer or some sort of dope – it simply substitutes for a natural chemical your body no longer manufactures.

Depression is not a character flaw so there’s nothing to be ashamed of. Seek help and if your family doctor doesn’t "do" depression, keep looking until you find one.

Oh yes, that reference to Winston Churchill, politician, soldier, statesman, journalist, Nobel laureate for literature, painter and saviour of the western world – he suffered from depression all his adult life.