Black dog isn't really invincible

Geoff Gallop

Geoff Gallop, professor and director of the graduate school of government at the University of Sydney, is a former premier of Western Australia.

The Australian
May 2, 2007

LAST week Beyondblue released the results of a survey on the evidence of depression within the professions. The survey, designed by Beyondblue, was integrated into Beaton Consulting's 2007 Annual Professions Study. The survey revealed higher than average depression scores among professionals as well as significant use of alcohol and other non-prescription drugs to manage the feelings of sadness and depression.

Six per cent to 16 per cent of the respondents from the professions indicated moderate or severe symptoms of depression, with lawyers recording the highest score.

These revealing figures provide cause for concern, particularly when coupled with the discovery that there is a lack of understanding about the nature of depression and what may be helpful in dealing with it. For example, more than half the sample indicated that it would be helpful to encourage someone with depression to take time off or a holiday. All this does is give the mind more time to stalk its victim.

Since my decision to seek medical help for depression early last year, I have learned a great deal about myself and the condition.

However, to learn these things, I had to acknowledge that I had a problem. Not talking about depression is part of its definition. We hold it in: it's personal and it's deep. Imagine a world in which every second feels like a year and the ability to laugh has been extinguished.

Abraham Lincoln described the feelings associated with depression with unerring clarity: "I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would be not one cheerful face on earth. Whether I shall ever be better, I cannot tell; I awfully forebode I shall not. To remain as I am is impossible. I must die or be better, it appears to me."

The guilt that depressives feel in the face of their and the world's many imperfections also works against their own liberation. They want to please and they feel everything that happens is exclusively their responsibility. The more they do, the more they feel they have to do. They act for others and they work beyond reason to achieve at the highest levels. To do otherwise - to put themselves and their wellbeing first - is to fail the test of life that has been created in their minds.

Herein lies the problem for many of our professionals and high achievers: they have lost control. That which drives them also has the potential to destroy them and, tragically, all too often it does.

As Mamta Gautam said of the legal profession in her Tristan Jepson Memorial Lecture in Sydney last year: "These personality traits are all very socially and professionally valuable, but personally very expensive."

In saying these things I find myself asking: "Why didn't I take action earlier?" We don't because the nature of the illness prevents it. It feeds off itself and in a world of individual ignorance and social stigma it claims many victims. Prejudice and melancholy feed off each other like psychological twins. The more the prejudice, the more the concealment; the more the concealment, the more the depression. However, I have also learned that liberation is possible. The causes and consequences of mental health (and illness) have at last emerged as an important subject for serious scientific analysis and proper public discussion. We have learned much from neuroscience and have at last discovered the wisdom of Eastern religion, psychology and philosophy. Depression can be treated and wellbeing sustained.

Indeed, research in North America has found that 60 per cent to 70 per cent of patients with depression respond to initial treatment with monodrug therapy (usually after four to eight weeks of treatment) or to a completed course of psychotherapy (usually 12 to 20 sessions, or about 12 weeks). Of the 30 per cent who do not respond to initial treatment, most will improve via an alternative approach and more than 90 per cent will eventually recover fully. From these statistics we can see that the prognosis of major depression is among the best of any medical disorder of similar severity.

Spreading this message will not prevent depression. Genetic endowment and personal circumstances determine that some of us will be depressive. But what it can do is prevent pain from turning into crisis, by countering prejudice and offering hope through a range of treatment options.

What it also does is place on the community's agenda the whole question of mental health and wellbeing. Life is full of suffering and contradiction, yet we complicate matters further with dysfunctional relationships and unrealisable aspirations. Some of us are able to cope, but too many are not.

This can mean individuals locked up inside themselves, their minds hammering away 24 hours a day, forever on the precipice of panic.

Genetic make-up and upbringing varies from one person to another. This fact of life shouldn't be an issue only for individuals as they try to make sense of it all, but also for governments as they consider their policies and priorities, for employers as they manage their workplaces and for families as they plan their future together.

It's all about greater awareness, individually and as a community.

We can and should better manage the pressures of today, just as we can and should seek a better life in the future.