Z is not depressed - but has friends who are

I have a friend who is strong, capable, a successful business-woman who, in partnership with her husband, runs a stressful business which, by its nature, means that one or other of them is on call at all times. Whatever the occasion, they might have to leave or make a phone call to ensure that someone deals with a situation that has arisen. On top of this, she has an elderly, frail and demanding mother, to whom she is devoted, but who can infuriate her. She also does voluntary work that involves her in heavy responsibilities, both for people and for finance.

What annoyed me last Sunday was when she told me that she just can't kick the heavy dose of anti-depressants that her doctor put her on last autumn.

I know too many people in this situation. What they should be told is that they are wonderful. Fabulous. They have coped with pressure that many people would find unendurable. They may have had traumas in their past that many of us cannot imagine having to deal with. They reach the end of their tether and this is not only understandable, but inevitable. The mind and body are not supposed to be able to endure the unendurable; sometimes we crack but, because of the nature of the pressures we are under today, this cannot be admitted. So they go to the doctor, say that they can't sleep, they cry, they lose their temper, they are losing (or gaining) weight, they have a constant headache, irritable bowels, aches and pains, stiff jaws through constant teeth-grinding, and what are they told? They are depressed and the way to deal with this is with anti-depressants.

These can help, in the short term. But they deal with the symptoms, not the problems. And, a few months later, they say that the sleepless nights and all the other problems are still there, the pills don't really help any more, but they can't do without them. If they try, in less tense times, to cut down, the anxieties kick in again.

My friend has taken steps to lessen her and her husband's work-loads, although the effects of this will not really come through for a few more months - and they acted more because of the physical effect on his health than the mental ones on hers - but in the meantime, she thinks she is a failure because she still feels that she can't cope and now she's hooked on powerful mind-altering drugs to boot.

I met a friend in town a while ago and we went for coffee. She moved house last year and she told me how much she is enjoying life in her retirement with her daughters nearby and with her grandchildren in close contact. "Still on the happy pills, mind you," she said. "One day I'll manage to get off them." Now, I know when she started taking them. It was years ago, when her last marriage broke up. Since then, she has put her life together and done it very well. But she can't kick the pills, even though she is happy and has a tranquil life now.

I know any number of people in this situation, and some of those are you, whose blogs I read, and whom I admire hugely. And I don't blame you if you need help, and I truly sympathise if you suffer from depression or mental illness, and I know that sometimes there is too much to bear and you can't offload work, anxiety and grief, and that drugs, properly prescribed for good reasons, can help.

But.
1 - I believe that doctors are still too ready to prescribe them. Some people need to be told, in the first instance, that their health should come first and that they need to cut down and slow down. They are not depressed because they are ill, but they are ill and depressed because they are overworked and overstressed. They might need some medicinal help in the short term, but it is more important to treat the cause than the symptoms.
2 - I become very upset when these people, however hard they try to cope with the shit that hits them at every point, bewail their inability to do so. Of course they can't. They are not meant to. They are not inadequate, they are normal. What sort of fool sleeps calmly through their bankruptcy, or their parent's terminal illness or impossible demands on their capabilities and emotions? When you are going through an awful time, your body reacts, however hard your brain tries to compensate.
3 - We expect and are expected to 'get over it' far too quickly. I think part of the blame lies with the soaps and similar fiction. A few weeks at most after a traumatic death or disaster, the community "comes to terms" with the losses, because the pressures of the storyline dictates that it can't keep harking back. And so we think we should be the same. We're not allowed to mourn, we're given a few weeks and then expected to snap back to normal. Life isn't like that. I remember a friend of mine, whose husband died at the age of 48, telling me that the second year was worse than the first and that she only started to cautiously regain her equilibrium towards the end of the third year. I know that it took me (in retrospect) three years and three months to recover from the strain of looking after my mother, her death and a very difficult situation in one of my voluntary jobs that I had dealt with very capably at the time. And I had a supportive family, enough money and fundamental security, which many people don't have.

I'm not saying that depression is not real - it is. And I'm not saying that no one should need medical assistance if it's caused by 'events' rather than a mental ailment. Actually, I've lost track of a conclusion and I don't think I know enough to come to one - just that doctors should look for causes, not just symptoms, and that we should all look at ourselves without judgment and with kindness. And I'm not criticising anyone who can't cope or who takes pills, just saying that one shouldn't look to them to make things better if they aren't.