Volume 24, Issue 18, 22 September 2014, Pages R851–R854
Open Archive
Summary
Depression
has become one of the biggest health problems globally, but in certain
places more than in others, suggesting cultural as well as biological
causes. Neuroscientists are only beginning to understand underlying
processes and to develop effective treatments for those cases where
conventional psychotherapy and drugs fail. Michael Gross reports.
Main Text
The
recent death by suicide of Hollywood actor Robin Williams triggered a
global discussion about mental health, bringing out all the manifold
questions, uncertainties, misconceptions and prejudices that surround
problems like major depressive disorder (depression) and bipolar
disorder, which is what Williams reportedly suffered from and which
involves alternating phases of depression and euphoria.
By
its very nature, views on a suicide in the state of depression depend
on people’s philosophy and outlook on life. Reactions range from the
view that depression is a deadly disease like cancer and suicide is just
its fatal symptom, through to the description of suicide as an act of
free will designed to escape an unbearable situation. Charities like the
Samaritans and Mind have warned that the latter view, if propagated in
the media, may trigger further suicides, as may the reporting of
excessive detail of the ways and means employed in the act. However,
with the global media competing over this exceptional story, this advice
was frequently neglected in the reporting.
In
the wake of Williams’ death, attention turned to the broader issues of
depression, which is widespread but still widely misunderstood. Major
depression, according to a definition from US psychiatrist Allen
Frances, “must be dense (i.e., present for most of the day, almost every
day); must last at least a few weeks; and must be severe enough to
cause clinically significant impairment” (quoted from Essentials of Psychiatric Diagnosis).
That sounds terrifying enough to justify an urgent call to a medical
practitioner, but sufferers who would need medical help are still facing
unhelpful comments like “just get over it” from people who fail to
understand that mental illness is just as real as physical disorders.
Such
misconceptions may be part of the reason why only a minority of
sufferers are actually getting the medical help they require.