Friday, 4 October 2013

A silence of three parts

(Consider the title a hint that if you’re a fantasy fan you should probably give Patrick Rothfuss’ The Kingkiller Chronicles a go. Image from

Regular readers will probably be aware by now that I’m not overly shy in giving my opinions on things, and that I do try to approach a subject reasonably and consider all the angles I can before writing it up. 

However, I’m sure we all have things which we struggle to meet with reason. One of mine is the abuse of the idea of free speech. 

To give some background, part of my job is transcribing detailed attendances and conversations, and working for a law firm means attention to detail and accuracy are paramount. However it also means I occasionally have to type something quite unpleasant.

Put simply I was typing up something fairly abusive and when challenged the individual turned round and said “I can say what I want, it’s called free speech!”

There seems to be an assumption that freedom of speech should somehow equal freedom from consequence. By your own logic if you have the freedom to say whatever you like, someone listening equally has the freedom to call you out on what you’ve said. To me it’s a part of being an adult that you recognise the fact that just because you can say it doesn't mean you should. 

In the sphere of illness, nowhere is this more prominent in my mind than the area of mental illness and in particular the subject of depression. 

Depression is not something I have personal experience of, but some people close to me have suffered or still suffer from it. I’m not going to sit here with a pretense of understanding the condition itself – what I wanted to do is comment on the fact the phenomenon above seems to be so much more prevalent in this area.

The little I have learned is that each person’s experience will be as individual as they are, and that there is no right answer that can neatly box everybody up. Similarly to most of the illnesses I talk about it can range from the mild to the soul-destroying, it’s not always easy to pinpoint a catalyst and it comes in many different forms and manifestations.

So why is it that everybody and their aunt and their dog has an opinion about depression?

Better yet, they all appear to feel that they have a right to express their opinion to sufferers without thinking about how possibly unhelpful it may be. Showing off their supposed knowledge and “informed” (make of the quotation marks what you will) opinions seems to be vastly more important than anything the sufferer might think or feel.

(The redoubtable Stephen Fry. Like him or loathe him, he's one of the foremost voices in combating the ignorance surrounding depression and those who suffer from it. Image from 

If the subject comes up I can guarantee you will see this happening. I've actually challenged people before and asked whether they have experience of depression – when they say no, most of the time its revealed that they've picked up their erroneous views from others who have no understanding and have taken the view as gospel without further thought (because actually evaluating it would be too much effort, right?), or they've done a quick search round the internet and cobbled together what they've found there.

Well Google isn't a doctor and if you genuinely think that a search engine will tell you enough to have an informed view of such a nuanced and variable condition then you are a colossal fool.

It may be outside my sphere of experience, but I still get irritated when I see people mouthing useless platitudes like “Just think positive!”, or “Just get some fresh air!” as if they’re talking to someone who is merely lazy (and apparently stupid).

I’m not suggesting that being outside in the fresh air and sunlight or taking exercise aren't sensible ideas, because that would be silly. However to tell that to someone with depression as though it is something they can just snap their fingers and decide is hugely ignorant and completely divorced from any compassion for their experiences.

And “think positive”? If it was as easy as that then depression and just about every other illness simply wouldn't exist, because everybody could just “think themselves better”. Subscribers to the method of auto-suggestion – training the brain into different thinking patterns by associating the old ones with something negative – are some of the worst I've seen for this approach.

It’s something new and shiny that works for their life (usually remarkable on the fact that depression is not involved) and they then seem to think that anything from a nail biting habit to suicidal thoughts can be fixed by something as simple as wearing a rubber band on your wrist and snapping it when you think anything negative.

Disappointingly I didn't make that example up. I've actually seen someone suggest that to a depressed individual. I've talked about this “what works for one must work for everybody” mentality before on TRB and it never ceases to amaze me that people are actually that blasé about their fellow human beings.

If it’s not telling people how to fix themselves then it’s dismissing the side effects of antidepressants (which they've never taken) as myth and invalidating the experiences of those who take them. 

Just a little piece of information: I take a drug called Amitriptyline for my IC and Fibromyalgia. In higher doses Amitriptyline is a tri-cyclic antidepressant. As with all medication, there’s an information leaflet in each box of tablets which explains the ingredients, anything which shouldn't be taken alongside it and also the list of possible side effects in order of how commonly they occur. 

The list is over two sides of the leaflet and it does include extreme mood issues and an array of cognitive difficulties – the things these knowledgeable folk dismiss as mere myth. Just to poke further holes in egos, it’s also worth noting that said list is part of the reason Amitriptyline and other tri-cyclic drugs are being phased out as front line depression treatments and being reserved for when other less problematic medications have proven unhelpful.

In common with other chronic illness sufferers, I've known several people who don’t like to mention they have or have had depression. They deliberately keep things vague to deflect the ignorant suggestions and worst of all the stigma that it’s “not really an illness”.

To bring this full circle back to my original point about free speech, I mentioned further up that it’s a part of being an adult to distinguish between things that you can say and things that you should.

Something even more important and even simpler yet: it’s about being decent as well as being right.

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