Like most good money making scams, the word “depression” began to migrate from clinical language into the lexicon of every jerk on your block through the medium of late-night television. It quickly spread deep into the sphere of “normalcy”, and created a place for itself among popular culture, effectively becoming a household name faster than blockbuster gems like Cinderella 2 hit DVD shelves. As if buying super-absorbent towels from that guy who faced charges for slapping real-life hookers wasn’t bad enough. Now, the white coats gotta get a piece of the action,too (and boy what lucrative action it is). It’s okay for hoe-slapping infomercial celebrities to sell us junk we don’t need (especially while exclaiming, “you’re gonna love my nuts” as he chops up a handful of cashews), but when doctors and the air of medical approval enter the scene, people are getting more than their wallets stolen—they’re minds are being reprogrammed in the process.

I’ve written about the intimate relationship between commerce and the macro psychology of a society, about how the values of a society affects markets and vise versa. Some of those posts, particularly, The REAL reason why Women get paid less than Men (No, it’s not the conspiracy you think), and Every Man for Himself: Why Consumer Culture killed Social Trust, demonstrate the true power of perception in molding reality. In this case, the word “depression” and all of its implications have become so mainstream, that the true meaning and understanding of the condition has taken on certain perceptual distortions that actually make the problem worse. This normalization of both the symptoms and language of depression becomes apparent when you notice that people no longer talk about being sad, or upset—they tell you they are depressed.

See if you can dig this…

Culture Shock

I read an article once that cited the long time experience of a physician in Hong Kong. In the 1980’s, Dr. Sing Lee had treated only a handful of women that exhibited the kind of self-starvation often associated with the western diagnoses of eating disorders like anorexia. However, though the starvation behaviors were present, the significance of them were completely different than what western victims reported, as Chinese girls had no fear of becoming fat. For Chinese girls who starved themselves, their complaints were mainly about stomachaches and feeling sad—NOT body image.

In those days, western ideas and definitions about the distinct behaviors of food restriction were not known in the East—that is, until Charlene Hsu Chi-Ying. When the exceedingly thin 14-year-old was found dead, having collapsed on a busy street in Hong Kong in 1994, the East sought out the wisdom of western medicine for answers. When they came upon the DSM (Diagnostic Statistical Manual of Mental Disorders) and found correlating details associated with anorexia, this information was quickly disseminated throughout the Chinese population. What resulted was a pure experiment in cultural studies.

So, what do you think happened? If you’re smart, the answer is simple; If you’re not, that’s okay, because life is probably a lot more interesting for you (surprises around every corner).

Soon after the western definition of such an eating disorder was made known to the Chinese population, cases of the disorder skyrocketed. After 1995, Dr. Lee began treated record numbers of  young girls with eating disorders. What’s more is that, unlike the complaints of previous sufferers—who felt sad and had stomach pain—the complaints of newer victims began to mirror those of western sufferers with fears of becoming fat and distorted perceptions about body image.

In other words, the symptoms of a suffering population are highly influenced by the information to which that population subscribes. If you can transfer this simple concept to the matter of how depression has become so prevalent among the American population, it becomes clear how one word can change a culture (not to mention a pharmaceutical company’s bottom line).

From TABOO to Acceptance

If you want to increase the likelihood of a population willing to buy anti-depressants, you’ve got to make depression O.K. If you want to make depression acceptable, you’ve got to normalize it through regular dialogue and images that make the condition seem prevalent and “not such a big deal”. In fact, that’s exactly what all medication commercials mean to sell you: ideas; ideas that will lead to action—and then, money.

“Hey, don’t worry, it’s not such a big deal. Ask your doc for this pill and everything’s gonna be fine. No sweat. See ya back out there big guy.”

Notice how they always say “ask” your doctor. This gives the impression that the audience is in control of their own treatment, encouraging them to talk to their doctor about ANY SYMPTOMS they think they might be having. This means that every itch, thought, and emotion are analyzed, categorized, and given a value of judgement that can ultimately turn a sad day into a doctor visit. And so, when you finally do sit down with your doctor, you’ll be sure to ask him/her to put you on the blue pill everyone’s taking to get back on track.

Reaching for the Top Shelf: What Happened to Just Plain Sad?

The real issue is that while the language of clinical depression has become more pervasive and acceptable throughout our everyday culture, it still carries the powerful connotation associated with clinical culture. Because the words “depression” and “depressed” bring up images of those late-night antidepressant commercials, even the common use of this language brings to mind the impression of a condition more sever than just being “sad”. But the thing is, sometimes we are just sad; sometimes we have a sad day, or a sad reaction to a particular event in our lives. It doesn’t mean that we need medication, or that we’re psychologically unstable at all.

Yet, less and less do we hear about people who are feeling a little “blue”, or “under the weather”; now people just hit the clutch and go right for the 6th gear: “I’m depressed today”. It never fails. Anytime we feel even remotely dissatisfied with life, we often reach for that top-shelf descriptor, that loaded word: “depressed”. Providing attention for the clinical diagnosis of depression is one thing, but disseminating that information to be thrown about so freely will not only make the condition more acceptable in terms of cultural taboos, but also, far more prevalent; just look at what happened to the Chinese.

So, we let’s wrap this up with a short checklist that will hopefully provide you with at least some gauge about the severity of your status, and maybe even provide you with the kind of balance necessary to delete the word “depressed” from your everyday vocab.

1.) What’s for Breakfast?

If you’re interested in food, have an appetite, and participate in appropriate eating, you’re probably not depressed. Notice I used the word “appropriate”. Persons with depression tend to exhibit either a lack of interest in food or over-indulgence. If you’re eating regularly, and not binging on stocks of food until you feel sick, you’re probably just sad.

2.) Bath Time

Did you shower today? Personal hygiene—or, rather, a lack there of—is a prime indicator of depressed persons. If you’ve bathed, put on deodorant, and are wearing clean clothes today, you’re probably just sad. Persons with real depression often neglect their personal hygiene, having no interest in showering, clean clothes, or maintaing their appearance. If you can’t stand the thought of going out without grooming yourself, you’re probably not depressed.

3.) The Disappearing Act

Maybe you’re not the social butterfly that some of your friends are, but most people have regular contact with others throughout their daily lives. Persons who are clinically depressed often isolate themselves and severely limit their interactions with others. If you’ve had the urge to talk to friends or family, and have engaged in interpersonal communication with others over the phone or in-person, you’re probably not depressed. Depressed persons often have little desire to interact with anyone—even those they usually feel comfortable around.

4.) The Little Joys

They say laughter is the best medicine, it’s also a pretty good indicator that someone is finding enjoyment in life. Being able to identify and participate in meaningful humor creates a value on life. But more than that, it’s a good sign that someone is ABLE to extract enjoyment and interest out of life. If you’re able to find the little joys in life, to get a sense of interest and desire to engage in activities and actions that bring you some satisfaction, you’re probably not depressed.

5.) The Time Frame Game

Most all of these conditions are best viewed within the context of their respective time frames. We can talk about grey areas and the mixing and matching of different signs of depression, but much of it comes down to “how long”. How long have you been isolating? Avoiding food? How long have you been neglecting your personal hygiene? How long has it been since you’ve found some joy—even in the smallest corner of life? Loosely translated from the DSM, most symptoms of major depression have to be present for MORE THAN 2 weeks. But more importantly, these symptoms have to be impacting your life in a negative way. So for example, if some dude just doesn’t shower because it’s part of his culture/religion/preference, and yet, he’s able to go to work and function well in the many roles of his life, he’s not depressed.

The Bottom Line

Real depression is a serious condition folks, and yet, corporate America (most notably, pharmaceutical companies), have pushed to make both the language and literature of depression part of everyday discussion. This invasion of such information into the layman’s world has done some good to bring attention to the true cases of clinical depression. However, one of the other (more detrimental) side effects of such dissemination of clinical knowledge is that people internalize it so well. It’s gotten to be that people have a hard time differentiating sad moods and “rough patches” from a serious case of detachment from life.

While this cultural phenomenon is certainly good for pharmaceutical companies that hope to make antidepressants as common and acceptable as Flintstone vitamins, it creates a serious detachment from human intuition about our experiences. Rather than looking inward and analyzing our personal patterns, we look outward, casting our eyes toward charts, popular statistics, and commercials that tell us about our experiences of sadness and what to do about it. Having our experiences named and categorized for us encourages us to stop asking questions of ourselves, to disengage from internal dialogue, and quells our curiosity to understand how WE experience sadness. In this way, while popular mental health culture may provide insight for those who have truly lost their way, it may also handicap those who never needed help in the first place.