'Ask yourself whether you are
happy," wrote John Stuart Mill in his 1873 Autobiography,
"and you cease to be so." If Mill was alive today
I suspect that he might go on to say: "Ask yourself whether
you are depressed, and you will surely find some reason to
While the elusive experience
of happiness might be compared to a butterfly which, if pursued,
always eludes your grasp; depression, once you begin to think
about it, may well land upon you with a thud. Depression has
become a medical term so broadly applied now that any absence
of personal happiness, of inner contentment or of material
comfort can easily be translated into the illness.
Now, I don't wish to imply that
depression is a word that should be removed from our lexicon.
But I would point out that it is being reshaped, stretched
and over used to the extent that a whole array of emotions
are in danger of being obliterated. Linguistic precision is
giving way to psycho-speak as sadness, "the blues,"
"feeling down," and "low spirits" are
now all clumped under the rubric of this clinical term, depression.
By sleight-of-word, our personal feelings are being transformed
into mental health problems suited to the diagnostic whims
and treatment offerings of therapists.
Consider the upcoming National
Depression Screening Day, October 7, sponsored throughout
Canada and the U.S. by mental health groups, modeled on similar
medical screening days for high blood pressure and glaucoma.
The expressed purpose is to educate the public about the dangers
of depression - to whit, it offers a free screening test to
help people find out if they are depressed and need treatment.
But why wait until Oct. 7? Screening
tests are readily available anytime on the Internet. One from
the New York University's Department of Psychiatry, for instance,
asks 10 questions and gives instant results.
The questions include: "Do
you feel sad, blue, unhappy or 'down in the dumps'?; Do you
feel tired, having little energy, unable to concentrate?;
Do you feel uneasy, restless or irritable?" and "Do
you have trouble sleeping or eating (too little or too much)?
for more than two weeks."
People rate their answers on
a five-point scale from "Never" (scoring 0) to "Most
of the time" (scoring four).
I gave it a try recently, checking
"Most of the time" for two of the items and "Never"
for the remaining eight questions. A click of my mouse and
back came the response: "Your answers reflect the presence
of depressive symptoms.
It is advised to seek a psychiatric
consultation. Ask us for Referral Information." Several
other combinations yielded the same reply, leaving me wondering
whether tests like this uncover actual depression or plant
the suggestion that one is depressed. Could it be that their
purpose is to open the door to psychological treatment?
When that door is opened, it
seems that the most likely treatment, other than the ever-popular
Prozac, is cognitive behaviour therapy which assumes that
depressed feelings and behaviours are a result of negative
thoughts and self-defeating beliefs. Therapists reason that
if people learn to understand and change their thought and
beliefs, depression can be reduced.
But what if the screening tests
are responsible for creating the depressive thinking? Perhaps
through the screening, some people may actually be led to
see themselves as depressed so that therapists, through treatment,
can then help them to stop thinking of themselves as depressed.
The American psychiatrist, Jerome
Frank, states the point well. In Persuasion and Healing, his
classic text on psychotherapy, he writes that "ironically,
mental health education, which aims to teach people how to
cope more effectively with life, has instead increased the
demand for psychotherapeutic help. By calling attention to
symptoms they might otherwise ignore and by labeling those
symptoms as signs of neurosis (and depression), mental health
education can create unwarranted anxieties, leading those
to seek psychotherapy who do not need it."
For a long time, questionnaires
have been recognized as effective marketing tools. It could
well be that the mental health industry has caught on to this
sales approach and is profiting from encouraging people to
ask the question "Am I depressed?"
Perhaps most of us would be
better off if we ignored the question and focused instead
on dealing with the woes which most of us are resilient enough
to overcome in time. So, beware the entrepreneur in helpers