By Lubna Abdel-Aziz They are coming out of the closets in droves, confessing a bout of depression without reservation or shame. Suddenly it almost seems fashionable to be in, or to have gone through, a state of depression. Once looked upon scornfully, with strange smiles, dry jokes, and queer notions, it is now the condition of the very "chic", the maladie de jour. All sorts of celebrities are admitting their depression, granting detailed interviews, and even writing books, and books, about it. Interest in learning more about this eternal note of sadness has skyrocketed. Bookshop shelves are bursting with volumes by psychologists, psychiatrists, artists and comedians. Once considered as mysterious as it was verboten, the strong tide of depression increases its volume and floods new territory, amassing more victims. How to stop it? Often dismissed casually as a bad mood, science has now extended its knowledge to this troublesome, complex, elusive condition that can lead to disastrous consequences if not medically attended to. No longer does the affected individual quarrel with his destiny, hiding it from curious eyes and all the prejudice of the ages. No longer does he feel the harm in talking about it, still less in treating it. There is nobility in facing the truth. The folly is in pretending it does not exist. With full compassion and delicate sentiment, modern science has finally focussed on this malady of the age. What is depression? Where does it come from? Why is it presently in the forefront of medical practice? Years ago scientists did not really know where depression came from, but recent studies show strong evidence that certain forms, such as clinical depression, depressive disorder, manic depressive, and dysthynia, are actually diseases caused by chemical imbalances. It is not a disease of this crazy technologically fast and furious age. Depression is as old as man himself. The Ebers Papyrus, one of the world's oldest medical documents, dating some 4,000 years ago and reflecting the medical knowledge of ancient Egyptians up to that date, used the precise definition of modern science: "a condition of severe despondency". Hippocratic writings of the fourth century describe a similar concept as "melancholia" derived from a black bile, "one of the four humours" introduced by the Greek physician Galen. Generally acknowledged as more serious than regular depression, which results in fatigue, apathy or irritability, "clinical depression" is a major depressive disorder. It often leads to intense sadness, melancholy, despair, negative thinking, often substance abuse and even suicide. Blinded by the darkness of existence, like a brazen prison, its victim is locked within this barren heart of a deathly frozen gloom. Who would not wish to escape the confinement of this dreary dungeon of depressive exile? With the staggering numbers recognised in so many countries, medical science is rushing to diagnose and treat this growing phenomenon. Clinical depression affects 7 to 18 per cent of the population; it is currently the leading cause of disability in North America as well as in other countries. In Australia one in four women and one in six men will suffer from depression. In Canada, 1.35 million people are affected. It can start at age 20 and more often than not it is a recurring disease, making it a major public health concern. According to the World Health Organisation (WHO), it is expected to become the second leading cause of disability worldwide (after heart disease) by the year 2020. Before you rush into self-diagnosis, here are some guidelines, but accurate diagnosis of the condition often befuddles even the specialist. Major depressive disorder (MDD), is characterised by a severely depressed mood presenting for over two weeks (excluding bereavement). Bipolar disorder of MDD is preceded by a period of elevated mood or mania. Some cases may experience psychotic features, hallucinations or delusions. Twice as many females as males report, or receive treatment for clinical depression. Why are some of us more inclined to succumb to depression, while others sail through the ebb and flow of life scarless and unharmed? Years ago scientists blamed depression on the environment, but recent studies have clearly shown that the predisposition to certain diseases, including mental illnesses and depression, are inherited. Though the specific gene or genes that actually cause clinical depression have not been identified, there is little doubt that clinical depression is a familial tendency caused by a chemical imbalance of the brain. No shame and no blame. Millions worldwide suffer these illnesses, and have for thousands of years. Unfortunately only 50 per cent seek treatment, or even acknowledge it. Herein lies the shame and blame. There are a variety of medical treatments, including drugs, acupuncture, exercise, meditation and other methods with satisfactory results. We are lucky to be living in this day and age where this faddish raging malaise can not only be openly discussed but successfully treated. It may be a badge of sorts to suffer a bout of depression. Notables in every field of the finer arts have been known to suffer its vicious and pernicious symptoms that may have contributed to heightened sensitivity and performance. Renowned writers Honoré de Balzac, Leo Tolstoy, Charles Dickens, Ernest Hemingway and Maxim Gorky are among hundreds whose pens suffered the pain of melancholy. Musicians of the calibre of Ludwig van Beethoven, Sergey Rachmaninoff, Gioacchino Rossini, Robert Schumann and Hector Berlioz often lived in a cloud of misty melancholy. Who can forget the creative genius of Vincent van Gogh during his period of severe depressive moods, or his close friend Paul Gauguin? The list of celebrities of our age is endless, yet their depression may have edged them on perhaps to greater heights; the high and the mighty like Napoleon, Sigmund Freud, Winston Churchill, Agatha Christie, Charles Darwin, the late princess Diana; clowns like Danny Kaye, Jim Carrey, and John Cleese, suffer behind their hysteric humour. Contemplative performers like Marlon Brando, Anthony Hopkins, and Audrey Hepburn, felt its piercing slings. Who would not wish to be included on such an impressive list. Notwithstanding, the ease and affluence of our age, it is so exhausting, so transitional, so unconscionably fickle, how can we help escape it all, but by succumbing to the exile of a depressive state. When unable to find our way back, we need to seek the sound armour of serenity and security, and the firm ground of psychological and medical help. Rather than fear a natural enemy within, triumph over it and have the last laugh. Yester night, the sun went hence And yet is here today John Donne (1572-1631)
