RUNAWAY DEPRESSION:
Depression is accelerating in our digital age of constant accessibility and expectations, but among those succumbing are the ones you’d least suspect – people with everything we’re raised to believe epitomises happiness, from success and celebrity to lovi
Why those who seemingly ‘have it all’ end it all
ina single week in June the world lost two stars. First, fashion design icon Kate Spade hanged herself with one of her signature scarves. Then celebrity chef and travel writer Anthony Bourdain did the same, as aptly – with the belt of a hotel bathrobe. But it was when internationally acclaimed and wellloved cardiologist UCT health dean Professor Bongani Mayosi took his life in July, after helping save so many through his pioneering work, that the questions raised hit home for most South Africans. Depression almost seems a logical response to the poverty, unemployment, violence, rape, child abuse, crime and racial tension in our beloved country. And according to Dr Sebolelo Seape, chairperson of the Psychiatry Management Group, it afflicts around 4.5 million of us – almost 10% of the population (against 6% of Americans, by World Health Organization estimates). A study in 2016 found that one in four South African workers suffers from depression, costing the country nearly 6% of the GDP (through absenteeism and presenteeism (coming to work unwell and not being productive). The South African Depression and Anxiety Group (SADAG) fields 400 desperate calls a day, which soared to 600 in the weeks following Mayosi’s death.
Somehow, Mayosi, Spade and Bourdain were not supposed to be as vulnerable as the rest of us. They were all at the top of their game, ostensibly with everything to live for, from professional success and beautiful families (all three left young daughters) to material comfort. Yes, Mayosi was undoubtedly
‘Is it not depressing to contemplate that even if we achieve all we strive for, it might not bring us happiness?
vulnerable, caught between his hard-won responsibilities as dean and the pressures of student demands at a painful juncture in our education transformation. Bourdain had spoken openly of drug use earlier in his life, although he had no narcotics in his body when he died, only alcohol. And Spade was having relationship issues, living apart from her husband. (She reportedly left a chilling note for her daughter aged 13: ‘Bea – I have always loved you. This is not your fault. Ask Daddy!’)
But if stars such as these had succumbed to depression, where did that leave the rest of us, still floundering around the lower rungs of life’s ladder?
Was it simply what the fridge magnet says: ‘You can see many smiles every day. But you can never know whose world is actually upside down’? Or, as the poet Miller Williams more elegantly phrased it: ‘Have compassion for everyone you meet… You do not know what wars are going on/Down there where the spirit meets the bone’?
THE STRESS OF SUCCESS
‘Depression is the end result of many factors – burnout, existential crisis (experiencing
HOW TO SPOT DEPRESSION in others
a lack of meaning), feeling helpless with no way out, isolated and misunderstood,’ says clinical psychologist Dr Colinda Linde, a SADAG board member.
‘In the context of success, exhaustion from burnout as well as the sheer hours put into achieving it can lead to depression. The pressure to be the best and maintain a brand and popularity are other causes of depression in those labelled successful. In all of these cases, no one can sustain extreme work hours or a perfect persona indefinitely, and when this identity starts to show the cracks, it’s often in the public eye, which compounds the pressure. Small wonder success can go alongside depression and stress!’ Stress, Linde says, is essentially the relationship between demands and resources. ‘When demands are high and there aren’t enough resources to balance them, we’re stressed. The normal demands of daily life can take the form of acute events or challenges, or appear as hassles that pop up as small obstacles through your day.’
While everyone has some combination of these, she says, a person in the public eye has additional pressure to be their brand all the time (the dreaded ‘expectation’). ‘There’s always someone on the lookout for a public figure to expose some sort of human frailty or less than perfect behaviour or appearance, and it’s then reported on in a public context.’
This set of demands is experienced by a minority, Linde says, who can often feel isolated and that no one else understands the contradiction they find themselves in: ‘On the one hand, having wealth, status and recognition is what most of us strive for, yet there’s often animosity, criticism and envy towards those who have attained these. The same envy can lead to “tall poppy” syndrome, where others are only too happy to take the successful person down. The concept of schadenfreude refers to the pleasure derived from someone else’s misfortune, and those in the public eye are particularly vulnerable to this from others.’
STRESS FOR THE REST
Again, where does that leave the rest of us? Is it not depressing to contemplate that even if we achieve all we strive for, it might not bring us happiness? That if
we manage to get accepted to university, graduate, land the right job, make it to the top and find success, rather than living happily ever after as we’ve been told by a myriad folktales and movies, we might find ourselves in the darkness of runaway depression?
It seems much may come down to our internal resources. ‘People with an internal locus of control believe they have the necessary tools, skills and support required to overcome life challenges and are in control of their lives. But people with an external locus of control believe the events in their lives are beyond their control,’ say clinical psychologists Voula Samouris and Evelyn Nagel-Malatji. The danger in the age of social media, with its artfully curated pictures of what success looks like (whether financial success, physical appearance or level of education) is that our locus of control can shift from internal to external, they say.
‘Failure to achieve completely unattainable goals can result in the onset of a depressed mood that in time requires professional intervention to assist the individual in reevaluating their goals and regaining an internal locus of control.’
To re-evaluate our goals, we need to redefine what happiness is. Studies suggest that while income and standards of living in many countries have soared in the past 50 years, happiness levels have dropped. Positive psychology pioneer Dr Martin Seligman
(Authentic Happiness) says research shows three elements to happiness: pleasure (the ‘smiley-face’ element), engagement (the depth of our involvement with work, family, romance and pastimes) and meaning (where we use our particular talents and passions for a larger purpose). Of these, he says, pleasure is the least significant.
Getting control of our negative emotions and feeling happy has been found to have a powerful effect on everything from depression to cardiovascular health – in one study cited by positive psychology researcher Ed Diener, happy people lived nine years longer than depressed ones. The question is how to achieve it.
Behavioural geneticist David Lykken, who followed 4000 sets of twins over 20 years, concluded in a paper in Psychological Science that as much as half of our satisfaction with life comes with our genes, which influence such characteristics as a sunny personality and the ability to handle stress well. But recent research suggests that while our genes influence the degree of happiness we’re able to experience, it’s up to us as to whether we work at the top or bottom end of our happiness range.
‘I’ve coached several clients who have achieved their financial goals by their early forties and found themselves unexpectedly in a state of depression, despair, or in one case, feeling suicidal,’ says Neil Bierbaum, executive coach, author and co-founder, with Linde, of the Practical Mindfulness programme.
‘In every case, they found a way out of it by creating an expanded or more meaningful goal for their lives. For one, this meant expanding his vision to a global instead of just a national property empire. For another, it meant finding a way to contribute to society through charities and mentoring others. Each learned that at the top of the ladder it can be quite empty and lonely, and you have to create a whole new purpose and source of meaning for your life. Bill Gates is probably the primary exemplar of this.’
BEATING DEPRESSION
Along with these measures, beating depression rests on recognising the signs early, in ourselves, our loved ones and colleagues (see How to Spot Depression in Others), finding or offering support and sourcing professional help.
Start with a doctor who can rule out or address physical problems such as anaemia and hormonal imbalance, which can feed depression, and direct you to other professionals, says SADAG operations director Cassey Chambers. ‘Cognitive behavioural therapy can teach ways to challenge negative assumptions and give practical coping skills and problem-solving strategies. Therapy also presents a safe environment where feelings can be explored.’
Simply exercising for 30 minutes a day can help relieve stress and boost feel-good endorphins, and some studies suggest that for mild to moderate depression it may be as effective as antidepressants. A balanced diet with plenty of fresh vegetables and fruit, a little lean protein and omega oils from fish or a supplement can also improve mood.
Otherwise, medication can address imbalances in brain chemicals responsible for mood. ‘And modern antidepressants have minimal side effects when taken as directed,’ says Chambers. ‘You don’t have to live with depression. Making use of free online resources and support groups can also help one cope with mental illness.’
To re-evaluate our goals, we need to redefine what happiness is.