Casting Some Light on Depression

The Colour of the World

Photo by Nino AndonisTalking with a friend the other day about how depression colours her sense of the world reminded me of just how much people who have never experienced depression can misunderstand it.

People often think that depression is simply having a bad day, or hitting a rough patch, or feeling sad. They assume that if someone is depressed, it means that person is unable to smile, or laugh, or find any type of levity in life.

But depression isn’t a passing feeling, although it does have an ebb and flow. It’s more like an underlying state of being, a subdued background to one’s life—or, in its more intense periods, it’s like being engulfed by a void or consumed by feelings of bleakness, despair, dread, or misery.

Some women describe depression as a pervasive heaviness. Others explain how it shades their view of the world, so they feel like they’re looking through grey-tinted lenses. Depression can turn life into a struggle, making the seemingly easy routine of daily life a formidable challenge.

Another Shade

Contrasting depression with the romantic and artistic associations of melancholy, Susan Sontag declared that “depression is melancholy minus its charms—the animation, the fits.”

But even if depression hasn’t achieved a reputation as a condition fit for creative types, in practice it has an intimate relation with art. Another friend explained to me that depression infuses her art, that in the throes of depression she produces work with a richness of emotion that she otherwise can’t tap into. Depression, she said, brings her closer to true feeling. I believe it; the best art comes from writers, painters, and musicians who have known intense unhappiness and seem to feel more than those around them.

So while depression is an ongoing struggle, for some it’s also a depth of feeling and a source of creativity.

The Female Side of Depression

For reasons that aren’t clear, depression affects more women than it does men. The same goes for people living with HIV: Rates of depression for positive women are higher than those for positive men. This may be due to physiological differences between women and men, or it may be due to the different social conditions faced by women, who tend to have a lower income, experience violence disproportionately, and act as primary caregiver to their partner, children, and other family members. The International Association for Suicide Prevention notes that structural factors such as “unemployment, poverty, oppression, marginalisation, stigmatisation, or racism” can contribute to depression.

But regardless of whether depression is the result of biological or social conditions, it doesn’t mean that someone is flawed or weak. If you have depression, it doesn’t mean that something is wrong with you. Historically psychiatry has disproportionately based its classifications of disorders on women’s behaviour, with the effect of pathologizing much of what might otherwise be considered normal responses to issues faced by women, such as violence and health. A positive woman may have a prior history of depression, or she may experience depression for the first time after being diagnosed as HIV+, but either way it can be seen as a normal response.

Dealing with the Dark

Depression can be seen as normal. But at the same time, you don’t have to passively accept it when it’s interfering with your life. It’s important to recognize when you need support.

For women living with HIV, depression can negatively impact adherence to treatment. Studies have shown that patients with depression are more likely to miss doses of medication, so figuring out how to deal with both the depression and HIV infection is important.

If you feel that depression is having an adverse effect on your life, you can consider a number of options. Social support is key—identifying family members, friends, or support workers with whom you can connect is important. Exercise and nutrition are also prime considerations, as physical activity and healthful food can affect mood. Getting adequate sunlight and sleep can also help. In addition, women find that a variety of activities can be useful as coping strategies, including meditation, journalling, reading, listening to music—it comes down to the individual, so explore what works for you. Medication and herbal remedies may also be options for you, but be sure to discuss them with your doctor, as they can interfere with some HIV medications.

The Well Project also has information on women, depression, and HIV, which can be found here.