We rely on words to define us.  If we try to express a specific condition without the right words attached, we become lost and we are unable to clearly understand each other.  While teaching one of my Public Health courses, a group discussion about clinical depression led us into an examination of the word “depression” and how the home cultures of some of the students’ parents did not allow, or define, the concept of “depression” in a serious, medical, sense. 


If you are clinically depressed, but your language has no word to give meaning to your condition, what do you become?  What is the label for your “depression?”

It seems, according to our class discussion, that your symptoms are either ignored or you are given a label that the majority finds more useful to wield against you:  “Lazy,” “tired,” and “undependable” were a few options.

Students from India, Nigeria and Thailand plainly said there was no concept for “depression” in their native culture and many felt their parents “would not allow” them to accept medication for — or the labeling of — their condition as “depressive.”

I asked if their Thai, Nigerian or Indian dictionaries provided definitions for “depression” and all of them said “the word does not exist in our language.”

As homework, I asked them to ask their parents to explain the concept of “depression” and the results reported during next class indicated a complete parental misunderstanding of what it means to be “depressed” and, after the condition was explained to them, a total and complete dismissal of a misdiagnosis that has no bearing in reality.

I asked how their parents would react to having their children placed on medication to deal with their depressive states and every student reported their parents would not accept the idea of medicating a disease that does not exist.  One student’s mother said, “No medication. Get a job instead.  It will make you feel better.”

So is depression real, verifiable, and treatable — or is it merely conditional?  Is depression all of the mind and not in the body?  Is the remedy to feeling depressed to simply change the topic from oneself to serving the external world in labor and deeds? 

Instead of denying the darkness and pushing people into the light — are we only pressing people deeper into a depressive state by medicating them to keep them boxed within their own mind — creating a cipher of an existence instead of one that sloughs off the hard times to perpetually create the happy moment?

If a culture of minds refuses to define “depression” by recording it in a dictionary or embedding it in a national dialogue — does that condition cease to exist, or is it only given a more convenient tag?

I am reminded of a previous argument I made here against the new and nonsensical medical “diagnosis” of “fibromyalgia” — which is now taking on a life of its own as “The New Depression” — by claiming various aches and pains as a medically certifiable condition in need of medication when, five years ago, we managed aches and pains with aspirin and, a generation ago, we healed the same condition with a shot of whiskey and an earlier bedtime.

Don’t try, however, to take away someone’s “fibromyalgia” label — they cherish that diagnosis and they will fight you to keep it with every muscle and bone in their body — because they are comforted in the acknowledgment of their vague condition by the medical profession.

Are we becoming a world of complainers seeking to pop a pill to fix every discomfort?

Have we lost our inherent toughness to solider on in the dark and rain and muck just because we believe tomorrow will be a brighter day?

Is is unnatural to force sunshine into a darkness that seeks no light?  

Does every negative feeling, pain, and ache require medical intervention?

29 Comments

  1. Hi Katha,
    I was asking the students to use their parent’s dictionary from their home country. I had several Indian students that told me no such word exists on the printed page for a medical definition of depression.
    Now, in the modern era, when words and slang and meaning are updated on a daily basis on the web, anything can be easily defined and propagated.
    Your URL proves interesting because most of the “depression” definitions have to do with the economy and business. There isn’t a single entry that defines “depression” as a serious medical condition — it is only loosely linked with feeling “glum” and “sad” and one definition even uses “laziness” as a synonym! — and we know clinical depression is much more than that.
    In my standard hardcopy of Merriam-Websters Unabridged Dictionary, I have definitions for: “Agitated Depression,” “Clinical Depression,” “Manic Depression,” Retarded Depression,” “Anaclitic Depression,” and “Major Depression” and they are all different strata of medically diagnosed depression.
    I can get even more specific by going into the Websters Medical Dictionary — here’s that dictionary’s definition of “Major Depressive Order:”

    a mood disorder having a clinical course involving one or more episodes of serious psychological depression that last two or more weeks each with no intervening episodes of mania and are characterized especially by a loss of interest or pleasure in almost all activities and by variable symptoms of depression (as loss of appetite, sleep disturbances, loss of energy, impaired concentration, or suicidal thoughts)

  2. Fascinating topic, David!
    For reasons ranging from ignorance and a misplaced attempt to protect it, so many cultures fail to incorporate the things we continue to learn about the world and the human condition into their languages.
    In the case of the word “depression”, although we can find literal equivalents in other languages, often they do not contain its medical import.
    In the link that Katha provided of the Hind-English dictionary, I’m pretty sure that definition 4 that seems to include depression is a case of a contemporary lexicographer’s personal knowledge of languages that allows him to make that connection. In daily use, the word doesn’t imply all that clinical depression does in English.

  3. Exactly, Dananjay!
    Katha’s fourth definition proves my point:
    “(a) gloomy, glum, depressed; sad; ~ता glumness, sadness, depression.”
    To lump “depression” in with those other words is precisely the attitude of the parents in question and their response to being depressed by “Bucking Up” and “Getting a job!” and, as one student said, “Just don’t feel that way.”
    How can we begin to advance the cause of depression as a medically treatable condition if there is no good definition in the intellectual culture that makes it clear depression is a “serious break in the mind that affects the body” — if the official labels only believe it to be a fleeting emotion?

  4. Firstly I like the way you have almost continued on from Katha’s post on the cultural interpretations of certain words and how “English” travels differently.
    Our understanding of depression as a medical condition has developed considerably over the last 50 years. In many paces and in some age groups the *pull yourself together* treatment is the only recognized treatment and REAL clinical depression goes unnoticed, unrecognized and untreated.
    20 years ago my mother had what was politely called a “nervous breakdown”. This followed a nasty dose of bronchitis, which messed with her blood sugar levels, gave a false reading of diabetes and lead to the loss of her driving license and subsequently her independence. My father bless him did his best to try and help her “pull herself together” – luckily the intervention of myself and then the doctor got her on the right medicine and she went on to live another 20 years with only one repeat occurrence – which was promptly treated.
    They came from a very stoic generation – who endured by nature (far more then they should have done) and who because of their age were not au fait with the gains in understanding and scope that modern science was making in the areas of mental health and its treatment.
    On a more personal note – I myself have wavered close to the depression line myself – after the death of my son and after the death of my mother.
    So far I have managed to stay on the right side of the line. Both times my doctors have been at the stage of offering medication to assist – both times I stepped back and said give me a couple of months – if I am not right then I will try the pills. Even I have a fear/prejudice of being labeled/flagged up as mentally ill.

  5. Great comment, Nicola! I appreciate the brave and detailed insight into how depression has run through your family. Depression was always historically seen as a weakness of spirit and not a breaking of the mind. To have depression was to not be a team player and to set yourself apart from the mainstream thinking of the day.
    I, too, am glad there is so much detailed information about medical depression — that sort of “proof of diagnosis” is currently missing for fibromyalgia — because it makes is easier for people to try to get help.
    When Prozac first hit the market — you could tell who was on that pill because they were always happy and smiling and they raised suspicion because they were so much up and out of the dark. It’s too bad Prozac doesn’t always last in the long term for many people. Sometimes a neutral grey is the best place to be between the dark and the light.
    Actress Vivien Leigh was manically bi-polar — the treatment in the 1950s was electric shock — she had several miscarriages and she died at home of tuberculosis at the age of 53 because she didn’t want the shame of staying in the hospital. One wonders what sort of life she might’ve had if she had proper, modern, medical treatment. Instead, she suffered and those around here suffered even more. Some might argue to a right point that it may have been her depression that helped make her a star. Without her darkness, we never may have seen her light.

  6. I hope that being open about it means that one more person has the courage to recognize it and not to be afraid of it.
    Stress, Anxiety, Depression (SAD) affects so many people – far too many lives are ruined by it.
    When I was a child our local Mental Hospital was full of electric shock patients – it was a center for such treatment. As children we were terribly cruel and imagined them all to be monsters created by Frankenstein.
    As a teenager I did voluntary rehab work with the patients – basket making and weaving cane. While I was there the electric shock treatments were being phased out and the early drug regimes were being introduced.
    Vivien Leigh’s story is doubly tragic to carry the stigma of both mental illness and tuberculosis. That stark contrast with her image of Screen Goddess must have been hard for her to live with.
    There are other examples of geniuses that have had similar battles …… there seems to be a very fine line in the mind between genius and depression/mental illness – Churchill being one of the most famous UK examples.
    I wonder if the line is similar to that and autistic savant?

  7. I love knowing your history of volunteering to help the depressed, Nicola! You did a fine thing and made up for the unfortunate peer pressure that pushed you into being impolite.
    They say there’s a fine line between genius/madness and I think a lot of people in that category drift between the two all day long. Some are better at hiding their insanity than others.
    Vivien Leigh would return home after her shock treatments with burn marks on her temples. That must have been a terrible, visible, scarring to live with and try to deal with the inflections of others into your life.
    Autistic Savants are incredible beings. I think we should be putting them to work on solving the big problems of the day instead of making them into sideshow freak displays. They have a verifiable gift that amazes — why don’t we welcome them into us more?

  8. These fine lines fascinate me – that delicate balance and how some people manage to walk it and how others do not.
    We do not do enough research into our minds – they are the most incredible organ.
    Sadly I feel Autistic Savants are treated so badly because it is the way that society treats anything they do not understand – ie they fear them and push them away.
    My aunt was a head teacher at a school for autistic children and used to tell the most heart rending tales of children that were literally “parked” there for the duration. Luckily she also told us of the breakthroughs and the joys and rewards as well – so we were able to have a window into their world and see that it was not all doom and gloom.

  9. Bravo, David. This is a good topic for discussion. Why must we label disease? If people have chronic, clinical depression that they can’t ever get well from, why do we have to define it? Why can’t we just accept that they are sick and help them?

  10. Nicola,
    I think the problem with the genius savant is what I’ve mentioned here before: The mediocre mind can only recognize mediocrity. Genius is lost on them because they don’t recognize it or understand it and so it ceases to exist in their middling world.
    For savants to thrive, they need to be acknowledged and accounted for and mainstreamed on their own terms — but those in power positions to make that happen are either threatened by their strange genius or they’re too dull to recognize the higher power of the savant mind.
    I agree the lines of the mind are fascinating. How is language formed? Why are we separated into two halves? How can we make the whole mind work together instead of just wasting away?
    In my limited experience with savants, the disconnect isn’t between the genius and its expression — the disconnect comes in the ability to cogently communicate the genius to those who are unable to understand it. So the matter of the savant becomes one of not having the right vocabulary, memes and imaginative grammar to make the whole connection instead of just feeling the spikes of the different thoughts being processed.

  11. I take your point that labels should not matter, Anne — only the needs of the person matters — but if we use labels to create common ground and understanding, don’t we need those labels to help us understand the needs of the disabled, the diseased and the depressed?

  12. Synchronicity in action – a documentary about Savants on the Discovery channel in the UK at the moment.
    They are showing some of the first brain scans they have managed to do – when the subject is calculating they use the area of the brain we use for movement – it is amazing. They have film of the brain flashing in all the *wrong* areas.
    I will see if they have it on-line anywhere.

  13. Hi David,
    There is no way I can show you the hard copy of any standard bilingual dictionary that I have with me but the link I provided with the meaning contains the same.
    I understand your point that none of those addresses the clinical part of it the way it should.

  14. Hi David I was just wondering if you had any other evidence for there not being a word for depression in many countries, I’m writing an essay on ethnic minorities and health care and would like to use your point but need a peer-approved reference for it.Many thanks!