Instead of forcing people with depression to adapt to the "regular" world, why doesn't the "regular" world try and adapt and accommodate people with depression?

I was first truly aware I suffered from depression, in my early twenties.  Having married at twenty-one and twelve months later gone through the devastating trauma of suffering a stillbirth, I was advised to go to counselling to talk through my feelings about the failed pregnancy and my daughter's death.  What came out in those sessions, was all my experiences of loss throughout my lifetime and I suddenly realised I'd been depressed through adolescence and almost certainly back in my childhood too.

One in four of us, or one in three, depending on who's statistics you believe, will suffer an episode of depression severe enough for us to go and seek medical help for that, at some point in our lifetime.

The reality is of course, that those of us with a history of depression don't tend to just have one off episodes in our life, and then we're right as rain again.  For most of us, if you suffered once from depression, you're always aware it's there.  Clinical depression is such a powerful and distressing illness to go through, it's hard to convince yourself everything will be great again from now on and that's all very much in the past. Absolutely!  Totally!  Definitely!

I think many do attempt to take control, by trying to convince themselves the depression has been banished forever now, but more and more of us are finding the courage to talk about how it really feels to live with that cloud hanging over us, or the threat of it, constantly.  Will it come back today?  Next month?  If I become ill?  When I've retired?

Treatment for depression still tends to focus on antidepressants, in the short term, and talking therapies - counselling, psychotherapy and learning ways to manage anxiety through approaches like CBT.  No-one claims they can cure depression, and with good reason.  For the many millions of us who suffer this debilitating disease (and the World Health Organisation does classify it as a disease) very few have ever come out and proclaimed to have been cured of it.

So millions in the UK suffer from it, relationships break down over it, working days are lost because of it, many even lose their lives as a result of it, and yet we still won't accept how devastating the effects are, within our culture.  We refuse to acknowledge the colossal impact depression has on most of us, in some way or other, whether that's being a sufferer ourselves or caring about someone else who is, and the trauma and frustration of seeing their suffering .

Society, governments, family, employers all play their part in perpetuating the notion that depression tends to be quite a minor and transient thing, and as a result, it's impossible to work towards relieving suffering, if you refuse to believe the suffering is there.  Take a few pills, talk to the nice lady for fifty minutes, then you'll feel better. 

The reason it is so difficult for the vast majority of people to really talk about and acknowledge, is that we all know it could happen to us, all it takes is a little trigger event, and we all know we could be heading on a downward spiral to psychological hell.  A death in the family, losing a job, debts piling up, children going off the rails, finding a lump - all of these things are distressing enough to trigger a bout of depression in even the most cheerful, positive souls. 

And that fear is the reason it's not talked about as much as it should be.  As much as it needs to be if we want to try and relieve some of the suffering people are going through.

For all the research and the profound theories, going right back to Sigmund Freud's time, all we know about depression really, is that we don't know very much.  Neuroscience is making greater strides now, but researchers still admit, we're in the very infancy of trying to understand what's going wrong in the brain, when someone suffers from depression.  Because it is a physical disease of the brain, we can put people in a scanner now and see that certain regions of their brain aren't functioning in the same way as for someone who is not suffering from depression.  People with depression aren't just imagining it, any more than someone with cirrhosis of the liver is imagining that, or someone born without legs is imagining their feet are missing.

Six sessions of CBT and pills to make you feel happier for a while, will not help someone grow their legs back or learn to carry on, as if they had fully functioning feet.  Problems within the brain itself, missing and damaged neurons and synapses, overactive amygdalae, lie at the heart of depressive illness.  These are physical problems which result in the brain struggling to function as it should.  In my view, too much emphasis in placed on urging depression sufferers to focus on getting better, with a sort of mind over matter approach, and not enough emphasis is placed on the reality, that this person has an emotional disability, which makes everything in life much harder to achieve.

I can't help wondering if, instead of forcing the depressed person to put all their effort into denying their negative feelings - through distraction, or drugs or self-help courses - we could try to adapt, as a society to including people with depression much more.  Accepting them for what they are, a person who suffers from time to time with depression, and when they're suffering, society could try compassion and patience and validation, instead of denial.

Most of us would accept these days, that adults who suffer from depression, tend to have come from families where they weren't endorsed as an individual person, where they were given far too many negative messages about themselves, predominantly from parents, and not shown love and compassion when they failed to live up to other people's standards.

This lack of compassion now, in society, this need to give a pill or an informative book to cure your condition, is a bit like telling a child who's just been beaten to have a sweetie to take the pain away.

The sweetie never took the pain away, it just fed our festering resentment.

I feel a need to end this on a positive note though, and that will say a lot about me, do I also have embedded within me, some need to leave readers feeling better?  Quite possibly.

My own story and outcome is probably as positive as it could have been, given the circumstances.  Hundreds of hours of counselling, dozens and dozens of self-help manuals, training as a psychodynamic therapist to learn where depression and neurosis comes from, writing novels and blogs to express feelings and frustrations which once just festered in the darkest corners of my mind, have all helped me to manage my depression, to the degree that I haven't had a serious episode since I was in my thirties and I'm fifty now.  It is always there, the worry, I do suffer more anxiety than lots of people and I'd be lying if I claimed to be in any way cured, but now I can recognise the signs easily, and take practical steps to minimise stress, such as getting enough sleep, eating well, getting lots of exercise and sometimes avoiding certain people when I'm aware I'm under more pressure than usual.  I live a relatively happy life, self-awareness allows me to have positive relationships with people and I think I tend to be liked and respected by friends and colleagues.

What helps more than anything, is listening to other people talking about their experiences of depression, such as Stephen Fry, recently, and the musician, John Grant.  Hearing these eloquent accounts of suffering, doesn't make me more depressed, it makes me feel more normal, because good, decent, wonderful people out there have struggled all their lives with the same emotional disability I developed in childhood.  I accept them and have compassion for their suffering, and so I have compassion for myself.

Now we need employers, governments, families and so on, to accept the seriousness of our disability, our disease.  We need kindness from them, only this will help build our self-confidence at times of distress.  Instead of denying our suffering and forcing us to carry on as if nothing is wrong (the same invalidation we suffered in childhood) society needs to show us patience and compassion.  They might be surprised by the results.