Last week a friend of mine on Facebook shared a quote from actor, writer and comedian Stephen Fry regarding depression, which read:
“If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.
Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.”
I enjoy listening to and watching Stephen Fry in general, and I particularly like his early comedy work. These days he speaks candidly about his experiences with bipolar disorder with the aim of inspiring sufferers of depression in general to feel more comfortable talking about it, and non-sufferers to be more understanding and sympathetic. That’s great, but there’s one problem which I feel needs addressing. I find his claim that “depression…is…like the weather” and isn’t a “…response to a bad situation” a curious one because such a belief is really not supported by reason or evidence, which I shall show in a moment. Also, It is an unhelpful claim to make about depression because it may lead people to wrongly believe that the only effective way to treat it is with medication (prescribed or otherwise) which could cause more harm in the long-term. More broadly, it could be interpreted as a legitimate way for people to absolve themselves of responsibility for the “bad situations” they create for others as a result of their own unscrupulous or wicked behaviour. “It’s not because I humiliate and threaten you that you’re depressed”, an abusive partner might say, “it’s because depression is like the weather and you’re just a bit under it. It’ll pass.”
The major problem with claiming that depression is like the weather and not a response to bad situations is that Mr Fry is left with the very difficult task of explaining why people suffer from various degrees of depression after or during traumatic life events, such as becoming seriously ill or a loved one dying; why around half of unemployed people suffer from depression; why there is a strong correlation between adverse childhood experiences and depression in adulthood; and a strong correlation between bullying in childhood and depression in later life.
If depression was like the weather we would expect to see instances of depression much more evenly distributed among all people regardless of how much adversity they had in their lives or how much they had been abused by others. But that’s not the case.
To be as charitable as I can to Mr Fry, I am open to the possibility that he may have been referring exclusively to the episodes of depression associated with bipolar disorder, from which he suffers, when he spoke of depression being like the weather. If to him it feels like his episodes of depression are like the weather in the sense that they seem to come over him randomly and without warning, regardless of what he is doing, thinking or experiencing, then I see no reason not to believe him. But even if this is true it doesn’t mean that the initial development of bipolar disorder itself in his brain was entirely the result of events outside of his or anyone else’s control – i.e. that bipolar disorder is the result of genetic misfortune. The best evidence we currently have suggests otherwise.
Although genetic influences are currently believed to account for 60-80% of the risk of developing the disorder, environmental factors (i.e. bad situations) play a significant role too. According to Wikipedia:
“There have been repeated findings that 30–50% of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated on average with earlier onset, a higher rate of suicide attempts, and more co-occurring disorders such as PTSD. The total number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorder compared to those without, particularly events stemming from a harsh environment rather than from the child’s own behavior.”
Research has shown that Bipolar Disorder sufferers have physiological differences in their brains, often referred to as ‘chemical imbalances’ by the layman. Even if Mr Fry believes that his Bipolar disorder is merely the result of ‘chemical imbalances’ in his brain, the question remains what caused those imbalances? Was he born with them or did they result from the brain’s responses to bad situations? There is one leading hypothesis that indicates it could be stress in early life. This theory is explained on Wikipedia as follows:
“According to the “kindling” hypothesis, when people who are genetically predisposed toward bipolar disorder experience stressful events, the stress threshold at which mood changes occur becomes progressively lower, until the episodes eventually start (and recur) spontaneously. There is evidence supporting an association between early-life stress and dysfunction of the hypothalamic-pituitary-adrenal axis (HPA axis) leading to its over activation, which may play a role in the pathogenesis of bipolar disorder.”
This theory suggests that even though Mr Fry was most probably unfortunate enough to be genetically predisposed toward bipolar disorder, it may have been stressful events in his early life that sparked his bipolar disorder into life, as it were. If this theory is correct, then it is possible that he may never have experienced episodes of low mood in adulthood of the severity which has caused him much distress throughout his life or even at all, if he had not experienced a sufficient number of sufficiently stressful and/or traumatic events in his early life – whatever they may have been. Furthermore, if it’s true that the episodes eventually start to recur spontaneously, then this could explain Mr Fry’s experience of them and why he describes them as being like periods of weather that must be endured.
Other studies reveal that depression in general is often a response to bad situations. The Adverse Childhood Experiences Study (conducted upon 17,000 volunteers), for example, found that the more categories of trauma experienced in childhood (such as emotional or physical neglect), the greater the likelihood of experiencing depression and suicide attempts in adulthood (as well as numerous other health problems).
Contrary to Mr Fry’s claim, then, depression in general is a response to bad situations, either ones experienced in the past or being experiencing in the present, regardless of how genetically predisposed we are to depressive moods. Even though bipolar disorder has a significant genetic influence in its cause, evidence suggests that it takes a certain level of stress and adverse experiences in early life to act as kindling to start the fire of bipolar.
Knowing that general depression is a response we have to adverse experiences can empower people to address the cause(s) rather than just resigning themselves to ‘weathering the storm’ of its effects, so to speak, by medicating themselves either with prescription drugs or alcohol. Correctly viewing depression as a response to traumatic experiences that happened to us in the past or that we’re living through can incentivize people to pro-actively seek ways to overcome or manage it, such as therapy, journalling or talking with a friend. Accepting and better understanding the true nature of depression also helps us, especially parents, to be mindful that our own actions aren’t creating stressful and traumatic experiences for our loved ones. Furthermore, I would argue that if most people accepted that depression is a response to bad situations resulting from misfortune or mistreatment, then the task of helping someone with depression becomes a lot less daunting, and perhaps many more people would be more willing to help. After all, it’s easier to conceive of ways to help someone who says I’m depressed because of X than it is to think of ways to help someone who says they are depressed because…well…just because. If you believe depression is like the weather, then you’ll probably just respond with something like “it’ll pass mate, just sit tight and try not to worry.” Which in reality is no help at all.
In another interview Mr Fry has claimed of suicidal thoughts and suicide:
“There is no ‘why’, it’s not the right question. There’s no reason. If there were a reason for it, you could reason someone out of it, and you could tell them why they shouldn’t take their own life…”
Here he is implying that it is impossible to convince someone not to take their own life, which is surely not true. Is it likely that no man who ever stood on a window ledge threatening to jump off has been convinced not to do so by a sympathetic stranger? That no one, not a single person, who was about to take an overdose was ever talked out of it by a friend? Again, I think this is a terribly unhelpful idea to spread because if people believe that reason is utterly powerless in such situations, then they may not bother trying to talk someone out of killing themselves. We should never assume that reason won’t work because reason is what makes human beings unique as a species. It’s our superpower. It’s the tool that has enabled all human progress. We should never underestimate the power of reason to help people.
Having said all that, in order to convince someone not to kill themselves you don’t necessarily need logical coherent, objective arguments, you may only need to convince them that they have undervalued their own life. But this is tricky, it’s like trying to convince someone that they should like strawberry ice cream and that’s because the value of a person’s life is determined by the individual in the same way as the niceness of strawberry ice cream is determined by the taster. Value is necessarily subjective. Because only my mind controls my body, only I can decide upon the value of my life, and therefore whether I shall keep my body alive and functioning. I can of course take into account other people’s valuations of my life, but ultimately it must still be my judgement.
Broadly, Mr Fry seems to be claiming that desiring to kill oneself and attempting to kill oneself is irrational, there is no “why”. But to conceive of action aimed at satisfying a desire (which suicide clearly is) as irrational is a mistake, as one man showed.
Ludwig von Mises, in his treatise on the logic of human action, showed that human action is always rational.
“Human action is necessarily always rational. The term ‘rational action’ is therefore pleonastic and must be rejected as such. When applied to the ultimate ends of action, the terms rational and irrational are inappropriate and meaningless. The ultimate end of action is always the satisfaction of some desires of the acting man.”
Michael Rozeff of the Mises Institute explained it another way:
“If human action always aims at a purpose, which by definition it does, then human action must be rational, that is, consistent with reason or guided by one’s will and intellect. It can never be termed irrational.”
When Mr Fry took a large amount of prescription pills with the tragic aim of killing himself he took that action because he wanted to satisfy his desire to kill himself. It was an act that was guided by his will, it was a rational act.
It is possible that what Mr Fry actually meant when he said there is no “why” is that, after the suicide attempt, he no longer had the desire to kill himself and at all other times since he has had no desire to kill himself. In other words, he can see no reason why he did and would desire to end his life. I don’t doubt that this is true, but he must have had the desire to kill himself when he tried to, otherwise why would he have attempted to do so? There is only two possible ways in which Mr Fry could have acted to kill himself without having the correlating desire to do so. Either he was hallucinating and believed he was actually doing something else when he took the pills (i.e. he thought he was eating an ice cream sundae) or his body was being physically controlled by some external force (what Mises would define as irrational action), and therefore he took the pills not of his own volition. The latter is obviously an absurd proposition and the former, according to Mr Fry’s accounts, is not true.
The point is, contrary to Mr Fry’s claim’s, you can convince someone that they shouldn’t take their life, but not by telling them that they are acting irrationally – because to them that would be like being told you shouldn’t like vanilla ice cream – but by convincing them to place a higher value on their life, on life itself. You need to sell life to them and make it seem more desirable than instantly and permanently ending their mental anguish. How difficult a task that is will depend upon the severity of that anguish, of course.
Mr Fry’s periods of depression as a result of bipolar disorder have been so severe as to be life-threatening, and so I can certainly understand why he now takes medication in order to lessen the degree to which his mood swings. The depressive episodes associated with bipolar disorder are classed as equivalent in severity to ‘major depression’, also known as clinical depression. They last from two weeks to potentially up to six months if not treated. Bipolar, then, is up at the severe end of the depression scale and is often treated with mood stabilizers and anti-psychotics, but most people who experience depression at some point in their life or through periods of their life won’t experience such a severe form. At the less severe end of the depression scale, using reason in the form of talking therapies is an effective way to treat depression resulting from the experiences we had in our early lives and that we have throughout our lives. If we resort to medication too readily based on the assumption that the power of the reasoning mind is insufficient on its own to help in the way it seems to be for many bipolar sufferers, then we run the risk of only ever treating the symptoms and not the cause. And we also unnecessarily put as ourselves at risk of suffering from the negative side-effects that some medications can cause.
I would like to end by echoing the sentiments of Stephen Fry when he extolled the virtues of being a friend to someone suffering from depression. Let’s indeed be there for people suffering from depression. Let’s do our best to understand what they are going through. Let’s listen to them and be there for them in their darkest moments. Let’s use the power and kindness of our reasoning minds to gently remind them that the sun is always shining above the clouds, that they aren’t alone and that things aren’t hopeless.
At times we all lose perspective on our problems, a rip tide of negative emotions and thoughts drags us out to sea and before we know it we’re far away from the shores of reason. And that’s precisely when we need the reasoning mind of a loved one, a friend or a therapist to tow us back into shore and back to a healthy perspective. Usually, soon after talking with a friend or therapist about our feelings of depression, or writing down our thoughts, we feel at least a bit better about life, and that reminds us of an important truth: we have power over our mood. We are reminded that our depressed mood isn’t beyond our control like the weather, even though it might have felt like it, and at once a great weight is lifted from our shoulders. Our perspective suddenly shifts, the clouds clear a little and we realise that it is possible to forge a path to feeling better.
Prescribed medication can numb the emotional pain of depression, but it can’t bring about the essential shift in our perspective on our problems that talking therapies can, which we need to motivate us to continue acting to treat our depression. Only our reasoning minds and the reasoning minds of others can do that.