Have you ever woken up with feelings of hopelessness, desperation, and fear? Then, there it is, the accompanying physical pain? In my case it is the searing pain in my gut that greeted me each and every day. I call it the black pile. Sounds somewhat melodramatic doesn’t it? These feelings and the resulting physical manifestations are experienced in some form or another by 49% of leaders every day. With any other physical disease or ailment this would be considered an epidemic. Why then, the reticence to be open and transparent about depression?
In general, we stay away from deep and personal conversations about depression because of the subjectivity of the disease and the stigma of weakness.
With any physical disease and condition there are a plethora of physical tests doctors can request. For most diseases, the science is quite strong, and the diagnosis leads to established protocols and treatment – all very objective. Research is well-funded, and physical health breakthroughs happen with regularity.
Depression, or any other mental illness requires a subjective diagnosis. It is characterized as the invisible disease, there is no blood test, and no cure. As a result, several misconceptions have become prevalent.
First, there is the creditability of the notion of a chemical imbalance in the body. Serotonin is an important chemical and neurotransmitter that has a wide variety of functions in the human body. It is sometimes called the happy chemical, because it contributes to wellbeing and happiness. In the late 60’s and early 70’s, mental health professionals surmised, without empirical proof, that depression is caused by a lack of this chemical. They theorized that since serotonin is responsible for happiness and their depression patients were clinically unhappy, the lack of serotonin must be the reason. This theory has been debunked numerous times and yet the psychiatric community and the pharmaceutical industry still stand by it.
Secondly, pharmaceutical manufacturers and their powerful lobby have a substantial stake in this highly profitable segment, as a result they have been very successful in perpetuating this myth. Testing is notoriously problematic and there have been documented cases where the placebo outperformed the actual drug. Big Pharma has provided less than credible clinical trial results, resulting in the development and marketing of an ever-expanding the set of medications whose efficacy is suspect. By the end of 2020, the global spend on anti-depressants is projected to be north of $17B. This total doesn’t include the billions in spending for the growing number of medications required to quell the side effects of the anti-depressants.
Sadly, the efficacy of anti-depressants has turned out be a hoax. I believe the reliance on anti-depressants is a result of two factors.
First, the physical health community can prescribe anti-depressant medication, and yet they don’t have near the education required to be knowledgeable enough about depression to medicate. Without the consultation of a mental health professional the administering of anti-depressants is a crap shoot. A staggering 72.7% of anti-depressant users have not consulted with a Psychiatrist or Psychologist. If, over time, the dosage stops providing relief, doctors just up the dose. How many of you have experienced this? In my 32 years of diagnosed depression, I have been prescribed 4 different medications and 5 dosage increases.
Second, I strongly believe the placebo effect must be considered with respect to anti-depressants. Because depression creates a feeling of hopelessness we are open to “hope” and the “trained professionals” advocating for the medication in positive ways. The medication actually has an effect as a result of the sub-conscious and unconscious minds believing in both the hope and the doctor’s encouragement and perceived competency. For a small minority it is life-long relief. Sadly, for the vast majority it becomes a never-ending cycle of new drugs and the associated dosage increases.
The mental health community is no better as it relies on medication and a parasitic/addictive relationship with patients. Many Psychiatrists have thriving practices treating long-term patients. This is one of the main reasons it may take a significant amount of time to secure an appointment. I have friends and colleagues that have told me they save up the issues they are dealing with for their weekly therapy sessions. These doctors and therapists rely on outdated processes and therapies that do not effectively deal with today’s issues. I was fortunate that my Psychiatrist taught me “take home” techniques and eastern-based therapies that allowed me to reduce the frequency of appointments to now where I visit on a quarterly basis. It is the therapist’s goal to assist their patients to access techniques and therapies that allow patients to heal themselves. If your therapist doesn’t have a plan to eventually reduce the frequency of appointments, you may want to find a new therapist.
Genetic disposition has also been refuted. Since my mother, her mother, and several of her sisters struggled with depression, I believed I was snookered. Yet, to my knowledge, my brother does not struggle with depression. My cousins have confirmed to me they do not have depressive feelings. Researchers are now convinced there is no specific gene that can trigger depression or any other mental illness for that matter.
We are now realizing depression is primarily caused by the environments we grew up in, the grind of our current lives, and disconnecting from what is important.
- Disconnecting from our work environment – We have no control of our work environment- what if we lose a client?
- Disconnecting from the people we love and respect – We just want to be alone.
- Disconnecting from emotional feelings – Who cares about me anyway?
- Disconnecting from the natural world – We can’t be bothered to get outside.
- Disconnecting from meaningful values – It’s too much work and who cares anyway.
- Disconnecting due to worry over financial issues – The life I’ve built for my family is so expensive, what if, in the future, I can’t afford it?
- Disconnecting due to childhood trauma – An environment of verbal and physical abuse has life-long implications.
- Disconnecting due to the loss of authenticity – Just tell them what they want to hear.
Does any of the above ring true for you?
In my life, I have been exposed to horrible verbal and emotional abuse, both directed at me and at other family members. This was especially prevalent and at its most extreme while leading our fast-growing family business, and as a father, husband, son, and brother. I have come to realize I call it the black pile as a result of the layering of unresolved emotional abuse issues.
As leaders struggling with depression, we lead two distinct lives. The external life is the “fake it ‘till you make it” life. Outwardly, we lead with purpose, drive and a confidence. In the internal life we are hopeless, fearful, and waiting for the other shoe to drop. We purposely make excuses for our behavior citing anything other than depression that is bothering us. As a result, authenticity is often the first casualty of depression. The stigma surrounding depression is that those that suffer are weak; the last thing we as leaders, struggling with depression are is weak. Though inauthentically, we still manage to lead successful companies. We push through, don’t we?
Where would we be, if we normalized the conversation around mental illness?
Imagine a life having overcome and managing depression. Imagine a life where the day starts full of hopefulness and anticipation, not fear. Imagine a life without fear of disclosure of the disease. What could we, as leaders struggling with depression achieve? Simply experiencing happiness would be a quantum leap in our lives – wouldn’t it?
John Panigas provides workshops, coaching and in-house mental wellbeing programs to leaders and organizations that realize there is both, an economical and personal cost of depression to the business and the team. He can be reached at www.johnpanigas.com