Depression is the problem we don’t talk about.
“Oh no, we don’t talk about that.”
Several years ago, the coordinator at a large conference venue tried very hard to talk my mother out of making a presentation on her personal struggles – and ultimate triumphs – over depression. Apparently, it was not considered suitable.
Or maybe it was just too uncomfortable a subject.
Those of us who suffer from this illness are acutely aware of the discomfort it creates in others. The topic creates a kind of nervous panic in people’s eyes; the muscles in their face and body clench in order to mask a massive amount of internal squirming.
In general, people seem about as interested in talking about depression as they are in chewing a mouthful of poison ivy.
And yet, I can’t think of many other topics that are more relevant, or more important, in the world today.
To her credit, my mom insisted on giving her presentation as she had originally planned. She instinctively felt that it was the right thing to do.
When she walked off stage at the end, she was inundated by conference attendees who wanted to talk to her about their experiences and thank her for sharing hers. She told me later that it took more than three hours for the crowd to finally disperse.
My mom was right. Depression is a big problem, and we need to start talking about it.
Depression is second only to anxiety in numbers of mind-brain disorders around the world. In a recent report of over 51,000 individuals from 21 countries, about 4.6% (about one in every 22 adults) reported experiencing depressive symptoms over the past year.1 The United States came in third in this study with a prevalence rate of 6.7%, which translates to about one in every 15 adults. Spain won the silver medal at 6.9%; Portugal won the gold with 7% (about one in 14 adults).
The results were even worse for treatment. Of the world citizens who had experienced depression, only one in 6 reported that they felt that they had received adequate care.
I should emphasize that that was only the average – as you might expect, there were huge disparities across income brackets. While less than one in four among the world’s most affluent reported receiving adequate care, only 4 in 100 among the world’s poor reported the same.
Such high prevalence and low treatment rates make it easier to understand why depression is now the leading cause of medical disability globally.2
Why did I start this website?
My reason is pretty simple: I want to do my part to help the 300 million people around the world who are suffering from this illness.3
300 million is a huge number. Just to put it into perspective, the U.S. population at the time of this writing is 327 million.4 Which means that the depressed people of the world are now massive enough to form their own nation. And the rest of us are watching that nation slowly deteriorate and die in front of our eyes.
I should say that I believe that there is already some good information out there, provided by healthcare professionals and counselors that I trust and respect. But at least for now, the growth rate of this disease is still outstripping treatment rates. It is continuing to grow and spread among people of all ages and backgrounds.
Depression is a huge – but mostly invisible and unspoken – problem in my community. And I suspect it is for yours, too.
This means that more help is needed to fight it, and I have an ever-growing passion to try to help.
How can I help you? My two unique perspectives on Depression
I hope this is one of only a handful of posts that focus on me. I’d frankly rather hear about you, listen to your specific struggles, and then see how I can help.
But at the start, I think you have a right to know what kind of help I may be able to offer. So, in this very first blog post, let me share my two unique perspectives on this illness.
First, I was trained as a neuroscientist. Neuroscientists are the laboratory scientists who do the basic research to figure out what exactly a disease does to the mind and body and what methods may work best to treat it. Our work is meant to inform and continually improve the treatment strategies used by those who work directly with patients: psychiatrists, counselors, and other types of health-care professionals.
As a neuroscientist, I have spent the last 20 years researching, reading, and teaching about how psychological stress affects the brain.
I’m not necessarily talking about physical stressors that represent physical danger, although the world has seen plenty of that lately in the form of hurricanes, earthquakes, wildfires, as well as human atrocities like mass shootings, rapes, and murders.
It’s obvious that those types of stressors represent physical threats to the body.
What we tend to forget, though, is how severely they can also threaten the mind.
Feelings of fear, frustration, anguish, and despair can outlive a traumatic event for years, decades, or even a lifetime.
So, without trying to minimize the very real impact of physical stress, I think it’s fair to say that psychological/emotional stress is also a large problem on our planet. Especially when you also consider the compounding, day-to-day stresses we all experience at school, at work, and in our relationships.
Much of our stress will fester in our minds, like mental ulcers. Eventually, chronic stress can and often does lead to the breakdown of physical and mental health. Emotional or psychological stress is thought to contribute to something like 80-90% of physical illnesses. My research and reading on the topic tell me that this type of stress also contributes to mind-brain disorders such as anxiety and depression.
But while I view depression through a scientific lens, I have also viewed it in a much more personal and invasive way.
My second perspective is, I suffered from depression for much of my life.
For me, part of the cause is clearly genetic – in fact, I suspect depression is deeply rooted in my family tree. But looking back over my life history, I can also identify times where stressful life events played a role in triggering depression. If I am brave enough, I will talk more about those in later posts – not to get your pity, but just to say, “I’ve been there, too.”
I can’t help but wonder if our silence around depression stems at least in part from a fear that we are each alone, terribly alone, in experiencing it.
Epidemiological studies like those cited above provide concrete evidence otherwise. And they bring to light an awful paradox: depression affects more individuals now than ever before – yet isolates each victim in a bubble of fear on the inside, and potential judgment and stigma on the outside.
But I want to give you some good news: since I’ve been there myself, I’ve learned some very effective methods of handling it.
None of these methods require special, scientific knowledge (although I admit I personally like finding out the “why’s” as well as the “how’s” because I’m just nerdy that way).
So if I can learn them, you can, too.
That’s what this website will be all about.
What is the purpose of the “Leaving the Shadowland” website?
Here are my basic goals for this website. Future blog and/or podcast posts will:
- share stories of people I know who have overcome depression and the ways they did it;
- provide research-proven tips and tools to beat specific symptoms of depression and anxiety;
- provide research-proven tips and tools to improve overall brain health and mood;
- give some insights into the scientific links between stress, depression, and anxiety.
You can, of course, skip the science stuff if science is not your thing. But I encourage you NOT to skip it – and NOT just because I’m nerdy that way. Far more importantly, I believe that we all have a much better chance of beating something when we understand it.
My hope is that a deeper understanding of the links between stress, depression, and anxiety will help us to break those links and lead to stronger, healthier and happier minds.
At the risk of sounding completely obvious, let me finally add that treatments for any disease are useful only when they are put into practice. I myself struggle sometimes with “walking the walk” as well as “talking the talk.” I say this at the beginning so that we can encourage each other along the way. And when I give some treatment advice, I will try to be intentional about giving some actionable next steps to put that treatment into practice.
As a first step today, would you consider signing up for my email list? It would give me a boost to know that you are interested in hearing more. And I would love to hear from you, too, as that would help to shape the format and content of future podcasts and posts.
Why did I call it “Leaving the Shadowland”?
A final word about the website’s title. About a year ago, I started writing an autobiography of my own journey through depression. I struggled for a while to come up with a working title, but finally settled on “Leaving the Shadowland: a Neuroscientist’s Journey Through Depression.” (Now I’ve jinxed it and will probably end up changing it before it is published). It is an allusion to the following passage from Dante Alighieri’s poem The Divine Comedy:5
“In the middle of the journey of our life
I found myself in a dark wood,
For I had lost the right path.”
The dark wood is a shadowland that we can all leave, given the right navigation tools and guidance. And as you and I act on the knowledge we gain along the way, the path is sure to become brighter up ahead.
l Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., … & Bruffaerts, R. (2017). Undertreatment of people with major depressive disorder in 21 countries. The British Journal of Psychiatry, 210(2), 119-124.
2 World Health Organization. (2017). Depression Fact Sheet. https://www.who.int/mediacentre/factsheets/fs369/en/
3 World Health Organization. (2017). Depression and other common mental disorders: global health estimates.
4 https://www.worldometers.info/world-population/us-population/
5 Pt. 1 Inferno – Canto 1 – (1-3). https://www.poetryfoundation.org/poems/56211/via
Dr. Pamela Coburn-Litvak has published research articles on exercise and stress in Neuroscience and Neurobiology of Learning and Behavior. Her latest book, Leaving the Shadowland of Stress, Anxiety, and Depression, was published in 2020.
After receiving a Ph.D. in Neurobiology and Behavior from the State University of New York at Stony Brook, she served as both Assistant Professor of Physiology & Pharmacology and Special Assistant to the Vice President for Research Affairs at Loma Linda University in Loma Linda, California. She then joined the Biology department at Andrews University and developed courses in human physiology as well as the neurobiology of mental illness. She also founded Rock @ Science LLC, a company that specializes in health and science education and web development. She co-developed the brain and body physiology segment of the Stress: Beyond Coping seminar with its creator, Dr. William “Skip” MacCarty, DMin.
Dr. Coburn-Litvak currently lives in California with her husband. Their two daughters are mostly grown and attending school elsewhere.
When she’s not studying or teaching about stress, she enjoys stress-relieving activities like puttering around the garden, taking nature walks with her family, knitting, cooking, and reading.