CW: mental health
Jan Scott, a Professor of Psychological Medicine at Newcastle University, and Dr Mary Jane Tacchi, a consultant psychiatrist, make a formidable duo. The former, more outgoing and easily slipping into the role of professor, the latter slightly more introverted and observant but nevertheless an easy complement to her colleague. This duo took the stage at the Edinburgh Science Festival to give a “Very Short Introduction to Depression.”
The setting was intimate, with little of the overwhelming sense of grandeur that might occur at a larger conference or festival. As Scott took the stage, the audience applauded, much to her surprise. “That is usually reserved for academic conferences,” she informed with an amused smile. After her warm welcome, she made it very clear that the talk she and her colleague Dr Tacchi were going to give, was not in any way about self-help, not an exhaustive overview of depression, and wouldn’t go in too much detail.
Depression is still diagnosed in a categorical fashion: you either have it, or you don’t. But that does not preclude people from experiencing depressive mood states on a spectrum, even if it does not meet the threshold for a clinical depression
The global burden of depression has been acknowledged by the World Bank and the World Health Organisation (WHO), which is something Scott mentioned. She emphasised that depression and other mental disorders are amongst the top issues affecting young people worldwide. Youth surviving communicable diseases, such as malaria, that might have been fatal in childhood just years ago, will now be more likely to suffer from depression and die of related causes later in life.
Depression is far from being a Western issue alone. Even though there is acknowledgement — and consensus, at least between the World Bank and the WHO — of depression being a clear public health issue, defining depression seems rather more difficult. Dr Scott attempted to explain the difference between a clinical depression and a low mood state, and emphasised how psychiatry, in line with other fields in medicine, is now trying to take a more dimensional approach to diagnosis rather than the usual categorical approach. Depression is still diagnosed in a categorical fashion: you either have it, or you don’t. But that does not preclude people from experiencing depressive mood states on a spectrum, even if it does not meet the threshold for a clinical depression. Scott concluded with the need for an integrated model of depression that takes environment, behaviour, emotions and how they influence one another into account.
For her turn, Dr Mary Jane Tacchi talked about the treatment of depression. She talked about how many people nowadays seem to think depression is just medicalising unhappiness. However, that view does not take into account how debilitating depression often is for the person suffering from it. There still seems to be a treatment gap with only about 50 per cent of people with depression actually receiving treatment. Even though there seemingly is an increase in media attention and a concerted effort to tackle stigmatisation, the attitude surrounding mental health might still make it difficult for people to reach out. Moreover, treatments such as antidepressants have side-effects and take a while to work, causing many people to pull out of treatment or to not attempt this route at all. Counselling and cognitive-behavioural therapy work, but quite a bit of courage is necessary to reach out to a therapist. Moreover, one bad experience can make the situation worse. There is also an increase in newer therapies like mindfulness and chronotherapy, which focus on grounding the mind and resetting one’s circadian rhythm, respectively. But the most important thing, in my opinion, that Dr Tacchi mentioned was that when it comes to therapy, one size does not fit all. It is important for there to be a dialogue between therapist and client. It should be recognized that patients still have agency.
Scott concluded with the need for an integrated model of depression that takes environment, behaviour, emotions and how they influence one another into account
This short introduction to depression was indeed rather short, albeit quite comprehensive. Bringing such a major and complex topic like depression to the attention of a wider audience, many of whom will have either experienced or known someone with depression, in a clear and comprehensible way is an accomplishment in and of itself. However, at times the speakers didn’t go quite deep enough, and left me wanting more. It would have been interesting if we got a slightly less surface-level view on the continuous stigmatization of depression, and how this influences the treatment gap, from these two experts. During the Q&A session I found the questions asked and the quality of the answers to compensate for the lack of depth I, at times, missed during the main talk. Overall, it was refreshing to hear professionals talk about depression with such passion and for an audience to be so respectful and engaged. If we are to change the stigma surrounding mental illness, formats like these can be very useful. More of this, please!
This post was written by Tyara Uiterloo and edited by Karolina Zieba.