Time for another Freudian Script, the series on psychology and psychiatry for writers. The topic this week is: Depression.
DISCLAIMER: This blog post is designed for writers of fiction. If you are concerned that you or someone you know has symptoms of mental health problems, please see your doctor.
What is depression?
You know that bit in the movie where it’s all gone to shit – the “All is Lost” moment? And the hero grows a beard, drinks a lot of whiskey and becomes a recluse. He may even contemplate his gun collection with a mournful expression. But then some small piece of inspiration comes along and he decides to fight on, and the beard and the whiskey and the melancholy is forgotten.
Yeah, that’s not depression.
It could be described as an acute stress reaction or an adjustment disorder, depending on the length of the misery. In the case of Christian from Moulin Rouge, it is grief. But it is not depression.
Depression is a potentially fatal disease characterised by low mood, low activity and low energy. It involves loss of pleasure, loss of concentration and loss of motivation. It is almost always accompanied by low self-esteem and feelings of hopelessness. It is “unresponsive to circumstances”, though life events can precede an episode. It can occur as one discrete episode, recurrent episodes, or a chronic course where symptoms wax and wane in intensity but never entirely disappear. It can also be part of bipolar affective disorder (aka manic depression).
The moderate to severe forms include “biological symptoms”, like loss of appetite, insomnia (particularly waking up early), slowed movements and loss of libido. At its worst, depression can also cause a distortion of reality, resulting in psychosis.
Churchill described depression as “the black dog”, a constant unwelcome – and feared – companion that is difficult to shake off.
Suicide can occur in the context of depressive illness, but it can also be part of mania, psychosis, grief, post-traumatic stress, or a reaction to circumstances. As this topic is a separate beast, I will address it in a later post.
Cinema loves misery. Misery, after all, makes for good drama. Misery, sadness, grief – these are all part of the normal human experience. Depression is an abnormal state of mind. A large part of the portrayals of “depression” are examples of misery. For example:
I can’t think of many excellent examples of depression on film. Frank in Little Miss Sunshine is good, particularly the opening scenes. Arguably, Bruce Wayne at the beginning of Dark Knight Rises. Eeyore from Winnie the Pooh is more apathetic and anhedonic in the books than in the Disney version.
The problem with depression in film is that conventional screenwriting states that protagonists should be active – they should be instruments of their own fate. Depression is the opposite of active, and sufferers can feel out of control and going nowhere.
In TV shows, there is more potential for a “depressive episode”, but a character who spends twenty hours a day in bed, barely moving, barely speaking, is a hard sell to a medium built on visuals. Literature presents a better opportunity to explore the state of mind that accompanies a depressive illness, like Katniss in Mockingjay.
So, what’s missing from current portrayals of depression?
For me, the biggest problem is recovery. Movie protagonists shake off their blues, shave their beards and throw away their whiskey. Suddenly, they’re kicking arse and taking names like nothing every happened.
Treatment for depression can include talking therapies and medication. However, let’s assume your hero doesn’t haven’t time for six-to-eight cognitive behavioural therapy sessions or a few weeks’ grace to try some antidepressants. Therefore, recovery will almost certainly be slower and more painful.
This could be shown by continuing insomnia, with accompanying signs of irritability and frustration. Poor concentration makes every task harder, if she can even be motivated to start them. Eating is a chore not a pleasure. And return to poor coping mechanisms, like alcohol, is a constant temptation.
In short: make it difficult. Recovery from depression isn’t a light switch – people don’t just “snap out of it” or “pull themselves together”. To continue to portray depressive episodes in that manner is insulting to those you have to summon all their physical and mental strength to get out of bed in the morning while suffering debilitating depression.
Reading accounts of depression can help with portrayal – Your Stories from MIND, the mental health charity, can be a useful starting point. And chances are that you know someone who has suffered with depression – 1 in 4 people experience a mental health problem in a given year, with about 10% of people in the UK have a depressive episode.
Authentic experiences are the key to authentic writing. And depression is no different.
If you need advice or guidance on writing a character with a mental illness, please contact me by e-mail or in the comments below – I am always happy to help out!