The Continuing Stigma Of Depression

Editor’s Note: Jonathan Rottenberg Ph.D. is a leading researcher in the area of emotion and psychopathology, where he has focused on major depression. He recently edited  Emotion and Psychopathology: Bridging Affective and Clinical Science,published by the American Psychological Association.

Since receiving his PhD degree from Stanford University, he has been at the University of South Florida, where he is an Associate Professor of Psychology and Director of the Mood and Emotion Laboratory. His work has been generously funded by the National Institutes of Mental Health and he has authored over 35 scientific publications, including many in the top journals in psychology and psychiatry. His work has received national and international media coverage, reported in outlets such as Science News, Scientific American, The New York Times, and BBC radio.

Part of the mission of patient advocacy groups is to reduce the stigma associated with depression. This is noble and important work because historically people who have suffered from depression have tended to suffer in silence and/or not sought treatment because of the shame associated with admitting depression. In the US in the 19th and 20th centuries, virtually every form of mental illness was associated with a moral failing or sign of a weak character.

Seemingly in tandem with the efforts of patient advocacy groups, pharmaceutical companies have expended enormous resources in advertising so that the public will come to see depression as a medical illness. Given that something like 27 million people are taking antidepressants, it is clear that it has become more acceptable to take medications for depression.

But has the stigma associated with depression changed in any meaningful way? My sense is no.

A quick internet search finds remarkably abundant evidence of the continuing stigma of depression. I was particularly struck by a poll in which 92 percent of Britons said that admitting a mental disorder would damage their career.

My hunch is that the disease/defect model of depression, which I have written about elsewhere is unwittingly contributing to the ongoing stigma of depression. Through the lens of the disease model, the legions of the formerly depressed are a “broken” people who need lifelong assistance.  I would like to see a more revolutionary public education approach, with campaigns that emphasize the unique strengths that are required to endure depression.

Even if a person is helped by drugs or therapy, grappling with a severe depression requires enormous courage. In many ways, a person who has emerged from the grip of depression has just passed the most severe of trials in the human experience. If we acknowledge that surviving depression requires a special toughness, we will see not see formerly depressed people as a broken legion, but as a resource who can teach us all about overcoming adversity. I think it is unlikely that such views will be widespread until we are out of the thrall of the disease model.

While I applaud groups such as the National Alliance on Mental Illness in their effort to reduce the stigma of depression, I believe they have erred in so completely casting their lot with the disease model. I believe this unfortunate state of affairs has resulted from perceiving only two choices about what kind of problem depression is—either it is a disease or it is a moral failing.

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