“What do you have to be depressed about?”

If you have experienced depression while living what appears to be a fairly nice life, you’ve probably had someone ask you, “What do you have to be depressed about?”

Sometimes people who ask this question are genuinely curious because they think that depression is necessarily “about” something and they just don’t understand what, in your case, it could be “about.” Sometimes, though, people who perceive your life to be better than theirs feel resentful and jealous and, upon hearing that you are suffering from depression, demand to know what could possibly be wrong with your life that could cause a mental illness.

The origins of depression are complicated and still not very well-understood. One model that’s gained ground lately is called the diathesis-stress model. The term “diathesis” refers to a vulnerability, which could be genetic, biological, environmental, or psychological. “Stress” refers to a catalyzing event, a life stressor that can increase one’s chances of developing a disorder (the diathesis-stress model has been used to describe more than just depression).

One specific type of diathesis that has been researched concerns a specific gene, known as the serotonin transporter gene or 5-HTTLPR. Some studies suggest that people with a particular variant of the gene are more likely to develop depression, but only if they have a significant life stressor. If not, then there’s no difference between people with the different variations of the gene.

The results are mixed so far, but this is just one example of a way in which having “something to be depressed about” can indeed provoke depression. But it’s not the whole story. People without significant life stressors can still get depression, and people who do have life stressors are still much more likely to get depression if they have that genetic predisposition–the diathesis.

Diathesis can come in all sorts of forms. Having learned poor cognitive coping skills as a child could be a diathesis. Having abnormalities in the brain’s neurochemistry could also be a diathesis, although the “chemical imbalance” theory of depression as we’re used to seeing it is more or less bullshit.

Some types of diathesis might be considered to count as “something to be depressed about,” such as living in poverty, having a chronic health condition, or having an unstable or abusive family life. Others, such as having genetic predispositions or brain abnormalities, would not count as such for most people. Asking someone what they have to be depressed about is therefore not very useful.

But moving away from the science of depression’s origins, I’ll state the obvious: no matter how well you know someone, you never know everything that’s going on in their life. Not even if it’s your kid. The person may have a significant life stressor that’s triggering their depression that they just haven’t told you about, and they probably won’t if you sarcastically ask them what they have to be depressed about. If you’re genuinely curious, a better way to phrase that question is, “I’m sorry to hear you have depression. Is there anything that’s triggering it for you?”

The important thing with that is to never ask questions like you already know the answers. The question, “What do you have to be depressed about?” comes along with the implied answer, “Nothing.” Even if you don’t think it does. That’s how many people are going to hear it. So don’t get too caught up on the literal meaning of the words you are saying, and think about how they’re going to be interpreted.

The hypocrisy of the “What do you have to be depressed about?” question becomes blatant when you consider our typical response to those who do, by all accounts, have something to be depressed “about.” What tends to happen is that when we feel that depression is to be expected in a given situation, we also frame it as “okay.” Normal. Natural. It’ll pass on its own and we shouldn’t interfere.

This might explain the controversy over the decision to remove the bereavement exception from the newest edition of the DSM. Previously, people who were grieving had a two-month “window” during which they could not be diagnosed with depression, which often looks very similar to bereavement. With the publication of the DSM-5, this exception was removed. Lots of people were Very Concerned that this means that we’re “medicalizing” a “normal” process such as grieving.

I know I probably over-rely on comparisons to physical health, but that’s because they can be very illuminating. If you’re subjected to a some loud noise and you get a headache, or you work out strenuously and get extremely sore muscles, few people would suggest that you shouldn’t take medication to ease those pains just because they happened “naturally” (whatever that means). Being extremely sad, even “depressed,” as a response to a loved one dying is definitely “natural,” but that doesn’t mean it can’t interfere with your functioning as a person, and that you don’t deserve help dealing with it.

I’m not necessarily saying that high levels of grief should be diagnosed as depression, though. I’m just pointing out the hypocrisy of expecting people to produce compelling “reasons” for being depressed, but then refusing to consider people who do have compelling reasons to be depressed, even if they show all the symptoms.

My final gripe with the “What do you have to be depressed about?” question is that it’s often a way of trying to rank human suffering. What do you have to be depressed about? Some people are abused by their parents. What do you have to be depressed about? Some people are starving. What do you have to be depressed about? Some people have cancer.

Well, if you, personally, were abused by your parents, are starving, or have cancer, I wouldn’t fault you for feeling that the concerns of people with depression aren’t as serious as yours. That’s your right. But there are no measurements with which we can assess how bad someone has it. There is no Standard Life-Shittiness Unit. We need to stop looking for one, and treat every individual’s pain as legitimate.

If Not Now, When? On Politicizing Tragedy

I’m sure you’ve heard by now about the tragedy that happened in Connecticut this morning. If not, go read this and be ready to shed some tears. I definitely did.

Every time a preventable tragedy happens, we are implored not to “politicize” it. It’s disrespectful, we’re told, to talk politics when people are grieving.

I can see why people would feel that way, and I don’t want to delegitimize the way they feel. Everyone has their own way of grieving, especially when it’s this sort of collective grief. If you’d rather stay away from the discussions about gun control and access to mental health, by all means, stay away. Go do what you need to.

Some people grieve by praying or meditating. Some just want to get off the internet and do something relaxing or joyful. Some ignore it and go on as though nothing has happened; while I disagree with that approach, I think that one’s own wellbeing is the most important thing.

Some grieve by analyzing, discussing, and doing. To us, the only consolation is that maybe, this time, change will come. Prayer is meaningless to me, personally. Sitting quietly and reflecting is something I can only do for so long before I start to feel like I’m bursting out of my skin. After hearing the news today, I cried. Then I sought comfort from my friends online. Then I patiently waited for my little brother and sister–they are elementary school-age—to come home and I hugged them.

But I can’t feel at ease unless I talk about what could’ve caused this–all of the things that could’ve caused this. They’re not all political. It’s true that we have a culture of violence. It’s true that sometimes people snap. It’s true that sometimes shit just happens.

But it’s also true that gun control is sorely lacking. It’s true that people kill people, but they kill people with guns (among other things). It’s true that lobbies that don’t speak for most of us are the ones who get to determine gun policy in this country. It’s true that even if every citizen has the right to own a gun, they do not have the right to own a gun without any caveats, and they do not get to own an assault rifle.

It’s also true that mental healthcare is sorely lacking, too. It’s true that we don’t know whether or not this gunman had a mental illness and shouldn’t assume that he did, but that right now, the only thing I can think of that could stop a violent person from committing violence is professional, evidence-based help (if anything at all). It’s true that the stigma against seeking help can prevent people from seeking it, and it can prevent those close to people who need help from recommending it.

“Politicization” is a dirty word. But should it be?

Jon Stewart had an eerily prescient moment on the Daily show this past Monday when he talked about the controversy that sportscaster Bob Costas when he briefly discussed guns during an NFL halftime show. Stewart discusses the hypocrisy of insisting that we have to wait some arbitrary length of time before we discuss gun control in the wake of a tragedy, but talking about how said tragedy could’ve happened even without guns apparently has no waiting period.

He then delivers this line: “You can talk about guns, just not in the immediate wake of any event involving guns. But with approximately 30 gun-related murders daily in the United States, when will it ever be the right time to talk about the issue?”

Indeed. When will it ever be the right time?

Stewart is being hyperbolic, of course. It’s generally only large-scale tragedies like today’s that prompt the “don’t politicize the tragedy” response, but he’s right that we never really seem to find the right moment to have a serious discussion about guns. When a shooting hasn’t just occurred, people don’t think about the issue much. And when it has, we’re implored not to be disrespectful by talking about the issue in any way other than “wow this is so horrible.”

Like it or not, this is a political issue. It certainly has non-political components, but refusing to acknowledge that there are also political factors involved doesn’t do anyone any good.

The calls to avoid “politicizing” the issue sometimes come from ordinary people who want to grieve without talking about politics–and that’s their right. But it doesn’t mean that those of us who do want to talk about politics are being crass or disrespectful. It just means we have different ways of grieving, and that’s okay.

Sometimes, though, this sentiment comes from politicians themselves, and that is exactly when it becomes very dangerous. Addressing President Obama, Allison Benedikt writes:

The benefit of not “capitalizing” on the tragedy is that, in a few days, most of us will put this whole thing behind us. We have Christmas presents to buy and trees to decorate—this is a very busy time of year! So if you wait this one out, just kind of do the bare minimum of your job, our outrage will probably pass, and you can avoid any of those “usual Washington policy debates.”

Who exactly does it benefit when politicians choose not to talk about the political ramifications of mass shootings? It certainly doesn’t benefit the citizens.
Furthermore, when politicians call on us not to “politicize” an issue, they are, in fact, politicizing it. Ezra Klein writes:
Let’s be clear: That is a form of politicization. When political actors construct a political argument that threatens political consequences if other political actors pursue a certain political outcome, that is, almost by definition, a politicization of the issue. It’s just a form of politicization favoring those who prefer the status quo to stricter gun control laws.

For what it’s worth, I definitely prefer the type of politicization that gets a conversation going rather than the type that shuts it down.

Hillel, one of the most well-known Jewish leaders of all time, has a saying: “If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?”

If not now, when? When are we going to talk about guns?

For me, grieving goes hand-in-hand with dreaming and working for a better tomorrow.