How do you characterise something that since the dawn of mankind has proved excruciatingly difficult to grasp and define, by the people who simultaneously know it best and yet are also rendered incapable of understanding it?

The ‘thing’ in question is depression.  It might be more fitting to describe it as a condition, a disease, a becoming, a persona, a curse, a defence mechanism, a barrier – the terminology is as varied as the symptoms and the degrees to which it is experienced by more than 350 million people worldwide. 

We live in an age where rates of mental illness are on the up, and yet funding is on the decline.  In the UK, just 13% of NHS funding is spent on mental health, despite the fact that it accounts for more than a fifth (23%) of “the disease burden”, as Mark Winstanley, head of Rethink, puts it.

It’s a sad reminder, to put it mildly, of how that which we cannot always see or understand can be so easily sidestepped, regardless of the human fallout.

An insipid fog

The attempt to find the right words is important for an illness that is one of the leading causes of disability. Words make it real. They bring depression out of the shadows from where it haunts the lives of those affected. They counter the silence which can embed the stigma that compounds the symptoms. 

That’s why it’s encouraging to find an increasing focus on depression through the various mediums of radio shows, TV documentaries, theatrical pieces and books - once again proving the invaluable role of the arts in pricking our conscience and raising awareness by invoking our imagination.

One of the best articulations of depression that I’ve come across so far in my own research is Andrew Solomon’s book, The Noonday Demon.  Every page drips with deeply felt, diligently referenced and eminently insightful descriptions of what he defines as “the flaw in love”.

Solomon is hugely talented at applying metaphors to reveal how depression ravages the mind and the body – people are decaying trees, rusting buildings, rain-battered edifices exposed to an interminable torment that has the cumulative effect of “making you less and less”:

“Depression starts out insipid, fogs the days into a dull colour, weakens ordinary action until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed.”

Solomon compares our societal response to depression as one that lacks, but needs, the same level of collective action as the environmental chaos that looms large over humanity's survival – we cannot completely stem the change, but we can make some kind of impact if we care to.

For Solomon, depression is a form of “socio-economic pollution”, the climbing rates of which are “without question the consequence of modernity”:

“The pace of life, the technological chaos of it, the alienation of people from one another, the breakdown of traditional family structures, the loneliness that is endemic, the failure of systems of belief (religious, moral, political, social – anything that seemed once to give meaning and direction to life) have been catastrophic.”

Enter the arts

Since the death of her father in 2014, the novelist Nicci Gerrard has been campaigning for carers of people with dementia to have the right to be their loved ones in hospital, “to be their cognitive ramps, their experts in experiences, a voice for the voiceless”.  She has written movingly about the challenges of living with someone with dementia, and of articulating it.  In this Guardian article, she writes:

“One of the gifts of art is to enable us to enter into other people’s lives and selves -but how is this possible when lives have been dismantled, words fallen away, selves broken and lost?..... Dementia thwarts the attempts to describe its internal experience because it is beyond language. Art, however, can try to enter the silent darkness.”

Mental health is a common thread running through this year’s Edinburgh Fringe festival.  Brigitte Aphrodite is just one among the festival performers to take her personal experience of anxiety to the stage in the form of My Beautiful Black Dog.  Speaking to the Guardian’s Hannah Ellis-petersen she said: “We are never going to be able to talk about mental health and depression if we see it as this uncomfortable subject for everyone.”

Project 1 in 4 is a particularly inspired arts-based project aimed at raising awareness about how it feels to be on the battered end of mental ill-health through 100 sketches – one a day – illustrating different people’s anxieties, fears, their good days and their bad days - “because banishing the stigma of mental illness starts with awareness, and awareness begins with education, mindfulness and empathy”.

David Foster Wallace, the supreme master of words, captured the excruciating pain of feeling like a “joyless burden” in his short story, The Depressed Person, where the subject of the title lives in a state of escalating anguish induced by trying not to impose herself on the Support System of friends her therapist has encouraged her to confide in.  She needs them in ways that she is painfully aware are not conducive to their “comparatively nurturing and undamaged lives”. She continually tries to articulate “how bottomlessly horrible” she feels and each time, chastises herself for not being able to truly explain what or why.

Her Support System inadvertently isolates her because her friends perceive her illness as a negative burden she thinks they’d rather not have. 

Perception is important.  Creating a wider context for depression is important.  Placing it within the world as opposed to outside of it, is vital.   Hence stories, theatre productions, radio shows – all forms of talking, not as a cure but as a route to understanding, are vital, because as Solomon eloquently points out:

“We must help the disenfranchised whose suffering undermines so much of the world’s joy – for the sake both of those huddled masses and the privileged people who lack profound motivation in their own lives.”