“Mental illness affects all of us, but there are still many myths and misconceptions about these disorders. If people are willing to talk openly about mental health, we can defeat stigma and discrimination against people with mental illnesses. ” ~ Former First Lady Rosalynn Carter,

October 10, 2013 marks the twenty first anniversary of World Mental Health Day, established by The World Federation for Mental Health (WFMH). The theme this year is “mental health and older adults.” Last year, depression was at the forefront, with the World Health Organization (WHO) estimating that 350 million people worldwide are affected by the illness. In spite of this number, and the fact that depression can and does affect anyone, regardless of gender, age, race, ethnicity, or socio-economic status, a stigma persists.

Depression is not quite “as acceptable” as some physical illnesses, is it?  Certainly not as acceptable as the fairy tale version of early stage breast cancer which  – especially in October – attracts the lion’s share of media attention and most of the research funding. Breast Cancer Action points out that “metastatic breast cancer is what kills women, yet only 2% of research funding goes to treating metastatic disease.” Metastatic breast cancer is what killed Susan G. Komen too.

What are we so afraid of? Aging? Losing our faculties?  What lurks beneath the surface? Depression is non-communicable and highly treatable, but there are only certain diseases, disorders, and ailments that can be the subject of “polite” conversation. Unlike the “common cold,” its symptoms unapologetically made public with persistent sniffles, sneezes, loudly blown noses, and a tell-tale trail of balled-up Kleenex in its wake, the “common” depression sometimes seems more like a secret never to be told.

So who is affected by depression? In its report for last year’s World Mental Health Day Depression: A Global Crisis,  the WMHF reports that, worldwide, the following risk factors indicate a higher susceptibility to the illness:

1. Depression is two to three times more common in women, according to most studies.
2. Poverty
3. Low education
4. Genetics: you are two to three times more likely to develop depression if someone in your immediate family has the disorder
5. Exposure to violence
6. Separation or divorce, especially for men.
7. Other chronic illness.

Sobering. Given the numerous crises we face – all across the globe – on October 10, it should come as no surprise that depression and other mental health conditions are increasing. Still, we find ways to conceal it. Perhaps it is easier to  camouflage depression with the routines and rituals by which other people have always defined us.

In the Public Service Announcement, “I had a black dog. His name was depression.” ,” writer and illustrator, Matthew Johnstone, and WHO, provide some insight into depression, how to recognize it, confront it, and overcome it.

Very shortly after I was diagnosed with cancer, I slipped into an altered state, a kind of despair. I talked about it and through it, which brings me to the woman ensnared within Charlotte Perkins Gillman’s  The Yellow Wallpaper . . .

 There are things in that paper that nobody knows but me, or ever will.

Like Gillman’s character, I too felt diminished. Diminutive within cancer’s giant complexity. Depressed by it. Altered by it. Often wondering if the woman I used to be had disappeared forever within its labyrinth and willing her to come back.

Why had Charlotte Perkins Gillman written such a story? On World Mental Health Day, it seems fitting to share the story behind the story. In 1913, a century ago, she explained:

Why I Wrote “The Yellow Wallpaper”

Many and many a reader has asked that. When the story first came out, in the New England Magazine about 1891, a Boston physician made protest in The Transcript. Such a story ought not to be written, he said; it was enough to drive anyone mad to read it.

 

Now the story of the story is this:

For many years I suffered from a severe and continuous nervous breakdown tending to melancholia–and beyond. During about the third year of this trouble I went, in devout faith and some faint stir of hope, to a noted specialist in nervous diseases, the best known in the country. This wise man put me to bed and applied the rest cure, to which a still-good physique responded so promptly that he concluded there was nothing much the matter with me, and sent me home with solemn advice to “live as domestic a life as far as possible,” to “have but two hours’ intellectual life a day,” and “never to touch pen, brush, or pencil again” as long as I lived. This was in 1887.

I went home and obeyed those directions for some three months, and came so near the borderline of utter mental ruin that I could see over.Then, using the remnants of intelligence that remained, and helped by a wise friend, I cast the noted specialist’s advice to the winds and went to work again–work, the normal life of every human being; work, in which is joy and growth and service, without which one is a pauper and a parasite–ultimately recovering some measure of power.

Being naturally moved to rejoicing by this narrow escape, I wrote The Yellow Wallpaper, with its embellishments and additions, to carry out the ideal (I never had hallucinations or objections to my mural decorations) and sent a copy to the physician who so nearly drove me mad. He never acknowledged it.

The little book is valued by alienists and as a good specimen of one kind of literature. It has, to my knowledge, saved one woman from a similar fate–so terrifying her family that they let her out into normal activity and she recovered.

But the best result is this. Many years later I was told that the great specialist had admitted to friends of his that he had altered his treatment of neurasthenia since reading The Yellow Wallpaper.

 It was not intended to drive people crazy, but to save people from being driven crazy, and it worked.”

What do you need to bring? Just your commitment to publishing a blog entry on Wednesday, Oct. 10, 2013, about a mental health issue that’s close to your heart. It may be on the topic of access to treatment, resources or support within your local community. It may be on an individual’s personal struggle with a mental health concern. It may be about the prejudice a person faced when discussing the issue with a family member or co-worker. Help flood the Internet voices that can help bring mental health to discussions and readers that might not often hear about these issues.

Together, we should be able to stomp out the stigma associated with mental illness, shouldn’t we? Too many people are suffering. Lest we forget the people behind those staggering numbers, remember the premise of Sir Austin Bradford Hill, pioneer of the randomized clinical trial:

 Health statistics represent people with the tears wiped off.

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