Need Help with Depresson? Take a Lesson from Julius Caesar

by Martin

in Depression Diagnosis

Need help with depression?

If so, who do you think you might talk to?

What about your friend next door? The guys in the bar? That nice understanding woman at work? Maybe Oprah? The faith healer? The homeopathic woman in the office above the baker’s shop?

Well, here’s a thing: why not talk to your doctor?

Yes, that’s right, your ordinary, family general practitioner – the person that the medical profession calls your primary care physician.

Sounds obvious doesn’t it. But sadly, according to a study by researchers at the University of California, 43% of people would not tell their family doctor about symptoms of depression if they thought were experiencing them.

Yes you read that right, 43%. Nearly half.

This is so shocking that it bears repeating. Nearly 50% of people who may be suffering from depression would not tell their doctor about it.

I don’t know why this surprises me so much, because I was one of that 43% for years. I suppose I just thought I was special.





Reasons not to get help with depression

These were the main reasons given by those questioned for not discussing possible depression with their doctor:

  • Fear of having to take anti-depressant medication; 22.9% of respondents gave this reason.

  • Fear of being sent for counselling or psychotherapy; 13.4%.

  • Fear of being sent to a psychiatrist: 13.7%.

  • Belief that it was not the doctor’s job to deal with emotional issues; 15.6%.

  • Concerns about the privacy of their medical records; 15.4%. Interestingly this fear was expressed more frequently by those who had previously been treated for depression, which may suggest they had good reason for their concerns. More specifically, people were concerned that information about their depression may be disclosed to their employers.

  • Fear of being branded as a ‘psychiatric patient’: 11.8%.

If you’ve read my About page, you’ll see that these were some of the very reasons why I resisted getting help with depression. And I still think that most of them are pretty good reasons. They shouldn’t be, but they are. Here’s why.




Good reasons

Fear of taking anti-depressants is valid. The medication has side effects and, notwithstanding the questionable claims that SSRIs and SNRIs are not addictive, they are not easy to stop taking.

The fear of therapy or counselling is understandable too. Very many people including, for starters, nearly all men, are uncomfortable with or just unused to talking about their feelings.

The stigma around being a ‘psychiatric patient’, is also very real. A broad range of conditions come within the mental health sphere and I think it’s fair to say that amongst those not involved in that world there’s very little understanding about those conditions and little comprehension of the distinctions between them. Let’s face who wants to be thought of as a ‘nutter’, which is the caring and sensitive descriptor that you are likely attract where I come from.

The privacy implications are also significant. When I first told my doctor about my depression I instructed her not to write anything down. Maybe I was just being paranoid (a ‘nutter’, even?), but I don’t think so. There are circumstances where your records will be seen by others.

When I practised law at the bar in the UK I used to advise clients on personal injury claims. In most cases, the entirety of a claimant’s medical records had to be disclosed. What’s more, if there was any suggestion of a psychological rather than physical cause of ongoing injury, any references in the records to past psychological problems would be used against the claimant by the defendant.

There are also some other very commonplace circumstances where you will have to disclose that you have been treated for depression; life insurance applications, some job applications, applications to foster or adopt children and so on.

So, all in all, it doesn’t look good.

But wait, bear with me while we take a history lesson.

What can Caesar can teach us?

The lesson features a small river in north eastern Italy that had a significant part to play in ancient Roman history. The river marked the northern boundary of Roman territory.

During the time of the Roman Republic, governors of Rome’s provinces were forbidden to enter Roman territory with their armies. To do so was considered an act of insurrection and a capital offence.

In 49 BC, Julius Caesar was one such governor. On the 10 January that year, Caesar led one of his legions south across the river and towards Rome. In doing so, he knew that what he had done meant that war with Pompey, then ruler of Rome, was inevitable.

The river Caesar crossed was called the Rubicon.

And if you ‘fess up to your doctor about your depression, you too are going to be crossing the Rubicon.

You will be passing a point of no return. And, as a result, you could face any of the problems identified above.

You shouldn’t have to face those problems and the pharmaceutical industry, the medical profession, governments, employers and the like should do more to prevent them arising.

But despite that, ask yourself this: what are you going to do if you don’t cross the river?

Here are some plausible answers (feel free to add some more of your own):

  • live with untreated depression for the rest of your life

  • destroy your relationships with those closest to you

  • find that you can no longer work effectively and lose your job

  • do physical harm to yourself and/or others

  • jump into the river, rather than cross it.

The fact is that you have to cross the Rubicon to get help with your depression. You have to do it because not doing it is so much worse.

Take heart from Caesar’s story. After he crossed the Rubicon, he defeated Pompey and went on to be Emperor and possibly the greatest leader Rome ever had.

Resources

Bell, Robert A., Franks, Peter, Duberstein, Paul R., Epstein, Ronald M., Feldman, Mitchell D., Garcia, Erik Fernandez y, Kravitz, Richard L. Suffering in Silence: Reasons for Not Disclosing Depression in Primary Care Ann Fam Med 2011 9: 439-446.

RUOK dayRUODay is an Australian initiative that marks 15 September as a day to connect with others and ask them if they are okay:

It’s a national day of action which aims to prevent suicide by encouraging Australians to connect with someone they care about and help stop little problems turning into big ones.

Click the image to find out more.

Since we are talking about Doctors, then I can do you no greater service than to refer you to the mighty Dr Feelgood and their debut album Down By Jetty. Conceived amongst the oil refineries of Canvey Island in Essex, England, this is what R’n’B used to mean.

UK Readers:
Down By The Jetty



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About the Author

Father, husband, writer and website publisher, discontented in his day-job, he writes here about depression - his own and in general. You can follow Too Depressed on Twitter. Please share the content on this site with all your friends, followers and contacts using the buttons above.

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Last revised on November 17, 2011

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