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Depictions of Depression: Undoing the Stigmas

Posted May 14, 2018

Tags: advocacyart

"...it is crucial that people dealing with depressive symptoms, diagnosed or not, see themselves and are seen in a more complete light."

 

As society continues to advance through the digital age, film and television serve not only to entertain audiences but also to inform their perceptions. These narrative forms, fictional in nature but broad in impact, allow viewers to feel as if they “know” an experience that differs from their own. While this quality can certainly elicit empathy for a character, and another human being for that matter, it can also fuel negative stereotypes about the experiences that are being represented. Depression has long been a subject of exploration within the cinematic realm, ranging from Frank Capra’s It’s a Wonderful Life (1947) to Anna Boden’s It’s Kind of a Funny Story (2010). Even with this history of representation, however, it seems that the predominating media image of the condition is one of sadness that is all-consuming, and worse still, untreatable.

While sadness is a symptom of depression, reducing the affliction to this one emotion fails to account for both the complexities of the disorder and those experiencing it. Narrow-minded or sensationalized depictions of depression feed into a cycle of stigmatization within and beyond the mental health community. Visual arts can influence popular perception and reframe narratives; it is crucial that people dealing with depressive symptoms, diagnosed or not, see themselves and are seen in a more complete light.

Before media portrayals of depression can be dissected, it is important to understand what the condition actually entails. According to the American Psychological Association (APA), depression can include a “lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt, and suicidal ideation” (Depression).  The Diagnostic and Statistical Manual of Mental Disorders, or DSM-V, contains slightly more specific criteria, stating that symptoms must be present for a period of two weeks or more and that the mood represents a change from the person’s baseline (Diagnostic Criteria, 2010). At times, these indicators can be exacerbated by the tendency for depression to be comorbid, meaning the depression is present alongside another disorder. In “The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future,” David H. Barlow writes that “relatively few people suffer from anxiety or depression alone; when patients did meet criteria for a single disorder at one point in time, an additional anxiety or depressive episode disorder almost certainly emerged at a later time” (Barlow, 2013, p.3). Barlow’s findings would suggest that depression persists not only because of a cycle of negative emotions but also due to increased anxieties about those emotions.

While it may seem that these negative feelings are solely and immediately brought on by grief or trauma—after all, depression is often described as a feeling of loss—this is not always the case. Writer Andrew Solomon, in his deeply personal “Anatomy of Melancholy,” says that “it was when life was finally in order that depression came slinking in and spoiled everything” (Solomon, 1998). He realized years after his treatment process that his mother’s passing and his departure from a significant relationship, though preceding his downward spiral by a few years, may have contributed to his depressive episodes. Solomon contends that depression is neither a wholly environmental issue nor a biological one, as previously believed. Rather, “most depressive disorders are thought to involve a mixture of reactive (so-called neurotic) factors and internal (endogenous) factors; depression is seldom a simple genetic disease or a simple response to external troubles” (Solomon, 1998). In this way, the disorder should be examined through a varied lens, taking multiple perspectives into account. Patient narratives are framed by these multiple perspectives, including that which the media portrays. As Nicole Caputo states in “Narrative Processing of Entertainment Media and Mental Illness Stigma,” there is a “great responsibility placed upon media organizations to inform the public about mental illness” (Caputo, 2011, p.2).

Narrow-minded depictions of depression can contribute to the notion that it is, in essence, a death sentence; one such contributor is the hit Netflix series 13 Reasons Why. Based on the young adult novel by Jay Asher, the show follows teenager Clay Jensen and his high school peers as they receive a collection of tapes recorded by Hannah Baker, a student who committed suicide and sought to explain why she did it. The story touches upon timely issues like bullying, sexual assault, and self-harm; it drew so much critical acclaim and popularity, especially within the teen demographic, that it was renewed for a second season. That being said, the show has dangerous implications for conversations about suicide. While some critics praised the “bold artistic choice” to show Hannah’s death in graphic detail, mental health experts tended to disagree with the decision.

Bethonie Butler of The Washington Post states that “experts advise against sensational headlines or describing a suicide in graphic detail, which studies have shown can lead to suicide contagion, or ‘copycat’ suicides." The series certainly helped bring emotionally-charged topics to the forefront, but it seemed to push the idea that Hannah was finally “heard” once she ended her life. There is no mention of the role of mental illness, and no exploration of possible treatment options that she could have undertaken beyond meeting with her rather apathetic school guidance counselor, thus implying that she had no other choice. Dan Reidenberg, executive director of Suicide Awareness Voices of Education (SAVE), points out that the “counselor’s dismissal of Hannah’s concerns sends a horrible message” that could lead impressionable young viewers down a doomed path (Butler, 2017).

Julie Beck of The Atlantic examines psychologist Jonathan Adler’s ideas about agency and communion tending to correlate with better well-being, as evidenced by his longitudinal studies with depressed patients. Beck says that “it makes sense, since feelings of helplessness and hopelessness are classical symptoms of depression, that feeling in control would be good for mental health” (Beck, 2015). Though Hannah cannot control all of her experiences, she could have been a character who wants to regain her agency, thus spreading a more positive message. By showing her as a helpless victim of her circumstances, the series paints depression as a bottomless pit from which there is no escape. While 13 Reasons Why may have been well-intentioned, its portrayal of depression is flawed and should be treated as a platform from which more accurate representation can be achieved, rather than as a standard by which these depictions should be measured. 

Lars von Trier’s 2011 science-fiction art film Melancholia, while unique in its take on depression, perpetuates the stigma of the condition as all-consuming and inevitably destructive. Inspired by von Trier’s own depressive episodes, the film follows soon-to-be-married Justine as she arrives at her sister Claire’s estate for her wedding reception; there, she must contend with her dysfunctional family, her increasingly debilitating melancholy, and the impending obliteration of Earth by the titular rogue planet, Melancholia. In “The Magic Cave of Allegory: Lars von Trier’s Melancholia,” Christopher Peterson writes that the film can be seen as an extended metaphor for the effects of depression and that “since her worldview is enduringly negative, Justine finds no peace or consolation in Earth’s apparent escape from destruction." The film virtually likens Justine’s condition to a black hole of sorts, pulling everyone around her into its depths, which can send a misguided message to an audience. As Caputo states, “transportation, or immersion into a narrative, is found equally likely whether the narrative is perceived as fact or fiction…and audience members are found to accept false assertions in fictional narratives” (Caputo, 2011, p.4). While the film attempts to capture the emotional “catastrophe” of dealing with depression, it does not allow Justine any forward movement in the story, instead portraying her as the smaller-scale “rogue planet” of her own family.

Psychologist Dan P. McAdams claims that a “person’s evolving and dynamic life story is a key component of what constitutes the individuality of that particular person, living in a particular society at a particular historical moment” (McAdams, 2001, p.2). But Justine’s trajectory is far from dynamic, as the beginning of the film already reveals the fate of her character and the world around her. Depression is a real and often painful disorder, but it need not be presented as a perpetually apocalyptic one.

Insightful depictions of mental illness can be achieved, as evidenced by Stephen Chbosky’s 2012 coming-of-age drama The Perks of Being a Wallflower, based on the novel of the same name. The movie revolves around Charlie, an introverted freshman in high school dealing with clinical depression, a condition which is later revealed to be the result of his childhood trauma. He befriends two seniors, who guide him through the many pitfalls of adolescence, and forges a meaningful connection with his English teacher, who encourages his passion for writing.

Charlie has a supportive family but struggles to speak openly with them about his difficulties; instead, he addresses the audience through a journal. As Solomon concludes about his own experiences, “it is hard to talk to friends [and family] about depression during depression, so there’s solace to be found in strangers." In this way, films and television shows can serve as the “listening stranger,” providing people with a means of identification from which they can explain their circumstances and feel understood. Conversely, they can also serve to educate those who do not have firsthand experience with the disorder, allowing them to have a more well-rounded view of the condition. As researcher Lindsay M. Orchowski puts it, “just as a media event, such as an episode of child abuse, creates a template for every reported child abuse case following that, a similar phenomenon occurs in a film’s illustration of a given pathology."

Even as Charlie endures emotional lows, his friends and family are there to reassure him, despite not always realizing the extent of his situation. By the end though, Charlie has discussed the roots of his depression with a psychiatrist and seems to be on the path of improvement. McAdams says that “life stories are continually made and remade in social relationships and in the overall social context provided by culture;” a film like The Perks of Being a Wallflower can certainly assist in this endeavor, allowing people to reframe the manner in which these issues are discussed.

Depression, though at times described as mere sadness, is a complex condition that should be represented in the media with great care. According to Caputo, “major depressive illness will be the leading cause of disability in the world for women and children by 2020." With such an astounding level of commonality, it is crucial for the disorder to portrayed in an accurate and humane light. 13 Reasons Why and Melancholia, though culturally and artistically acclaimed, respectively, fuel the stigmas that depression is untreatable and all-consuming. Thus, these pieces should be used as tools for greater understanding rather than as ultimate definitions. The Perks of Being a Wallflower, meanwhile, takes care in presenting its protagonist as a dynamic and continually evolving character, providing a more realistic interpretation of teen depression. All three of these works attempt to address the subject head-on, but this does not always have to be the case.

Greta Gerwig’s 2017 directorial debut Lady Bird centers around a headstrong Sacramento teenager’s relationship with her mother; however, it also subtly hovers around the topic of mental health, most notably in the form of the girl’s father. In the film, the father takes medication to treat his depression, which has worsened as a result of the recent loss of his job. However, he is not depicted as a sad, helpless individual but rather as a supportive and caring figure who is willing to make sacrifices for his family, especially amidst their financial struggles. Although the father is not the central figure in the story, Gerwig portrays his experience with great subtlety and nuance, painting depression as a deeply human condition. Movies like Lady Bird and The Perks of Being a Wallflower do not operate on shock value but rather on authenticity, a quality that more media projects about mental health should implement.

(photo: "don't look away, when there's nothing there" by Bexi  is licensed under CC BY-NC-ND 2.0 )

 

References

13 Reasons Why (TV Series 2017– ). (n.d.). Retrieved February 27, 2018, from http://www.imdb.com/title/tt1837492/?ref_=nv_sr_1

Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2013). The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future. Clinical Psychological Science, 3. Retrieved February 27, 2018.

Beck, J. (2015, August 10). Life's Stories. Retrieved February 26, 2018, from https://www.theatlantic.com/health/archive/2015/08/life-stories-narrative-psychology-redemption-mental-health/400796/

Butler, B. (2017, April 14). Analysis | '13 Reasons Why' depicts a graphic suicide. Experts say there's a problem with that. Retrieved February 27, 2018, from https://www.washingtonpost.com/news/arts-and-entertainment/wp/2017/04/14/the-problem-with-how-13-reasons-why-treats-suicide/?utm_term=.c27760d163b3

Caputo, N. M., & Rouner, D. (2011). Narrative Processing of Entertainment Media and Mental Illness Stigma. Health Communication, 2-4. Retrieved March 14, 2018.

Depression. (n.d.). Retrieved February 27, 2018, from http://www.apa.org/topics/depression/

Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes. (2010). PSN Palo Alto. Retrieved March 14, 2018, from www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf

Lady Bird (2017). (n.d.). Retrieved March 16, 2018, from http://www.imdb.com/title/tt4925292/?ref_=nv_sr_1

McAdams, D. P. (2001). The Psychology of Life Stories. Review of General Psychology, 5(2), 2-18. Retrieved March 15, 2018.

Melancholia (2011). (n.d.). Retrieved March 16, 2018, from http://www.imdb.com/title/tt1527186/?ref_=nv_sr_1

Orchowski, L. M., Spickard, B. A., & Mcnamara, J. R. (2006). Cinema and the Valuing of Psychotherapy: Implications for Clinical Practice. Professional Psychology: Research and Practice, 37(5). Retrieved March 16, 2018.

The Perks of Being a Wallflower (2012). (n.d.). Retrieved March 16, 2018, from http://www.imdb.com/title/tt1659337/?ref_=nv_sr_1

Peterson, C. (2013). The Magic Cave of Allegory: Lars von Trier's Melancholia. Discourse, 35(3), 401. Retrieved March 15, 2018.

Solomon, A. (1998, January 12). Anatomy of Melancholy. Retrieved February 26, 2018, from https://www.newyorker.com/magazine/1998/01/12/anatomy-of-melancholy


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