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Sad Chaps

There Are Two Kinds of People in This World.

What? What?! This statement is only a preamble to nonsense.  Whenever anybody upchucks such tripe, for sale
I stop listening and think about my tuberoses. Dividing the difficulty of six billion people into two is obviously silly; however, dividing tuberoses is not silly and should be done annually to promote better flowering.

If there really are Two Kinds of People in This World these, these are possibly (a) people who believe that There Are Two Kinds of People in This World and (b) sensible people who don’t. Apart from this, it’s fairly pointless to go about popping humanity into colossal one-size-fits-half categories.  The crushing insensitivity of such dualism aside, the practise is bent.  People are terribly confusing and any hope we have to understand them exceeds this either/or solution and will always be upturned by lunchtime.

Clearly, there are more than Two Kinds of People in This World.  However, on occasion, I do understand the temptation to bisect.  This has a little to do with my tuberoses. And my grevilleas.  And my growing fascination for mulch.  Let me explain.

My mother has long held that There Are Two Kinds of People in This World.  There are those, like herself, who have “interests”. And then, there are those, like myself and my father, who have “obsessions”.  Given the current state of my garden, which is exemplary, and my growing debt to the garden super-store down the road, I fear she may have a point.

Although I can cultivate native lilies, I cannot cultivate moderation. When I took the decision some months ago to tart up the garden, I also took myself into territory that could reasonably be called obsessive.  This is evidenced by the dirt beneath my fingernails, the fact that Sharon at the mail-order nursery now recognises my number and greeted me yesterday with “don’t you think you’ve got enough clivia?” and the tough love speech I delivered yesterday to my hoya.   “I don’t CARE if you prefer tropical conditions,” I said to the waxy little leaves, “YOU WILL LEARN TO CLIMB BITCH.”

A kind person would call the hours I spend in the garden a proof of passion. Well, it’s not a passion. It’s more like a dermatitis that burns and grows the more it’s scratched.

It has always been so. For some of us, a hobby is a lovely way to pass the time. For others, it quickly curdles in the sun of our curiosity until it becomes a disease.

I have seen this problem take hold before. When I was fourteen, I was not content to enjoy Scrabble. Instead, I became a monster. Having memorised every two and three letter word in English and American standard dictionaries, I went to tournaments and dreamed of forming words like “quixotic” on a Triple Word square. Less of a hobby and more of a lexical heroin, Scrabble dominated my days and gave me little in return; save for the knowledge that an “eft” is a juvenile newt and is worth six points.   I gave up cold when I found myself dreaming of the eft and the ai (a sloth with three toes and two points) and am no longer a tile-carrying Scrabbler.

And now, I am a gardener.

To be gifted of such focus, in this case on ficus, is a burden. On the upside, I never have cause to buy cut flowers or salad greens. On the downside, I smell of manure (mostly sheep; sometimes chook) and cannot maintain adult conversation that does not have soil condition as its focus.

There Are Two Kinds of People in This World.  There are those with hobbies and there are those who bury themselves in sheep poo.
A few years back, information pills
my dad was headed toward the end of his professional life. A construction guy, sickness
he’d always been the kind of boss young labourers called The Duke of Bloody Wellington for his attention to the rules. Even in the site-shed, he used to make us kids wear hard-hats.  The brickies and the carpenters feared his set-square and the sparkies knew that on Trevor’s site, you couldn’t take a shortcut.

Every project dad started was finished on budget and on time; they unfolded in the way his spread-sheets foretold. Dad’s keystrokes were the first word and final authority on a job and he took this sense of planning to every facet of his life.

I knew then he was working on a retirement file.  He would approach the end of his duties with the same precision he’d overseen their execution. He’d planned his finale in Excel.

As it turned out, reality didn’t tally with his budget. When they brought Dad’s farewell party forward five years, it just didn’t compute.

Dad looked for work. Dad fixed the house. Dad fixed the neighbour’s house and then, when they told him they didn’t really fancy ten metres of new decking, he took up fly-fishing.  None of it made up for the lack of a building site.

In the face of a devastated spreadsheet and a life unlikely to break new ground again, he became so despondent he even gave up on his subscription to Horse Racing Australia.  So, my mother sent him to the doctor.

I don’t need to tell you what happened next. Dad was diagnosed with depression.

It happened to Serious Craig, too; a guy at my weekly poker night. His mother got ill with something unpronounceable and Craig had to give up his dream gig as a sound engineer for stable work and after-hours nursing duties. “Bummer,” said one of the guys at the card night. “Major Depressive Disorder,” said the GP who put Serious on pills.

They offered my Dad pills, too and suggested a yoga class; solutions about as appropriate as a mankini at a funeral. My dad is a man’s man and I can imagine him finding peace within the Sun Salute as easily as I can see Hulk Hogan in a Balenciaga tutu. “Depression” just didn’t suit him.

“I’m hardly depressed,” he told me.  “I just have the shits.”

These days, though, men aren’t allowed to just have the shits.

A bloke can’t be crapped off, he has Anxiety Disorder.  Now, if he is bruised by one of life’s monumental kicks, he has Depressive Illness.

Psychiatry’s most influential document, the Diagnostic and Statistical Manual of Mental Disorders (DSM) makes sure he’s depressed and not just reacting appropriately to some terrible shit.

In the terms of the DSM, it doesn’t matter if you’ve just been divorced, fired from your job or diagnosed with terminal cancer. The only medical exception to a diagnosis of depression is bereavement.  If you’re blue and not recently widowed, the chances that you’ll be diagnosed as mentally ill are great.

It’s true, of course, that there are mentally ill blokes who need all the intervention an army of shrinks and big Pharma can provide.  But, it’s also right that there are many who are simply not sick. They just have the shits. My dad didn’t need his bad mood explained by the doctors.  What he needed, as it turned out, was a new angle grinder.

If you take a look at the numbers, it seems blokes are a sorry lot. The Bureau of Statistics tells us that one in every five Australians will suffer depressive illness. The number of scripts for selective serotonin reuptake inhibitors (pills like Prozac and Zoloft) is locally upward of 12 million per year. The World Health Organisation predicts that depression, particularly of the male tint, will be a major global concern of the future. Lobby groups and politicians eat this stuff up with a big medicine spoon.

The mental health of men has become a bipartisan political favourite with leaders calling for “discussion” and “healing” and other forms of tutu.

Again, there are guys who need help. But there are many enduring the sundry tortures of drugs, yoga and awful books with misty mountains on the cover at their peril.  In the case of my father, of Serious Craig and my mate Pete who turned out to have a dodgy thyroid instead of the Acute Anxiety his doctor diagnosed, this Mental Health stuff did more harm than good.

I’m not on my own in arguing for a conservative approach to the diagnosis of mental illness in men. There are people with an alphabet soup of letters after their names asking for the same. Two of them, Doctors Horwitz and Wakefield, wrote a book about it a year or two ago. In The Loss of Sadness, these scholars argued that feeling like crap from time-to-time is “neither abnormal nor inappropriate” and that, very often, everyday sadness was forgotten.

This is a more radical argument than you might think. The DSM has some very narrow criteria for depression. You can hear it in the patter of your GP:  Do you find it difficult to focus? Do you ever feel tired? Do you ever think about death? The average bummed-out chap will hear this checklist and say of course I effing do.

As media and medicine often has it, an entire generation of men is clinically depressed or, in some other way, diagnosable. You’re not bored; you have “adult” ADHD. One too many macchiatos is Caffeine Induced Sleep Disorder and in the new version of the DSM due for publication in 2013, it has been widely reported that overuse of your Smartphone will emerge as a treatable illness. I don’t know what they’ll call it. Post-traumatic text disorder perhaps.

There are no biological markers for these disorders any more than there is a blood test or a brain scan for the blues.  This is not to say, of course, that depression does not exist. It’s just that when they can’t see it on a slide, doctors tend to diagnose it and medicate it with the rationale that it’s better to be safe than sorry.

Perhaps it isn’t. It’s quite possible over-diagnosis of depression compromises the study of this devastating illness.  And, back in the land of the everyday, it can make ordinary blokes feel far more desperate than they need. As Serious had it, “Great. Now, on top of everything else, I’m depressed and on Zoloft.”

It’s okay for a gent to have a bad mood without a medical term appended to it like a big pink ribbon.  It’s not okay for a generation of men to be medicated to the back teeth.

I watched my dad’s bad mood spiral from something ordinary and appropriate into a full-blown drama in the doctor’s office.  Fortunately, dad never got his wisdom from the side of a Zoloft box.  He knew he just had the shits. Over the years, he worked them away with his angle-grinder.

 This was a piece written for the FHM lads

8 Responses to “Sad Chaps”

  1. Sue says:

    Hey there, Helen.

    Cool piece, thanks for posting.

    The whole DSM-IV diagnosis of life is … well, it’s pathetic. What, so we’re meant to be up and at em producing every minute of our fucking lives, are we? Why can’t depression be a part of life? Why is melancholy seen as such a bad thing?

    Sometimes I think if we’re NOT feeling depressed there must be something wrong, seeing we get bombarded every bloody day with all of the bad shit that’s going on in the world without respite.

    I love that last line. “Over the years he worked them away with his angle grinder.” Cool. So much more creative a way than out of a bottle supplied by Glaxo Smith Kline.

    • Helen Razer says:

      It’s perverse, right? Sadly, the newest revision seems even worse. I am probably only saying this as I have Diagnostic Dissociative Disorder, or something.

  2. Sami says:

    Why exactly does “adult” ADHD get the scare quotes?

    I speak as someone who does, in fact, have adult ADHD, and also had childhood ADHD that managed to go undiagnosed (until I was 28) because not many people seem to have heard of it in the 80s. About thirty percent of children with AD(H)D will retain it as adults; the disorder is a symptom of an incomplete protein sheath around nerve-endings in the brain, and while a majority of sufferers outgrow it (is is theorised, according to my psychiatrist, that the hormone surge at puberty somehow causes the sheath to thicken), some do not.

    It’s not the same thing as boredom. I have experienced boredom maybe twice in my life, both times for a matter of minutes – mostly it’s a pretty alien concept to me. Why would anyone be bored when the world is so filled with fascinating and interesting and entertaining things? Boredom seems to me like a symptom of an extreme lack of creativity.

    However, it does cause some pretty comprehensive other difficulties a lot of the time, so I do take medication for it. I take my prescribed dose of dexamphetamines and the world slows down to a pace where I can match it, and stick with tasks and ideas long enough to complete them.

    One of the major distinguishing factors for ADHD, as opposed to other psychological or neurological issues, is in fact the way that for a person with ADHD, stimulants have a calmative effect, rather than, you know, stimulating.

    Psychology is a pretty fuzzy not-really-science, but some of this stuff does in fact come down to neurology, which isn’t very fuzzy at all. And adult ADHD is a very real thing that doesn’t deserve scare quotes.

  3. Helen Razer says:

    Sami, I was fairly careful to point out that depression is a real disorder. I didn’t do the same for ADHD (again, a disorder whose existence I would not dispute; although isn’t the demyelination idea a disputed theory? I.e. It’s not observable as in, say, Multiple Sclerosis. Re the drug thing, just as the occasional effectiveness of SSRIS does not “prove” that someone is depressed, the effectiveness of stimulants is not hard medical evidence for the existence of a disease in an individual) because it didn’t seem necessary. That is, in arguing against over-diagnosis of psychiatric and neuro-psychiatric disorders (with particular reference to depression) I repeatedly made the point that these are real things. And that their study is seriously compromised by the eagerness of the medical complex to flog drugs and, to a lesser degree, the eagerness of some individuals to have perfectly normal reactions to the trials of life medicalised. I do find the “adult” prefix odd; it doesn’t seem to tally with the usual nosology of medicine. It does smack of an urgent need to legitimise. And an urgent need to sell drugs. Having said this, I’ll say again: I did not, at any point, dispute the existence of psychiatric and neuro-psychiatric disorders. I just feel that over-diagnosis of these (and I was recently semi diagnosed with the neurological condition Asperger’s by a fairly lazy practitioner; I needed to give him a grand to make sure) can be cynical and damaging. Not only to people who are wrongly diagnosed but to medicine as a whole and, of course, people such as yourself who are legitimately ill. When there are millions eager for diagnosis (and Adderall) and thousands of doctors happy to sell, study is serously compromised. I really do think I made this point plain about mental health in general. And I apologise for the offence. I might feel so bad in an hour or two that I’ll remove the quotation marks.

  4. Ferny says:

    I really appreciate this post. Whenever there’s a piece questioning the over-diagnosis of psychiatric disorders, I always gird my loins for the “fish oil and self-flagellation” recommendations and the “No such thing! ‘Depressives’ just aren’t quite as good at coping skills when faced with normal, run-of-the-mill stressors! My mild-to-moderate temporary sadness is exactly the same as any case of so called ‘Major Depression’ ever recorded!” sanctimony. I found none of that in your piece.

    I really think over-diagnosis – along with gendered framing and narratives around depression – help contribute to societal attitudes that cast certifiable young women like me as attention-seeking ne’er do wells and fakers who just need to Get Over It.

    Even some people in my family are convinced that my problems will just disappear if I just learn to sleep “better”, and that my medication is just horrid and I have no real reason to be taking anything at all. Meanwhile, I’ve dealt with my illness for 9 years and the meds I’m on (combined with proper, actually in-depth psychological care) have really saved my life, where “light counselling” and “diet and exercise”* have repeatedly failed.

    *The maladies of a young lady aren’t that serious. One simply needs to to loosen one’s corset!

  5. Lee Bemrose says:

    Excellent piece.

  6. renee says:

    Really appreciated this piece, thanks.
    Having 3 immediate family members prescribed such drugs with very little extensive diagnosis (1 Doc visit’ll do it,) I can’t help but question the power behind those pushing these, and many other medications.
    I’m so tired of these quick-fix ideals. No time for sadness. No time for ailments. Amazingly effective pills only a signature (&$) away.
    And yeah, who wouldn’t get the shits on when experiencing a sudden bout of (supposed) dispensability. Personally I depend on feeling I can be of some use, or constructive in some way. Is that not human nature?
    I suspect my cynicism re medics may well be as good as an apple a day. I can only hope it’s as effective for everyone else.

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