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Why You Shouldn't Tell Someone With Depression to Adopt a 'Positive Outlook'

10/11/2015 12:54 GMT | Updated 05/11/2016 09:12 GMT

I'll start this on a positive note. Enormous strides have been made in our understanding, both medical and social, of mental health in the past few years. Highly effective campaigns such as Time to Talk and the increased willingness of people to come forward and discuss their mental issues in public forums are examples of initiatives that are not only incredibly courageous, but essential steps in destigmatising mental illness and confronting the lack of public knowledge about such conditions. This change has not happened in a vacuum either. Every credible political party in the 2015 General Election pledged to increase the amounts of funding that went both to research into mental health and support for sufferers. Indeed, there is much cause for celebration right now, amongst campaigners and sufferers alike.

But there is always something more we can do, and there are always better ways to understand what a person with a mental illness is going through. Often we react badly to the actions of people with mental illness out of ignorance. Sometimes we do so even when we are trying to help. Avoiding the wrong kind of reaction is often a question of recognising a mental illness for what it is: an illness, and failing to understand it in this vein often has harmful consequences. Note that you do not have to be a sufferer of mental illness to understand what someone is going through, and having a better understanding of this does not require you to be their therapist. What is does require is for each us to avoid mischaracterizing mental illness and consequently denying people agency over their own experiences.

This is particularly important in the context of depression. Given this is a condition that affects an estimated 350 million people worldwide, the chances are that there will be someone close to you that suffers from it. Understanding their condition is an essential prerequisite to supporting them. More importantly, we need to know how to do it in the right way. Let us start by deconstructing one of the most commonly uttered, and seemingly harmless, responses that people with depression often hear- have a "positive outlook", "cheer up", "look on the bright side". This will be all too familiar to many readers, and it really shouldn't be.

When you tell someone with depression that they should try having a "positive outlook", you might think that you are being helpful or that you are providing genuine advice, perhaps on the basis of your own experiences. But what needs to be understood is that, for most depression sufferers, it is simply not the case that it hasn't occurred to them not to be in a state of intense and asphyxiating sadness that engulfs them entirely. Rather, it's that having a "positive outlook" is not possible. Telling someone that they should be happy when they are not presupposes the idea that we somehow have complete agency over our own emotions- after all, we are perfectly able to change the way we interact with and perceive the world if we just made more an effort to think happy thoughts. This is probably not true of people in general, and it is certainly not true of depression sufferers. In that respect, telling someone to change their outlook is simply unhelpful.

But there's a bigger problem here. It is also important to bear in mind that the lack of general awareness of and information about depression applies to depression sufferers as well. Many have never received a diagnosis or believe that their depression is something else, something temporary rather than clinical. Even those who recognise their depression have still internalized the stigma surrounding mental illness and absorbed the narrative that it is something other than what it is- an illness which ought to be given treatment. That means that many people who suffer from depression will continue to absorb the negative messages fed to them by others, rather than simply ignoring unhelpful advice. So when you tell someone that they can alleviate their suffering through a self-initiated act such as changing the way they feel, the fact that they have not done so becomes a personal failure. In effect, this is equivalent to telling them that it is their fault that they are suffering in that way, and their continued suffering is a result of them failing to change things for themselves. Their condition is self-inflicted because they are incapable of cheering up, unlike all the happy, capable people around them.

Let's be clear: putting anyone in a position where they think this is true of themselves is incredibly unfair. This urgently needs to change.

Sufferers of depression often have extremely low self-esteem and are inclined to see themselves as doing something wrong, as useless, as incapable of amounting to anything. This is on top of the messages they have internalized their entire lives about what mental illness is and how sufferers ought to be treated. To change this, we must all recognise the inadvertent consequences of our actions and language. Telling sufferers of depression to "adopt a positive outlook" is both unhelpful and deeply dangerous.