When a pilot crashed a Germanwings plane into a mountainside in the French Alps last month, one word kept coming up over and over in the media coverage: depression. What did the airline know about the pilot's mental health, and what was he required to tell them?
Of course, being depressed is a very different thing from wanting to take the lives of others. But experts we talked with said that an event like this one — a violent act carried out by someone with a mental illness — increases the stigma for everyone with mental illness.
It also becomes more difficult for people with depression to be open about it.
According to the National Institute of Mental Health, 16 million Americans had at least one major depressive episode in the past year. Of that number, many struggle with whether and how to talk about their depression in the workplace.
This week on For The Record: Disclosing depression.
We spoke with two people with different perspectives on the question. (Click on the audio link to hear their full stories.)
Jay Lynch, professor of medicine, University of Florida
Lynch struggled with acute depression and went years without getting help. Lynch, an oncologist, has helped a lot of people suffering from cancer over many years. Some survive and some do not, and it started to wear on him.
Then a series of events threw him off. First, Sept. 11; two weeks after that, the son of one of his best friends killed himself. Then a patient he was very close to passed away. And Lynch's wife hurt her back, so it was up to him to manage their four kids.
He started to play a grim kind of mental game that started with a question.
"What if I was going to write a book and have the perfect suicide, what would that look like?" Lynch remembers. "If I can pull it off and it looks like an accident, then everybody's happy."
He never told anyone he was having these kinds of thoughts, not his wife, not his friends and definitely not anyone at work.
"And then one afternoon I was talking to a patient who's a very close friend," he says. "I just broke down talking to him, and I realized, 'OK, I can't hold it together anymore. I need to get the help I need,' and called one of my friends in psychiatry."
Susan Goldberg, assistant professor, Duquesne University
Goldberg, who studies mental illness, says using the word "depression" is tricky.
"The thing with depression," she says, "is that it can range from sort of mild being out-of-sorts that most people experience from time to time, to a very severe situation where people cannot get out of bed and feel lethargic and exhausted and have no reason for living. So the problem with our discourse is that the word depression covers this whole range."
Goldberg has done a lot of research about what happens to people when they tell friends, family or co-workers about their depression. She says it's not good to hide depression, but cautions people to be careful how and to whom they disclose their struggle.
"For some people — for most people I would think — having a friend, someone you can trust, someone you can say, 'Geez, today is a really rough day, I'm just struggling to make it through,' to have that kind of person in your work life would be really important," she says.
The problem is more common than people think, Goldberg says.
"I assure you, people listening to this, you have worked with someone with a mental health condition who has simply chosen not to disclose," she says.
First, we throw around the word depression too much, and it's not specific enough to encompass everything we use it for. Someone who is mildly depressed is far different from someone who is contemplating suicide, yet we use the same word to describe both situations. I know I throw that word "depressed" around a lot very casually and I'm going to think more before using it.
Second, in the reporting for this story, we ended up focusing on someone whose depression was triggered by a lot of external events. But it's important to remember that that's not how depression happens for everyone. Sometimes someone can feel acutely depressed, and it's not connected to something that's happened. They haven't lost a loved one or suffered some kind of tragedy, and that can sometimes make the condition harder to understand, recognize and thus treat.
Third, just because someone is thinking about killing himself doesn't mean he can't still be effective at his job. This seems a little counterintuitive, because you'd think that someone who was so consumed by such despair couldn't possibly be able to function. But they can, and sometimes, depending on the work, they can fulfill their tasks without raising any red flags, which is why mental illness can be so hard to detect in our loved ones — and in ourselves.
RACHEL MARTIN, HOST:
This is WEEKEND EDITION from NPR News. I'm Rachel Martin. And this is For The Record. When a Germanwings plane went down in France last month, apparently crashed on purpose by a pilot, one word kept coming up over and over in the media coverage...
UNIDENTIFIED MAN #1: The copilot had severe depression...
UNIDENTIFIED WOMAN #1: ...Copilot's depression...
UNIDENTIFIED MAN #2: ...Pilot's depression...
UNIDENTIFIED WOMAN #2: ...The pilot for depression that the pilot was suffering from...
UNIDENTIFIED MAN #3: ...Had a history of depression...
UNIDENTIFIED WOMAN #3: ...Depression.
MARTIN: Of course being depressed is a very different thing from wanting to take the lives of others. But experts we spoke with said that an event like this - a violent act carried out by someone with a mental illness - increases the stigma for everyone with depression, and it becomes more difficult for them to be open about it. According to the National Institute of Mental Health, 16 million Americans had at least one major depressive episode in the past year. Of that number, many struggle with if and how to talk about their depression in the workplace. For The Record today - disclosing depression.
SUSAN GOLDBERG: I assure you, people listening to this, you have worked with someone with a mental health condition who has simply chosen not to disclose.
MARTIN: This is Susan Goldberg.
GOLDBERG: I'm an assistant professor at Duquesne University.
MARTIN: She studies mental illness, and she says the word depression is tricky.
GOLDBERG: The thing with depression is that it can range from sort of a mild being out of sorts that most people experience from time to time to a very severe situation where people cannot get out of bed and feel lethargic and exhausted and have no reason for living. So the problem with our discourse is that the word depression covers this whole range.
MARTIN: Dr. Goldberg has done a lot of research about what happens to people when they tell friends, family or coworkers about their depression. We'll hear more from her in a few moments, but first - the story of how one man, a doctor, struggled with acute depression and went months without getting help.
JAY LYNCH: My name is Jay Lynch. I'm a professor of medicine here at the University of Florida.
MARTIN: Lynch is an oncologist. That means over the years he's helped a lot of people suffering from cancer. Some survive, some do not, and it started to wear on him.
LYNCH: I found myself increasingly short tempered. When my pager would go off, it would cause almost sort of electrical sensations. And if you'd asked my family they would've said, yeah, dad is under a lot of stress. But, you know, as a physician, one of the things is you don't often talk about this kind of stuff. Everybody is stressed. Everybody is busy, and you just sort of suck it up and go on.
MARTIN: Now depression isn't always brought on by a lot of traumatic outside events, but for Jay it was. There was 9/11. Two weeks after that, the son of one of his best friends killed himself. Then a patient Lynch was very close to passed away. And his wife hurt her back, so it was up to him to manage their four kids.
LYNCH: And so each of these things kind of took its toll.
MARTIN: He started to play a very grim kind of mental game that focused on a question.
LYNCH: What if I was going to write a book and have the perfect suicide. What would that look like?
MARTIN: It got more specific. He imagined scenarios and how people would react.
LYNCH: If I could pull it off and it looks like an accident, then everybody is happy. You know, there will be a funeral where everybody spends two minutes talking about all my virtues. And then they would all go on and live their lives, and everyone would be happy.
MARTIN: He never told anyone he was having these kinds of thoughts - not his wife, not his friends and definitely not anyone at work. Then in 2002, a college friend of his passed away, and he was together with his old crew of buddies who gathered for the memorial service. They were sitting around a table, and each of them just began to unload, talking about hard stuff they were going through - problems with kids, one guy was struggling with alcohol. Then they turned to him.
LYNCH: And Jay, how about you? You're being awful quiet. And it was that - but then what I said, you know, yeah, I just laid it out. I'm not doing well at all and contemplating how to do the perfect suicide. And it was at that point that everyone - they were so gracious. The good friends, they came around me, and they prayed for me.
MARTIN: He went back home, but he still didn't know exactly what to do.
LYNCH: Then one afternoon I was talking to a patient who was a very close friend. And I just broke down talking to him. And I realized OK, I can't hold it together anymore. I need to get the help I need and called one of my friends in psychiatry.
MARTIN: Lynch started taking medication, and it helped quickly.
LYNCH: It was like somebody turned on a light in a dark room.
MARTIN: What do you think kept you from recognizing your own depression for so long?
LYNCH: That's a fair question. I think I would've called it stress. I would've called it maybe burnout. And if you had asked people around me they would've said, you know, Jay is not doing well. But they didn't know what to say or how to help.
MARTIN: Which is part of the problem - right? - that if you tell someone you are depressed, they might not understand. And it will just make things uncomfortable. So it becomes easier to just not say anything, convince yourself you can deal with it on your own. But Dr. Susan Goldberg says that kind of suppression has consequences.
GOLDBERG: The downside of nondisclosure is hiding, not telling who you really are. For example, one person talked about how they had lost custody of their child because of their mental illness. But they didn't want people to know, so they would make up stories. Oh, today we went fishing. Or today he was playing ball, and we went to the ballgame.
So this pressure of having to keep a lie to hide a crucial aspect of your experience becomes very heavy and weighty. And for some people - for most people, I would think, having a friend, someone you could trust, someone you could say, geez today is a really rough day. I'm just struggling to make it through. To have that kind of person in your work life would be really important.
MARTIN: But telling can be risky. Some of the people Dr. Goldberg talked to in her study lost their jobs after they disclosed their mental illnesses. So she says it's important to remember a few things if you're considering going public. Think about what's happening in the world. If there's been some high profile tragedy in the news, some violence committed by a person with a mental illness, that's probably not the best time to open up. Dr. Goldberg also says it might make sense to wait until you've established yourself in a job before you tell your employer, and be selective about who you decide to tell. Maybe it's someone in HR or just someone at work you can trust.
Jay Lynch says he didn't suffer any backlash after opening up about his depression. But it was still a lonely spot to be in. There weren't a lot of other doctors who had come forward with something like this, so he started sharing his story publicly with his medical students and on a medical blog because he wanted to be an example.
LYNCH: We need to open space for people to be OK to talk about this. And if we can just be honest about this, I think we'll all be better off, honestly, Rachel.
MARTIN: It has been 13 years since Jay Lynch tried to plan the perfect suicide. Today he still has dark days, but now he knows how to get out of them. And he's got support from his church, his family and his work. Transcript provided by NPR, Copyright NPR.