Not a laughing matter

Labels used without understanding harm real sufferers more than we realise

The inclusion of ‘depression’ – a medical term – into the everyday vocabulary of ordinary, healthy people, has enormously padded the word’s impact on us. Not everyone who’s sad is depressed. Not everyone who’s grieving his or her loss is depressed.

‘Depression’ denotes a disorder, not one of the usual mood states that every human being is bound to feel whenever one, say, gets fired from one’s job, or breaks up with one’s significant other. Yet, at the same time, depression is not necessarily the state portrayed in movies and popular TV-shows; like a haggard-looking person staring into space while sipping a glass of chardonnay, and carelessly smoking a cigarette.

Separating depression from common ‘negative’ states of emotion, like grief and sadness, is best left to professionals trained in this task. And with increasing awareness of depression, there appears to be at least some basic idea of ‘sadness’ and ‘depression’ not being the same thing.

Similarly, there exists a great degree of confusion among the general population about the difference between ‘anxiety’ – again, a medical term – from ordinary nervousness. Once again, differentiating one from the other can be a daunting task, and is best handled by professionals. Indeed, there are varying degrees of anxiety, and not all who are ‘anxious’ feel exactly the same.

The Diagnostic and Statistical Manual, fifth edition (DSM-5) offers some useful guidelines in identifying anxiety. Generalised anxiety disorder is marked by excessive worry for six months or more, which is difficult to control and interferes with one’s sleep pattern and other everyday activities. This may not mean feeling anxious all the time (even a severely depressed person smiles once in a while), but a general sense of dread of things going irreparably and irredeemably wrong.

Everyone worries; nobody’s immune to the slow burn of nervousness. Anxiety affects roughly 18% of the population above the age of 18, and may vary markedly in severity.

It is not unusual for anxiety and depression to go hand in hand, which of course, must not be confused with the ordinary coexistence of nervousness and sadness.  An anxious person is likely to suffer social losses due to his propensity to over think and under act, and a constant string of small losses can result in a depressive state – often what is simply called a ‘mixed anxiety-depressive disorder’.

There is a simpler way to explain the difference between anxiety and nervousness. Anxiety doesn’t make sense, whereas nervousness does.

Waiting in a hallway for an interview, is a perfectly reasonable time to ‘stress out’. The night before an examination is a sensible time to feel uncomfortable, and consider taking a sleeping pill to put your mind at ease. Setting up the projector to give a presentation to your unforgiving senior staff, rattles the best of us.

Anxiety is a state of nervousness that exists for its own sake. It has little reason to be; it just is.

It is a negative emotional state which does not make sense to anyone except the person afflicted with it. It involves recurring thoughts of despair and doom in the future, which hamper one’s functionality in the present.

Anxiety is the dread of pressing ‘send’ after writing an email to an associate or a significant other, understanding the finality of this simple action. This behaviour stems from a sense of paralysing fear of disappointing or annoying the recipient of said email, which when calmly contemplated, does not seem to make a lot of sense. Note that I use the word ‘fear’ here in a generic sense, otherwise it too has a special meaning in psychiatric lingo.

Anxiety is the practice of getting out of bed every night to recheck your doors and windows; or rushing back to the parking lot in the sweltering afternoon sun to make sure you’ve locked the car. Your friends might joke about you of having ‘OCD’, but it’s not; it’s simply anxiety.

Anxiety causes sufferers to be easily overwhelmed by simple, otherwise manageable tasks; and the resulting discomfort is often dealt with by evading the problem until it can no longer be avoided. An anxious person may avoid responding to your text, until it’s absolutely necessary to do so; or avoid submitting one’s project until minutes before the deadline. Anxious people are master procrastinators.

Anxiety is the inner conflict of wanting to see your friends; while simultaneously hoping that your friends cancel the plan, thus sparing you the emotional anguish of preparing for the meeting.

When an average person mistakes his nervousness for anxiety, and pretends to comprehend the torment of an anxious person, one could sound extremely disrespectful. To tell an anxious person that you “know what it feels like”, is to put on display your ignorance of ‘anxiety’, and the gravity of this word. In fact, there are almost no instances where the phrase “I know what you feel like” can ever be acceptable, because we may well process the same circumstances differently.

It’s quite likely that we all know someone who suffers from anxiety, and it’s imperative that we express some empathy.