Dr. Jeff Daskalakis is Chief of the Mood and Anxiety Division and Head of the Temerty Centre for Therapeutic Brain Intervention at CAMH. He is also a Professor of Psychiatry at the University of Toronto; Dr. Kwame McKenzie, Medical Director at the Centre for Addiction and Mental Health CAMH.
As it became clear that crash investigators believed the young Germanwings co-pilot deliberately brought down his plane, news coverage has focused on his psychological and physical health. We have been conducting a sort of psychological autopsy in the media by putting together fragments of information from his life to try to answer the question, 'why did he do it?'
Knowing that he suffered from depression, many have speculated that his symptoms overwhelmed him and this was an act of homicide-suicide. However, those with a deeper knowledge of psychiatry will probably come to a different conclusion. They would know that people who die by suicide rarely hurt other people and are much more a danger to themselves than to others.
In the wake of such a terrible loss of life, it is natural to seek an explanation to help cope. The difficult truth is that it is unlikely we will ever know for sure. Second-hand information from people trying to make sense of what has happened rarely leads to an accurate assessment or diagnosis.
But if we are not careful, a further damaging outcome of this tragic story could occur. The stigma and stereotypes associated with mental illness will be inflamed, and people in the work force who need help will be afraid to come forward.
We know that the stigma of mental illness is a major barrier that prevents people from getting care. In Ontario alone, as many as 65 per cent of people with depression remain untreated. People fear that if they come forward, friends, family and co-workers will treat them differently; that they will be passed over for promotion, avoided, mistrusted.
Depression is the most common form of mental illness and is one of the leading causes of disability worldwide. It is a complex mood disorder that ranges in severity. It is an illness that robs people of things many of us take for granted like social relationships, fulfillment through work and the ability to experience pleasure and enjoyment. While depression can be crushing, it is treatable, and treatments are improving at a rapid pace.
In most cases, depression can be effectively treated with types of psychotherapy that help people better understand and resolve experiences that may trigger their symptoms. There is also an array of effective non-addictive medications that help people lift themselves out of their depression, quickly granting more energy, better sleep and less frustration.
The management of depression is as effective as the treatment of many other medical conditions but we are still improving it. The growing use of personalized medicine – genetic testing to tailor psychiatric medication treatment – cuts out the need for trial-and-error prescribing and is helping people get better faster. And for people who do not improve with psychotherapy or medication there is now a form of non-invasive brain stimulation that works well.
The fact that there are more treatments for depression than at any point in the past serves as a salutary reminder of the need to lessen the stigma associated with depression to ensure that people receive the help they deserve.
Stigmatising depression may decrease the chance of people coming forward for help. The outcome of that is not that there will be another airplane crash, it is that we risk an increase in the number of people with depression who kill themselves and the number of families who suffer in silence.