Over the last few days, there’s been a flurry of news articles about a recent depression study suggesting that it’s possible to diagnose adult depression with a blood test. You can read about it here or in myriad other places, but the gist is that depressed people have different levels of nine RNA blood markers than non-depressed people. Not only that, but the specific combination of these levels in individual patients can predict which kind of treatment will work best for them – medication, cognitive behavioral therapy, or maybe both. This aspect of the test is huge, because it can help doctors get their patients feeling better faster by providing the correct treatment right away instead of having to experiment and see what works for them. Also, three of these RNA markers can also be measured to detect a predisposition to depression in a person who is not currently depressed – levels of these three markers remain different from those of patients without depression, even after a depressed patient achieves remission. So these markers may eventually be used to help identify people who have never been depressed before but should be monitored closely for symptoms.
Isn’t science awesome?
This is just one study and it only involved 64 patients, so there’s a lot more work to be done, but this is exciting news nevertheless. I’ve already been diagnosed with major depression and have found therapy that’s working, but I’m still really excited about the potential social ramifications of this kind of testing. I think that being able to biologically test for depression, to prove the diagnosis with quantifiable data, will strike a huge blow against the stigma surrounding mental illness and silence the hordes of ill-informed critics who insist that clinical depression does not exist and people just need to get a grip and stop wallowing. (It is true that not all people who feel depressed have clinical depression. Some people are just going through a rough patch due to personal circumstances and/or need a bit of a life makeover. But many people do not believe there is a difference.)
Needless to say, I’ve been gobbling up every bit of information I can find about this, because it marks a key moment in mental health care. Currently, the diagnostic process in mental health care consists mainly of compiling the symptoms reported by the patient and seeing what they add up to. There are various tests that can be done on paper, but the field is sorely lacking in biological methods for diagnosis. The other fields of medicine used to operate this same way — a century ago. So at last, the mental health field is beginning to catch up, and this can only mean improved quality of care for patients and therefore improved treatment outcomes.
So I read an article about this on Facebook yesterday, and then I did a terrible thing. I knew better, but I did it anyway.
I did the thing a person should never do.
I started reading the comments.
When you begin reading internet comments, you are stepping right up to the edge of a black hole and peering inside. And eventually, if you keep reading, you’re going to fall in. It’s inevitable. And it’s probably going to ruin your day and make you despair for the human race.
I don’t know why I started reading the comments on this article, because obviously the subject of mental health in general and depression in particular is personal for me and reading other people’s idiotic comments will not do anything except upset me. So I don’t know if it was some sick masochistic impulse that made me start reading or what, but there I was.
Out of the hundreds of comments, there were several from people who saw this as the positive thing that it actually is and were remarking on how marvelous this is and how it’s an important moment in science, etc. Then there were the people who have to criticize everything, even good things, and they were chiming in with scoffing, haughty comments about how the test group was ridiculously small so how does this study mean anything, actual mainstream use of this test is years away so why all the excitement about it, etc. Then there were the anti-establishment zealots who see anything related to health care and immediately begin screaming WAKE UP, SHEEPLE, BIG PHARMA IS OUT TO GET YOU and raving about how all doctors are irresponsible pill-pushers maliciously trying to drug the daylights out of their patients instead of actually helping them. (All doctors? Really?)
And then, of course, there were the trolls.
You see them in comment sections across the internet – those people who simply cannot pass up an opportunity to say something ugly and cruel, who flaunt their willful ignorance like it’s something to be proud of, who feed off other people’s angry responses because that’s exactly why they are there – for the satisfaction of making other people feel as angry and hateful as they do, to force other people to stoop to their level, and because negative attention is better than none at all. People who spend a fair amount of time online are familiar with trolls and know not to feed them by giving them the attention they seek. But it’s hard sometimes. It’s SO hard to see someone being cruel and ignorant and not stand up for the actual truth, to not fight back against a person spreading incorrect, sometimes dangerous information in a public setting.
A few of my favorites that I saw yesterday (and yes, these are verbatim):
“There are already blood tests for depression. They’re called [blood] spatter patterns.”
“Depression is a state of mind, not an illness. Smoke a joint and get over yourselves.”
“Depression is a mindset. You people are weak and if we didn’t live in such a cushy supportive lifestyle, natural selection would’ve run its course.”
I wish I could say that I’m immune to the words of random strangers on the internet. That would be a great superpower to have. But these comments left me reeling. I’ve watched people being ignorant and wantonly cruel on the internet countless times, but on a sensitive subject such as this, it really got under my skin. It was devastating to see people being so dismissive of something that’s been a major presence in my mind and my life for almost a year now, that’s often rendered me nearly immobile with sadness and self-loathing and pain, that’s left me literally sitting on my hands to keep myself from raking my skin with my fingernails to see if bringing my pain to the outside would relieve some of the agony I felt inside, that recently caused me to spend an entire evening sobbing and thinking obsessively about the bottle of vodka in my fridge and whether I had enough pain pills in the house to chase with it and never wake up again. To be living this experience and see someone reduce it to a bad joke about suicide, to be told that I could fix it by smoking a joint, that I’m suffering because of a character flaw, or that this is just Darwinism trying to weed me out of the gene pool…I don’t have the words for the hurt and anger that makes me feel, and I don’t have words strong enough to explain how wrong those people are in their thinking and how awful and despicable it is to air that kind of garbage anywhere, much less in a space where there are likely to be a lot of people with a personal connection to depression. The impotent rage almost choked me, because I knew I could respond to these people and attempt to correct or discredit them, but I also knew it wouldn’t accomplish anything. They weren’t there to participate in an intelligent discussion about mental health issues – they were there to provoke people, and unfortunately it worked on me. But I started to feel better later in the day when I remembered that this weekend I’m participating in an event that will accomplish something.
Tomorrow I’m participating in the American Foundation for Suicide Prevention’s Out of the Darkness walk. They have a huge national walk every year, but this one is the Chicagoland community walk organized by the AFSP’s Illinois chapter. More than 4,500 people are participating, and together we have raised over $600,000 for research grants, legislative efforts, and community outreach programs to prevent loss of life by suicide and remove the stigma surrounding mental illness. I am so proud to be a part of this amazing event, and I also feel strong and empowered because I’m supporting an organization that stands up against the stigma and ignorance and cruelty that so many people with mental illness face and works tirelessly to help people in crisis get the help and support they need, because their illness is both real and treatable. Responding to individual jerks on the internet might not make a difference, but supporting the AFSP will, and talking openly about my depression will, and I’m doing both of those things.
Crawl back under your bridges, trolls.