So, perhaps you cringed at this title and thought- "toxic positivity?!- so now millennials are telling me I can’t even be positive, in case I offend someone- what can you say these days?” Of course, it's only natural to want to turn away from more intense subject matters- especially if you're British. But hear me out here, because although yes, constant negativity never got anyone anywhere, there's a lot of evidence to suggest that constant positivity can be just as bad. And I'd like to prove it to you with what I know about depression, stress and how our minds have evolved.
Disclaimer: the following may involve some very honest and negative content.
Why We Should Be Talking About Being Depressed
In the UK, 19.7% of people have experienced symptoms of anxiety or depression. Around 7% of people in the US will have experienced a major depression in the last year. It is the second leading cause of disability worldwide, after back pain.
That means almost certainly someone you have known personally would have gone through this, whether you knew it or not.
And for those of you who prefer to think in how that affects you and the economy you live in, depression and other mental health issues account for a third of the disease burden in the UK from the ages of 15-29- more than any other long-term condition. In fact, a 2013 Chief medical report estimated that the burden of mental health cost the UK roughly 4.5% of GDP, priced at about £100 billion per year. The WHO predicted that it will be the leading cause of mortality and morbidity by 2030.
My point: it’s prevalent. We can deny it no longer.
But how is talking about it over a pint at the pub supposed to help any of this? People should just go get treated, right?
Well, my argument is that people don’t get treated because they don’t know how to recognise the warning signs of a real problem, precisely because no one talks about it. That's not even mentioning the whole stigma issue. Don't get me started...oh wait, too late. Nearly 9 out of 10 people surveyed said stigma and discrimination negatively impacted their mental health condition while 30% of people surveyed believe depression is caused by a weak personality. The impacts of this are very real, because it delays people seeking treatment. And studies have shown that the chances of not recovering increase exponentially, the longer you take to seek help and for each successive episode.
So in fact, it shouldn't just be talked about in the pub. It should be talked about in schools, at team meeting agendas, in election campaigns and yes, in casual conversation, if we're going to get any closer to it being dealt with and so we can start to develop some emotional literacy.
What is Toxic Positivity?
Toxic positivity doesn't mean we should allow ourselves to be negative all the time. In fact, its precisely this all or nothing thinking that it wants to do away with. Toxic positivity is the kind of positivity that just isn't very honest. In the age of social media where everyone is living their best life, and there’s a constant stream of self-help clickbait telling you to be positive, a lot of people are seeing a world through a shiny summer lit filter.
But when the WHO tells us that depression is the second leading cause of disability worldwide, then how does this world make any sense? Obviously, people much prefer looking at positive content but when it starts to pervade all our social interactions, off-screen as well as on, it makes it harder for people to process failure and understand how to deal with setbacks.
Call me a negative Nancy but the Buddhists said it and they're some pretty wise guys, so I'm just going to tell it how it is for once- life can really suck! There, now doesn't that feel a little better.
Another kind of Toxic Positivity is the kind that invalidates another person's emotions. This is a tricky thing to figure out as the right response to an upset can be very nuanced in different situations and people. But in general, if you see that a person is suffering from something that is out of their control and you just keep telling them to "never give up, keep trying, just try to be positive"- this just makes people feel bad about feeling bad. A better approach would be to acknowledge the pain they're feeling, listen to it and then help that person to find someone or something that can help them gain back control.
So how do we know when to be encouraging and when to accept that life is such a beach? Mostly, we don't. It takes sage-like expertise. Which is why it needs to be taught in schools and discussed with friends.
In my experience, people seem to have the general idea that responding to emotional upsets is guided by common sense. This widely held assumption may be true for the Dalai Lama or Gandhi, but actually its supremely complicated. When someone tells you they can't come see you because their mother is terminally ill at the moment or they don't understand why they've been rejected from so many interviews- do you know how to respond to maximise this person's sense of ease? Maybe you could venture a guess- but it doesn't have to be guesswork, and it shouldn't be, because there are frameworks out there
So, first things first, let’s increase that emotional literacy and get to understanding what depression is, so you can spot it from a distance.
The Worst Disease in Existence
First of all, I cannot emphasise enough that depression is not a choice, it happens to you- the dysregulation of chemicals and atrophy of neurons in the brain is universally agreed upon by scientists. This is not a case of- “oh, get it together”.
Second, there are different kinds of depression. Of all the made-for-TV tragic diseases out there, from lung disease, to split personality, to cancer, major depression is, by its very definition, the most miserable and utterly tortuous. You are shaking your head in disbelief at that now, but you only really know if you've experienced it or someone close to you has. Every move you make is painful and everything that exists around you is a threat to your being, a lot of the time you may have a feeling of being out of your own body and on the worst of days, you feel utter emotional agony at every moment.
Dysthymia is a less severe but more persistent kind of depression, but still marked by painful feelings of anhedonia (the inability to feel pleasure), apathy and a feeling of being doomed in some way. In fact it has been shown that the areas activated in the brain when we feel physical pain, are the same areas activated when we feel mental pain. It’s as real as a kick in the shin.
Depressive symptoms do not necessarily however require a diagnosis. The symptoms may be episodic or onset by a traumatic event; we call this grief. Everyone experiences it differently.
Things you would never say to people with life-threatening illnesses, but you would to someone with depression
•Well of course it sucks to have leukaemia, but it doesn’t do any good to dwell on it now does it?
Oh come on we all deal with this insulin deficiency stuff, stop being a baby and get on with things.
•Oh you have Alzheimer’s? Yea, I feel like that all the time
•What did you do to cause yourself to get Colon cancer?
•Well you may have ingested a lethal toxin into your body, but it’s a sunny day so let’s go for a walk in the park, and then you’ll feel better.
•Oh your head is on fire? Let’s try to see the bright side.
•So you’ve broken your leg- you can’t let that stop you achieving your dreams and hiking Kilimanjaro.How it Works in the Brain
To avoid running the risk of turning this into a scientific essay, I’m going to have to massively simplify exactly what happens- but you’ll get the general mechanism.
So obviously bad stuff happens to everyone. Maybe you have lost a job you loved- you go out drinking a few too many nights in a row and ask yourself what it all means. You might get a release of glucocorticoid stress hormone, get a little depressed but eventually recover. Then maybe, the love of your life dumps you and the next thing you know you’re sitting on your sofa drowning in Cheeto dust for a few days (or weeks). This is life. However, around the fourth or fifth time that a major stressful event occurs in quick succession, your brain chemistry changes.
As neuroendocrinologist Robert Sapolsky describes it, the cycle starts kicking off on its own and you no longer need a major stressful event to make the glucocorticoid flood gates open. Your ventral striatum starts underperforming (critical for feeling pleasure) and your right prefrontal cortex kicks it up a notch. This is because, when a threat is not solved through cortisol, it recruits the prefrontal cortex so you engage in effortful problem solving. After many sustained stress responses, the right prefrontal cortex then starts ruminating on the fact that no one is helping the refugees and if we all die alone anyway what’s the point in anything and why is the advertisement of this pack of Hob Knobs trying to control my desires?
But when its negative abstract thought that doesn’t seem to lead anywhere, then you get the prefrontal cortex whispering to the amygdala that there’s a spanner in the works here. The amygdala’s job is to encode implicit fear conditioning and starts being this hyper-threat detector. The stress response is fuelled over an over by this- think, there’s a tiger constantly chasing around the thoughts in your head.
The constant release of glucocorticoids are now incapacitating the hippocampus- a wonderful place where old memories reside- and can help you rationalise your fear. The longer this goes on, the harder it is to gain back control through the hippocampus and you end up with the pleasure circuits of the brain underperforming, sleep dysregulation, hormone dysregulation, psychomotor retardation (finding all movement exhausting) and sometimes even a stomach ulcer.
This is a little bit of a simplification. The neurochemistry is much more complicated and there are many different ways symptoms are experienced. But the take home here is that depression is as biological as diabetes. What a person may look like on the outside is just a wet towel sitting on the edge of the bed, lifeless, and we think “well it looks to me like you're just lazy”. But what’s actually going on is a huge biological internal battle that exhausts them to the point of physical inertia. The overcompensation of the stress response cannot just be controlled at a whim.
The Ancient Mind and the Modern World
That is because this system is evolutionarily encoded into us. Back in hunter-gatherer days the stress response was much more useful as the main daily activities were chasing down animals for food, being chased by animals, being threatened by disease or traversing intensely dangerous climates and terrains. Luckily or not, for them, they didn't have taxes to pay, or high school popularity contests to deal with or work presentations. Now the adrenaline released from the stress response simply has nowhere to go but to circulate around and around, as the prefrontal cortex tries to figure out how to get the rent paid by the end of the month.
So, depression is essentially a collision between an ancient mind and a modern world. So for any of you out there that are depressed and need a self-esteem boost- just think, you're a perfect example of what evolution intended. All those successful people- they're the faulty ones.
But of course that's not true- no one is faulty here.
Fighting the Pandemic
So if we evolved to deal with a life of struggle and hardship, and then suddenly everyone is telling you to just live in the now, get high on life and unleash your potential, its not surprising that that can feel a little exhausting.
Emotions happen without our say so, but what we do have a say in is what we say. There is a lot of power in your words. So say to all your friends to tell you if they feel sad and you tell them when you are. If you don't know how to express it, research and teach yourself. It may not be obvious to you but there's a huge chance that someone you know has experienced depression and been ashamed of it. You will have an influence on someone.