Depression is the Cruelest Disease in the World

Is it? One could argue there are crueler diseases or conditions than Depression: Cancer, Schizophrenia, Alzheimer’s, Anorgasmia. It’s a subjective call.

What one aught to keep in mind, however, is that how a disease affects a person’s feeling of well-being is immensely important. Depression, especially its major forms, strips its victims of the very moods needed to more easily travel from one day to the next.

Often, Depression shadows other diseases – and Depression is the cruelest part because it can beat-down the will of patients to hope realistically. And it’s not just diseases either: Postpartum Depression is a stunning example of its cruelty.

Think about that: one of the brightest moments of life – a mother’s bringing-forth of a joy – dulled by the eerie pastel-mix of fear and sadness and despondency and, cruelest of all in extremes: psychosis.

What’ more: Depression acts like a social repellent, retarding the very thing which can help the most – social ties and bonds and support. And like salt into a wound, many cultures breed a malicious ignorance about the condition, inflicting more pain and isolation.


Perhaps the only positive thing about Depression is that it’s loaded with positive-feedback loops of down-ward spiraling sequelae:

  • Less sociability > more isolation > more depression > less sociability …
  • Decreased ability to enjoy life > more depression > even less ability to enjoy life > more depression …
  • Negative-thinking > more depression > reinforcement of negative-thinking > more depression …
  • Less self-insight > less chance of seeking help > more depression > less self-insight …

Depression assaults every system of the human body. It’s not just neurotransmitters that are skewed: hormonal molecules and immunity cells are disturbed. And from those disturbances ripple others. It’s rather amazing that our bodies still manage to rescue enough homeostatic functionality to keep things going!

A goal of therapy is to slow and reverse those feedback loops, some of which are biochemical, others psychological, others social. It’s not necessarily the easiest process, but we’ve learned a lot in the last couple decades. And we have even more to learn – all the more reason to stay tuned!


If you look at much of the major conditions – obesity, diabetes, cardiovascular disease – you likely will find that depression of some variant preceded, maybe for years.

Now here’s where Depression gets even crueler. Grief is one of our most powerful channels to connect with the deepness and profundity and truth of human life. It’s something we all must go through at certain moments of our lives. Not to grieve is not to live fully.

And therein lies Depression’s cruelest claw: it mangles the healing of grief, replacing grief with biochemical surreality.

We live in a culture (here in the U.S.) that tends to avoid grief. It’s actually more of a hypomanic culture: colorful shopping malls, grandiose political talk, champagne tastes on beer budgets, goal-directed foreign adventures that are soon forgotten like drug-addled parties under full-moons.

The problem with hypomanias is that they eventually turn abruptly and abandon the passenger, leaving her on the side of some weird back-road. Depressed.

That may be where we’re headed: a sort of collective post-hypomanic Depression. Maybe it’s rather fitting that we are now in the largest economic Depression since the 1930s – one that may last a decade or more. An economic Depression preceded by decades-long financial hyopmania.

If that’s true, then we critically and urgently need a reformation.

Healthcare reform starts with the head.

If our heads are in the wrong place, how we provide and finance health care won’t change much for the better. We must meet our needs for each other before we can meet all the other stuff of reform. Health is social. If it ain’t, it’s sickness.


But rather than try to make a societal appeal here, I think the best I can do is to say something to you, reader. Everything starts with the individual.

There’s a chance that you will experience clinical depression, if you haven’t already. Or maybe one of your friends. Or a relative.

Pay more attention to this cruelty inherent in the human condition. It affects you more than you may realize (or me for that matter).

I encourage you, therefore, to take the time to watch Robert Sapolsky’s Standford lecture: Depression in the U.S.. Robert Sapolsky’s lecture may be one of the most comprehensive overviews of clinical depression and it’s well worth the time.

Now I must apologize here: there’s a chance my encouragement to watch a near-hour long lecture  is cruel. If you are too depressed, 52 minutes may be too long. It’s certainly 50 minutes too long if you’re addicted to the Internet. 😉

So here’s a much shorter clip that gets right into the jugular vein of clinical depression:


I’m sure that Depression has its place – it acts perhaps as a defense against life’s predations, much like our skin. It’s rather unfortunate – cruel in fact – that it so readily morphs into something akin to a ghost from another dimension trying desperately to coax and pull you there.

The saving graces, of course, are science, compassion, understanding and inspiration.

Our contemporary communications and sharing platforms may play an important part of helping to replace ignorance with knowledge; fear with courage; stigma with acceptance; isolation with connection; superstition with science; and denial with healing grief.

That’s why I care about all this social media nonsense.

I hope to bring this caring to my role as advisory board member on Mayo Clinic’s Center for Social Media.

@PhilBaumann –  @HealthIsSocial

Disclaimer: The content here is not medical advice, just a finger pointing to the moon. Point yourself or someone else to a medical professional. And make sure you work with a competent one – which is to say: talk to others and be vigilant in finding the right people and resources.

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0 Replies to “Depression is the Cruelest Disease in the World”

  1. Just to point out:

    The keyword here is ‘cruelest’, not statistical ‘top’. It’s the cruelty of the illness that’s the focus here.

  2. Thanks Phil. A great article with a thorough understanding of the issues. As I have Bipolar, I know the intense swings both upwards and downwards. After my initial first manic episode in 1987, followed by an extended party time on my happy chemicals. I crashed down into depression for 4 years… read more if interested (refer to My Profile, on my site).
    Regards, Peter

    1. Hi Peter,

      Thanks for stopping by!

      Definitely: Bipolar Disorder is an especially challenging condition to work with, but it’s great there have been a fair amount of advances in the last couple of decades – the stigma is still out there, but I’m starting to see some enlightenment.

      Will most certainly check out Great job!


  3. Phil, thanks for sharing these important thoughts on depression – personal and societal. As part of health care reform and as social media becomes more a part of our profession, I’d like to see physicians and mental health professionals come together to treat this, and other, mind-body illnesses. Unfortunately, now we are too encamped in “medication” and “therapy,” when really the treatment should include both in partnership as a matter of best practices.

  4. I have to say that, for me, anxiety is the worse disease in the world, having suffered both anxiety and depression. When I’m depressed it’s like a big dark blanket just falls over me. When I’m anxious, it’s like I’m being chased by something horrific that I can’t see or name but that pursues me none the less. Neither is ideal, but I’d take dark blanket over dread and fear any day.

  5. Phil,
    This is a terrific post. I’ve written on my blog told other survivors that I found clinical depression much more difficult than cancer. Those who suffered from depression – and had never been diagnosed with cancer — found that so hard to believe. Even a tweet I corresponded with, who clearly was severely disabled with depression to the point where full-time employment wasn’t possible, could not grasp that what she was up against was harder than treatment for breast cancer.
    But it was and is. I’ve had both. As soon as you say “I have cancer” there is an extraordinary outpouring of love and support. There are parades. The first “Relay for Life” I participated in shocked me. When I stepped out on the track people were clapping. It was everything I could do not to shout: “there are many who need your support and admiration more than I do.” An oddly humbling experience, but there you have it.
    I’m long winded but am passionate about this and the potential social media offers in connecting people with others “in the same boat.” When we reach the day when depression or any other mental illness is no longer considered “crazy” I’ll retire. I’m thinkin’ I’ll be busy for a long, long time.

    Thanks again,

  6. Great article and I would agree with your assessment to a certain extent. Just to extend the concept of cruelest I would have to nominate schizoaffective disorder depressive type as a contender.

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