Major Depressive Disorder
Major depressive disorder (MDD) is a mood disorder associated with depressive episodes such as depressed mood and/or loss of interest or pleasure in almost all activities.4,5 The symptoms are defined as lasting at least two weeks but usually they go on much longer – months or even years.6 In Europe, there are over 40 million people living with MDD.1 That’s nearly the equivalent to the national population of Spain. MDD is the leading cause of disability worldwide.7
Find out more about depression and MDD by downloading the infographic. By broadening our understanding of these conditions, we can all work together to help break depression for good.
1 in 4 people will be personally affected by mental health problems, such as depression, during their lives.3
Sadly, these conditions are so common that it’s likely that you know people affected by them, or you may be living with depression yourself. Even so, it can still be difficult at times to understand the devastating impact illnesses like depression can have on our lives. Breaking Depression aims to raise awareness of the challenges of living with different types of depression, including major depressive disorder (MDD). Breaking Depression has been initiated by Janssen, with support from the Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe).
Janssen has a strong heritage in helping to reduce the burden, disability and devastation caused by mental health disorders and is committed to transforming individual lives. From carers to healthcare professionals and people living with depression and MDD, we want to make sure we are all able to better care for ourselves and our loved ones. By broadening our understanding of the different types of depression, such as MDD, we can all work together to help break depression for good.
The art of Kintsugi
Kintsugi is the Japanese art of repairing broken objects with lacquer dusted or mixed with powdered gold. Translating to ‘golden joinery’, kintsugi treats breakage and repair as part of the history of an object, rather than something to conceal. Breaking Depression features eight works of kintsugi art, inspired by stories from people living with MDD. The mending of the broken ceramics celebrates each object’s cracks and imperfections while also reflecting the complex and lengthy repair process. Not only is this the very thing that makes each piece unique but it also shows that the object has had a life of its own and a story to tell. These ceramic sculptures each tell a visual story, revealing that with time, care and patience, people with MDD can begin the healing process.
Feelings can be difficult to describe and depression is one that people struggle with. The act of making, smashing and repairing follows a journey with depression and is integral to my art
Billie Bond is an award-winning sculptor and lecturer. Her work focuses on themes of identity and a personal obsession with exploring the duality in revealing the concealed and repairing the broken. In 2009, Billie sculpted her sister on the vacant fourth plinth in Trafalgar Square, London, as part of Anthony Gormley’s ‘One & Other’ public art project. Billie won the ‘Pure Arts Sculpture Prize’ in 2013, with the winning piece being exhibited in the Saatchi Gallery, London. She was also awarded a research residency at the Henry Moore Institute in Leeds in 2016. As well as creating her own work, Billie shares her skills and experiences through classes and individual tuition.
As an artist and ceramic restorer, I am able to use kintsugi to create an image about how positive traces of a healing process and an ongoing struggle with depression can coexist.
Johanna is a conceptual fine artist and skilled restorer of ceramics. Born in Poland, Johanna grew up in Germany and relocated to the UK in her mid-twenties. Her art aims to prompt a dialogue between the issue at the core of the work, its wider context and the viewer. Research is an integral part of Johanna’s practice. It informs both the materials and processes she uses and leads to a visual response that communicates the essence of the subject matter and reflects on issues it embodies. Johanna’s work is often sculptural and can manifest itself in a variety of materials including textile, clay and paper.
Breaking Depression: creating the campaign with kintsugi artist Billie BondMajor Depressive Disorder
Watch as artist Billie Bond explains the Breaking Depression campaign, where the art of kintsugi is used to portray the stories inspired by eight real people living with major depressive disorder (MDD).
Kintsugi is the Japanese art of repairing broken objects with lacquer dusted or mixed with powdered gold, treating breakage as part of the history of an object, rather than something to conceal.
The ceramic sculptures featured in Breaking Depression act as visual metaphors, which convey that with time, care and patience, people with MDD can begin the healing process.
With 1 in 4 people affected by mental health problems during their lifetime, Breaking Depression aims to raise awareness of the challenges of living with different types of depression, including MDD.1 The campaign has been initiated by Janssen, with support from the Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe).
Visit https://www.breakingdepression.eu/ and follow #BreakingDepression to find out more.
1. WHO. World Health Report. Available at http://www.who.int/whr/2001/media_centre/press_release/en/. Date accessed: September 2019.
The Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe) is a patient-driven pan-European organisation that represents the interests of persons affected by mental illness and advocates for their rights. If you are worried about your mental health, or someone else’s, visit GAMIAN-Europe for more information. In an emergency situation, get help immediately by calling the emergency services or your local mental health helpline.
The stories featured here are inspired by people on the journey with major depressive disorder (MDD). Each story has inspired one work of art, each with a unique life of its own. They all reveal that with time, care and patience, the healing process can begin.
“I started to experience symptoms about 16 years ago. I was going through hard times. I lost my two brothers and my mother, I lost my business and my home. In these moments I was not a good person. Anger was my reaction to everything. I was tearful and irritable. I could not cope with my anger. It was exhausting but I didn’t know that it was depression. Only years later, I learned that it was MDD. For me, depression is a monster. An ink-black octopus with tentacles that hit precisely on your painful points. Even when you have a small sprout of a desire to do something, the octopus rises and just breaks it with its tentacles. It is a ruthless enemy. I grew up in a big family where I could not openly express my feelings. Even now, after many years trying to talk about my inner feelings to specialised doctors and therapists, it is difficult for me to find the right words.
My MDD has affected my relationships with others. Honestly, for five long years I was suspicious of other people. I withdrew into myself, avoided close relationships. I threw out my old SIM card, I did not want to talk with anyone. The children tried to help me, especially my son. When my daughter went to work in South Korea, they decided a change of environment could help me. So they paid for my flight and treatment. In fact, the language barrier with doctors resulted in incorrectly prescribed treatment that worsened my condition. As a believer, I have my faith. It has been with me throughout my journey. When there is this terrible emptiness and no desire to live, I rely on prayer. As a mother, I dream of not being a burden to my two beautiful children. And I dream of my own house. Having lost it 16 years ago, I still wander around in exile in rented apartments. I realise that there are a lot of unresolved problems inside me. I am working on myself, but it is hard. To others experiencing MDD, be grateful when family and friends come to help because without warmth, care and support it is difficult to recover.”
“I wrote my first suicide note when I was 14. I didn’t do anything about it but I didn’t understand that it wasn’t a typical thing to do. All I knew was that I felt lonely all the time, like a physical pain in my chest. Sometimes I pictured my heart with blood leaking out of it. At the same time, I was getting good grades at school, so no one noticed anything was wrong – not my teachers and not my parents. Things got worse when I went away to uni, but I was good at hiding it. Or I thought I was. I started drinking a lot. Any time I wasn’t going out or studying, I felt like my brain was punishing me. A constant voice telling me I was useless, a horrible person, a waste. That no one would ever care about me and no one should. One day, a friend commented that I never smiled anymore.
I remember being surprised, and trying to work out if it was true. It was such a little thing but it helped me see how bad things were. As though I’d been sleepwalking and suddenly woken up. It also made me realise that I used to be different. That’s when I went to the counsellor. She sent me to a psychologist who, after a few sessions of talking about it, diagnosed me with depression. It was more than depression. I ended up taking a year out from my studies. For a long time, I stayed in bed all day. I felt like I’d failed, and thrown away every chance of being normal. After a while, when my mum got home from work, I would sit in the kitchen while she cooked. Eventually I started chopping things for her. And now I cook while she talks. It’s our routine. Cooking is such a simple, creative thing – I like the feel and the smell of ingredients, fresh herbs and things, and doing something for others makes me feel good too. Accepting that I have depression has helped me see that this sadness isn’t who I am as a person. It may always be with me but I know that if I let people help, I can have more good days.”
“You would never know I have depression. It doesn’t have a ‘look’. Sometimes, the day I ‘look’ the least depressed, I’m suffering the hardest. I’m good at leading a ‘normal’ life, trying to fit in. Hiding behind fake laughs and smiles. Why do I hide it? Pride I guess. Men are not allowed to be depressed. Admitting I have depression means I’m not a good husband or father, because I should be able to do it all, right? That’s what I think. Music is my life. It’s who I am. That’s why I teach it, I guess. I have a small wooden flute my grandparents gave me when I was about 10 and I still play it when I’m feeling down. It’s a comfort thing, improvising from one note to the next. There are no words to express how I feel when I’m low. My mind gets completely swamped. Thoughts and memories flow from the darkest corners of my mind. I really have to fight myself to keep me from drowning in blackness. When this happens, I become unbearable. I have total loss of control of my emotions. I get agitated and irritable with these irrational outbursts my wife and kids don’t understand. Even the slightest thing sets me off. It’s exhausting. But other times I go from angry, depressed to defiant… I have these bursts of energy to distract myself. Buzzing around the classroom, feigning excitement when someone hits the right note. Hoping to pull myself back from the edge. One of the most frustrating aspects of my depression is its unpredictability. It can be cruel and unforgiving. Talking about it has never helped. And it will never go away but, with the right treatment, it is manageable.
It has taken 15 years of living with major depressive disorder to finally become more satisfied with myself, and my work. It’s been a long and difficult road, but it’s been well worth the effort. And I have survived. I’m surviving.”
“I knew people looked at me and saw someone living their dream. I was a young guy, making a life from playing sport. I knew I was lucky, but that made me feel more of a failure. Like I had no right to be unhappy, no right to be depressed. I had everything I’d ever wanted and I still felt nothing. Just empty. As if there was no light left. I couldn’t say anything to the boys on the team. I was too worried about what they would think of me. I didn’t want to bring them down. But I began missing practices. I couldn’t face it. And my body felt so heavy – I couldn’t get out of bed, sometimes for days. What was the point? Finally, there was a day when I couldn’t make the game. I stayed in my room, just sweating and shaking. I still remember that sound of my heart thudding so hard and so loud in my chest – like, really banging – and wondering if this is what dying felt like.
The scary part is that I didn’t care, I hoped it would happen. I thought, at least everyone will forgive me for not being good enough. My uncle was the one who found me alone in my room, and I’ll never forget that moment. He just gave me a hug. That’s when I cried. And that’s when I realised that actually people want to help, they want to be there for you. But you have to talk to them. You have to ask for help. Life is pretty up and down still, but I know things can be okay. I try to keep to a routine and look after myself. I don’t feel ashamed of needing help to find my balance anymore – whether that is medication or taking time to talk about things. And I’m starting to play sport again. The exercise is good – my mind goes quiet and I just let my body do its thing. I play socially now because what I like most is being with people, enjoying something together, as a team.”
“Desperate, lonely, worthless and inferior. That’s how I’d describe me at my lowest. The moment I could no longer cope was when I started my job. I felt like a failure, always criticising myself. It was tiring and I was always sad. I cried a lot. That’s when I went to my GP. At first, it seemed like she didn’t take me seriously. I was told I just needed some rest, but that wasn’t enough. After some time, I was referred to a psychologist and then a psychiatrist, who started me on treatment. All in all, it took around two years for a diagnosis. After 18 months I wanted to stop the medication, so I did. But I didn’t realise how badly this would affect me. It got to the point where I was suicidal. I didn’t actually plan anything but I was convinced it would be better to go because I felt my life had no value to anyone. The only reason I didn’t kill myself was because my father was away on holiday at the time. I didn’t want to ruin his trip. I knew I had to see the psychiatrist again. He restarted my treatment and, luckily, everything went back to normal.
I keep my pills in this oval box. It’s gold with flowers on it. Quite frumpy, really. But I used to play with it as a child so it has good connotations for me. I still had bad days but I’d find a way through them. In fact, frequent trips to the garden centre became a big part of my life. I love being surrounded by nature and having the time to reflect. Flowers in particular bring me calm and help remind me that everything’s going to be OK. Today I’m happier. I take care of myself a lot, and working and living my life the way I want is something I need to keep doing. Depression is hard and negative and it does not bring joy, but I’m proud to say I found help and support to get me through it.”
“It’s been eight or nine years since my last episode. I guess you could say I’ve recovered, although it doesn’t feel like it sometimes. I remember first having problems when I was a teenager at school. Life wasn’t great for anyone in my family back then but, instead of talking about it, I took my frustrations out on other people. The only thing I cared about was this soft toy dog I kept at the bottom of my bed. I called him Milo and I used to tell him everything. He was my rock. Despite my terrible behaviour I still managed to get into college. That’s when things started to get worse. Instead of lashing out, I locked myself away. I felt hopeless. Like I wasn’t good at anything at all. Being depressed felt like torture. I was surrounded by constant dread and worry about almost everything, and treatment that didn’t seem to work. Alone in a hole and utterly heart broken.
That was me for weeks and weeks at a time and, honestly, you start to believe there’s no hope. I didn’t have many close friends but a couple of them were very supportive. Well, as supportive as they could have been with me in such a state all the time. They accompanied me to the psychiatrist who eventually diagnosed major depressive disorder. In a way, I felt lifted. My constant companion had a name. Something I could grab on to and try to understand. My depression no longer defines me, but it’s still very much a part of my life. I know how to feel it coming and, when it does, I have people who love me and care about me. They are literally life savers and I can’t imagine where I would be without them. It’s taken a long time to get here, but I’m here. Milo is still with me too. He’s a good listener, but I’m sure he looks at me funny sometimes. I guess I can live with that.”
“I have suffered from depression for decades. I’ve had three breakdowns and been hospitalised each time. I have seen three psychiatrists, five psychologists and too many counsellors to mention. You can’t tell can you? You can’t tell by the look in my eyes or the sound of my voice. You’re thinking ‘You're smiling though!’ Yes, I am smiling. I smiled for you. I smiled so I don’t make you feel bad. I also don’t want you to feel like there is something you can do to make me ‘feel better’. There isn’t anything anyone can do. I have tried almost every depression-related treatment available, even 10 rounds of ECT without success. I was in my 20s when I made the link between the horror of my existence and the term ‘depression’. Being alive was simply, totally and absolutely unbearable and I just wanted to fall asleep and never wake up. You can still function with depression. Some days I get up, do my make up, I smile, I leave the house, have a coffee. Always coffee. But there are days when I lie on the bathroom floor crying in desperation for the pain to end. Some days I can chat to friends online for hours, help them, talk about stuff with no problem. Other times I leave messages unanswered for weeks, months, and think about shutting myself off from everyone before they have a chance to shut off from me. Some days it feels like I’m drowning. But when you’ve suffered from depression for as long as I have, shuffled from doctor to doctor, trying just about every therapy in the book, you learn to become aware of the symptoms, the triggers, and stay in control.”
“I have struggled with depression for more than two thirds of my life. Think about that. Most of my life has been spent fighting my demons and convincing myself to stay, to keep fighting. ‘You don’t look suicidal’. I remember these words coming from a school counsellor after I’d told her I was having thoughts of suicide. I remember my 14-year-old self feeling embarrassed and confused. What was I supposed to look like? Fragile with a bottle of pills in one hand and a suicide note in the other? I wasn’t diagnosed until I was 25. Once my son was born, my postnatal and everyday depression fused and I almost lost it. It was always my dream to be a happy stay at home mum, and yet I felt worse and worse every day. I lost weight and developed severe insomnia. It took all of my energy to care for my baby even if I couldn’t function that well beyond my parenting duties. Yet my son saved my life. He is the reason I get up every day. I’d rather he see me battle my demons than think even a fraction of my pain was caused by him. A year and a half ago I decided to quit taking my antidepressants. I could feel myself slipping back to where I was before. There were days I’d almost convince myself that my son and my family would be better off without me. So I went back into therapy and, after talking about it, agreed to go back on my medication. A part of me feels like I have failed. But I know it’s not true. I am doing what is best for me, and my family. Yet the best part is I haven’t felt this good in a very long time. I want to keep working on myself so I can eventually be off my medication. But until then, I have to do what I have to do. With my therapy, walking the dog, the baking, and my amazing friends and family, I know I’m going to be okay.”