This is the final post built on Facebook comments when I came Out of the Closet to admit that I have lived through debilitating episodes of mental illness.

Sara wrote: “We speak as though mental illness is one thing, not many; not even depression is a single entity – and the same treatment certainly doesn’t work equally for even those with very similar symptoms.

“Also, mental illness is a full-body phenomenon and experience.  We know this, but we don’t really think or talk about it this way.”

The Age of Enlightenment left us believing our intellect to be in some sense separate from our body.  We have only recently had tools to examine how our brains work and we have barely begun to question our belief that the brain operates in isolation from other parts of our bodily system.

Liz pointed to an excellent article about how Mental Health May Depend on Creatures in the Gut.  Another friend who recommended The Emperor’s New Drugs convinced me that the antidepressant medication I credit with removing my symptoms did not do so in the way we imagine.

How could it not be true that our brains and guts are part of an overall system that governs our physical/mental health?  We just don’t yet know much yet about how it works.

Susan wrote: “I experienced severe depression after/as a result of cancer and its treatment 5 years ago.

“Anti-depressants for 9 months and encouragement from my insurer (!) to see a therapist, talking with him over the following three years, have helped enormously.  

“Every day is still a challenge, but I am also so very grateful for every day.”

We need to know more than that cancer makes us miserable.  We need to understand the mechanism.  Diagnosing and treating mental illness is still quite haphazard, especially because, as Sara points out, depression is not a single entity.

And even the existence of mental illness is often unrecognized.

Kelly wrote:  “Depression is very common among people with chronic illnesses, and often goes untreated.  I’ve always just assumed it was part of being ill, and tried to deal with it on my own.  

“Thank you for this post, Martin.  Along with the many comments, it has inspired me to talk to my doctor about treatment.”

Physical pain is almost certainly not the only thing someone with chronic or long-lasting illness is suffering.  They are most likely also depressed.  And the tragedy is, even if they recognize their depression, they will probably not seek treatment.

When we’re in a depressive episode we do not seek treatment because we feel it is the appropriate response to our situation.

When we get a respite from the physical pain, we don’t recognize that we should seek treatment for next time because we’re so relieved to be feeling better.

My depressive episodes were triggered by other situations, not physical pain, but the same dynamic applied.  I know from the same fundamental experience how unlikely it is that Kelly will in fact talk with her doctor about treatment for depression.

There are many stories of Buddhist masters who are impervious to pain.  One of my teachers whose serenity is truly amazing suffered an extremely painful illness last year.  “I thought I should be able to ignore the pain” he said, “but I soon discovered it was impossible, so I accepted the doctor’s recommendation and took the pain medicine.”

Pain is a call to action.  We must not ignore that call.

Both the source of pain and pain itself can be treated.  We don’t have to work on only one aspect of our illness.  It may take experimentation to find an effective treatment, and the same one may not continue to be effective.  We don’t consider that a reason not to seek treatment for physical illness.

So, if you know someone with chronic or long-lasting pain, please help them overcome their reluctance to seek treatment for every part of their suffering.