First published in the Daily Maverick 168 weekly newspaper.

This is how my beautiful friend feels when a depressive episode overwhelms her – they don’t call depression the black dog for nothing. She is in a clinic this week. Again. Luckily.

She is smart, uber-cool and so creatively talented I’m permanently in awe of her. But she can’t see that. She can’t see that she is a fabulous mother, partner, wife, friend and designer. She sees the ugly, the banal and the unsexy. And when the voices in her head tell her she is a fake and a fraud, there is nothing that I or anyone around her can say that helps her to see otherwise.

Two weeks ago Daily Maverick broke the story about former Spur CEO Pierre van Tonder’s ultimately successful attempt to take his own life. He died in hospital on Sunday 9 May. I won’t dwell on how grim that week must have been for his family – and how difficult the weeks going forward will be. But several people took my colleague Tim Cohen to task for writing the story. Why? Is it a distasteful subject? Why is it acceptable to write about a six-year-old boy drowning in a pit of urine and faeces, and to interview his family on the subject, but it’s not okay to write about a man – a leader in the business community, a husband, father and friend to many – taking his own life?

Just before this, in April, Anele “Nellie” Tembe, the fiancée of South African rap star AKA, apparently fell or jumped from a 10-storey building. Her family has not said whether she was suffering from any mental health issues, but her death has sparked conversation.

What is it about depression, and more broadly mental health, that we can’t talk about? And why can’t those suffering from it talk about it? Because it’s “invisible” and easy to ignore? When friends are ill with cancer or multiple sclerosis or any other hideous disease we bring soup, acknowledge them, give them the freedom to speak and understand their highs and lows. But not depression. Yet this is a condition faced by one in 10 people and up to one in five in areas experiencing conflict and other emergency situations, which, let’s face it, is many parts of SA right now.

Consider that depression is a major contributor to the overall global burden of disease and affects people of every age and socioeconomic status. Consider, too, that it goes hand in hand with anxiety and often with alcohol and drug addiction.

It is definitely something we should be talking about.

In many cases people continue with their day-to-day lives, trying to make it seem that nothing is wrong. They often isolate and keep their feelings to themselves. Sometimes this goes on for years. I now know that when my friend does not respond to calls and messages she is isolating, and it’s not because of Covid-19. She feels she is a burden, one that her friends and family should not have to deal with. Uncontrollable crying bouts and a worsening of all the symptoms come with this. She cannot simply “snap out of it”.

Do more men or more women suffer from depression? The research tells us that depression has no favourites. But perhaps more women receive treatment. In SA, we teach boys to be “tough”. We have a “pick yourself up, boys don’t cry” culture. Worse, we teach our boys that certain emotions like anger are more acceptable than showing vulnerabilities like fear and sadness. These lessons move with us from boyhood into adulthood.

And South Africa’s brutal corporate culture is not tolerant of anyone who cannot keep up the pace, though I do believe that this tone is changing. That said, the South African Depression and Anxiety Group (Sadag) has stated that the rates of depression among men in South Africa are at an all-time high and has launched a campaign to draw awareness to this fact.

Sadag asks: do you know of a man who is grumpy and irritable, and has no sense of humour? We could all probably find an example of a man (or woman) who fits that bill. Maybe he drinks too much or abuses alcohol? Tick. Maybe he works all the time, or compulsively seeks thrills in high-risk behaviour? Tick. Or maybe he seems isolated and withdrawn, and no longer interested in the people or activities he used to enjoy? These are some of the markers for depression, Sadag says. Do they sound familiar? I fear, for many of us, they may be all too familiar.

Just as anyone can fail an exam, or miscarry a baby, anyone can be clinically depressed. But as long as we talk about depression as though it’s uncommon, as long as we remain surprised by it, as long as we think of it as a problem only for the weak, we make it harder for those living with depression to open up and for us as a society to provide the support required. DM168

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for free to Pick n Pay Smart Shoppers at these Pick n Pay stores.