How Accurate Are Media Portrayals of Chronic Illness?

Chronic illness representation in the media has grown dramatically in the past 35 years, which is probably a good thing, because the more we talk about illnesses, the less stigma there is, and hopefully, the more research gets funded so that one day they may not have to be chronic (I know that’s probably way too big of a dream, but hey, gotta be at least somewhat optimistic). I think most of us can probably agree though, that many of these portrayals aren’t very good… or realistic. The main problem that I see, at least in the world of fiction, is that the stakes are always super high – it’s life or death – which isn’t the case for most of us living with chronic illness, at least not on a regular basis (and of course, it does depend what illness we are looking at). There’s also always some kind of unrealistic love story surrounding the illness, which from those I’ve talked to in real life, doesn’t seem to be the case for most people. But, we can probably forgive Hollywood because at the end of the day they’re a business trying to make money. So let’s dive into some, perhaps more accurate or partially accurate portrayals in the following categories: fictional film & tv, documentary film & tv, celebrities, and music.

Me in “Hell-A” (2018) – hopefully you get the reference to the Bran Van 3000 song.

Fictional Film & TV
This is where most of the problematic portrayals are, but there are some portrayals that are better. I’m not going to get into an extensive list, but just highlight a few. For TV, I would say Degrassi – and I don’t mean just the most recent iteration of this 30+ running show, but going back to the beginning. In Degrassi Junior High/Degrassi High (1987-1991), Caitlin was diagnosed with epilepsy, and LD had leukemia. The original series was extremely realistic in a lot of ways, which probably lent itself to doing these story lines well. A more recent version of the show apparently did a good job with a cystic fibrosis storyline.
Movies wise, I though Love and Other Drugs did a good job with a young person who had Parkinson’s, and Brain on Fire, took us through the journey of a young woman being diagnosed with a rare autoimmune disease. This movie was based on a true story. Of course, there are a number of other good portrayals out there, sometimes we just have to sift through the not-so-good ones first.

Caitlin (portrayed by Stacie Mystysin) on Degrassi Junior High.

Documentary Film & TV
This is a way better place to find accurate portrayals of chronic illness, because we’re actually following real people in their real lives (I do want to say that even in docs some things are contrived. I’ve worked on a few in my previous careers and we’ve had people change their clothes, or pick locations we should do things to help move the “story” along, but overall they are still more accurate than fiction). TV wise, I found a show (on Netflix I think) called Diagnosis, about a team of doctors diagnosing people with rare illnesses, that had been unable to be diagnosed by any other doctors. It was pretty cool (there was one girl who was ultimately diagnosed with somatic symptom disorder, which may be controversial for some of you, just a warning). Other docs that I liked include Gaga: Five Foot Two, which highlight Lady Gaga’s fibromyalgia; and Gleason, about former NFL-er Steve Gleason who was diagnosed with ALS in his early 30s.

Celebrities
I know a lot of people find it annoying when celebs talk about their illnesses, because at the end of the day, they have a ton of money and can usually afford amazing care and things that the rest of us can’t. Here’s why I like when celebs do talk about it: (1) it gets the convo going, (2) they often use their fame to help generate fundraising, and (3) it normalizes illness for people with and without illness. Some celebs who have done a good job in this arena are Michael J. Fox (Parkinson’s), Selma Blair (MS), Selena Gomez (Lupus), and Sarah Hyland (Kidney Dysplasia).

Music
This is the other category I would say is “highly accurate” because often the singer-songwriters are singing about their own personal experiences with their illness. Music is typically quite raw and real (some genres more so than other), and many of the songs about chronic illness feel honest. A couple we could highlight (and really there are a ton I could put here but I’m just going to pick a couple) are Believer by Imagine Dragons (about ankylosing spondylitis), Caves by Jack’s Mannequin (about leukemia), and Head Above Water by Avril Lavigne (about Lyme Disease).

What are some of your favourite portrayals of chronic illness in the media? Feel free to comment on the blog or tag me on Instagram @chronically.living_
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Treating Depression

Depression is one of the most common mental health problems (right up there with anxiety). It also commonly co-occurs with chronic illnesses. If you’re feeling depressed, or have been diagnosed with Major Depressive Disorder, it’s really important you are treating it in some form. As a therapist-in-training, I see many clients with depression – some with both depression and anxiety, some with perinatal depression, some with depression and chronic illness – and there are a lot of evidence-based treatments out there. It’s really important to know that you don’t have to suffer alone. So I thought this week, we’d talk about some common treatments, and some up-and-coming ones for depression. I also have an entire podcast episode dedicated to depression and chronic illness this week, which you can access here.

This week’s podcast.

For chronic illness, depression most frequently occurs in people with Alzheimer’s, autoimmune diseases of all sorts, cancer, coronary heart disease, diabetes, epilepsy, HIV/AIDS, hypothyroidism, and Parkinson’s. I got into the criteria for major depressive disorder in the podcast episode, so definitely check that out for more information. When it comes to treating depression, the two most common routes are anti-depressant medications and psychotherapy. Anti-depressants most commonly come in the form of SSRIs (selective serotonin reuptake inhibitors) that alter our brain chemistry because it is implicated in depression (our brains are not the only thing that is implicated though). There is a lot of research that supports anti-depressants in treating depression, though research also shows that it works as well as a placebo. In other words, if you believe it will help it will. Now don’t get me wrong, I fully support someone taking medication (unless you’re pregnant or breast-feeding and can’t – thus why I see many perinatal moms in my practice), however what a lot of people find is that just taking medication isn’t enough to see significant improvements in their symptoms, and many people don’t want to rely on medication forever.

Depression affects about 20% of the population in their lifetime.

That’s where option 2 comes in: psychotherapy. As a student, I see about 10 clients a week plus I co-facilitate a group for 2 hours a week. There is a lot of research that supports the use of psychotherapy. My podcast episode on anxiety, which you can access here, breaks down how much your therapist and you each contribute to your outcomes in therapy, which is important to know. As for what type of therapy, there are many to choose from and they all have good outcomes. CBT (cognitive-behavioural therapy) and it’s third-wave counterparts (DBT, ACT, SFT, etc) are the most common. Typically this involves a combination of talk therapy, where you tell your therapist about your thoughts and feelings, and then the therapist giving you some things to try out in session that you can also practice between sessions (some people call it “homework” but I don’t like that term). Another option for therapy is psychodynamic, which involves talk therapy plus the therapist often makes interpretations. And then there are the therapies that rely mostly on talk, utilizing the therapeutic relationship, such as person-centred, existential, etc. All of these can help and are something I highly recommend. There is also evidence that different lengths of therapy are beneficial as well, from one session of drop-in counselling to short-term (10-20 sessions) of CBT or long-term (more than 20 sessions) of person-centred therapy.

Our thoughts and feelings can be like quicksand. Our natural tendency is to struggle, but that only makes us sink deeper in. The actual way to get out of real quick sand: be a still and flat as possible and let yourself float to the surface.

If you are in immediate crisis because of self-harm, abuse, trauma, and suicidal thoughts/plans, then please contact your local help line. I’ve put some numbers in the show notes for my podcast on depression. A quick Google search can help you find them in your country. If you don’t like talking on the phone, there are some organization that offer texting services. I volunteered for Kids Help Phone in Canada which had switched to primarily a texting hotline since many young people prefer to text. You are strong for reaching out because it is not easy to.

Canada.

In terms of other treatments, a few are available for treatment-resistant and severe depression. Electroconvulsive therapy (ECT), which used to be called “shock therapy” can be helpful for people with severe depression, though there are some potential harmful side effects, and psychiatrists don’t commonly use this unless necessary. Transcranial Magnetic Stimulation (TMS) is another option for treatment-resistant depression where magnetic pulses stimulate the nerves in your brain. Newly approved in Canada (and how I got the idea for this post) is the use of Ketamine for treatment-resistant depression. Ketamine is a dissociative drug that has a lot of research supporting its use for depression. It activates your glutamate, dopamine and serotonin receptors in your brain. It takes effect much quicker than anti-depressants and has shown to decrease suicidal ideation. So far research shows no long-term side-effects, though because it is a psychedelic drug, there is the chance of substance dependency.

Great video for anxiety and depression.

Whether or not you have chronic illness, if you have depression there is hope for recovery, and lots of options available. Talk to your GP, your psychiatrist, a psychotherapist or whomever else is or could be part of your mental health care team. That way, you can keep making the most of it.