Anthony Bourdain's tragic death shows depression has many faces

The masterchef, like Kate Spade and Avicii before him, masked his pain in public – but as England footballer Danny Rose did last week, it's time to talk about mental health, says Justin Thomas

Fashion designer Kate Spade and chef Anthony Bourdain both suffered from depression. Bebeto Matthews / AP, Andy Kropa / Invision

The world has been left reeling by the death of Anthony Bourdain, found in his hotel room on Friday after apparently taking his own life at the age of 61.

To those who tuned in to his TV shows, he relished every aspect of life, from travelling and connecting with different cultures through food to sharing stories and bonding with those he met.

But depression has many faces and what the past week has told us is that many of those suffering present a mask in public while hiding their pain from the limelight.

We all face major life events. Celebrities – be they actors, singers, chefs, fashion designers, DJs or sports stars – often have to do this under the gaze of the camera lens and the sometimes cruel spotlight of public opinion.

Sometimes, as was the case with Bourdain and fashion designer Kate Spade, the person suffering might not show any outward signs. They might be jovial, smiling and considered the life and soul of the party.

Yet the UK’s Royal College of Psychiatrists estimates one in five people will become depressed at some point in their lives. Such statistics can sound fairly hollow though, especially if we are presently experiencing good mental health.

If we have never been clinically depressed, we might assume that we are, and will forever be, one of the fortunate four who manage to evade the condition.

But decades of research in clinical psychology have established that life events that interfere with our daily routines and our sense of purpose and social identity are frequent precursors to major depressive episodes.

Last week Tottenham Hotspur football star, the England defender Danny Rose, spoke frankly and bravely about his recent recovery from depression.

Rose traces the initial onset of his depression to a knee injury that kept him away from the game for eight months.

Sports stars like Rose also have to deal with the stressful prospect of only ever being one game away from a career-ending injury.

Statistics like the one-in-five are always difficult to comprehend in personal terms – unless you or someone you know is affected.

However, when people from all walks of life, including celebrities, start to share their personal experiences of mental health problems, it brings home the reality that nobody is immune.

Such personal stories might also move us towards doing more to safeguard our own psychological wellbeing and that of our loved ones.

Rose’s disclosure was brave because, like it or not, the stigmatisation of mental health problems persists, especially towards men experiencing depression.

In many societies, there is an expectation that men should be tough, unemotional and assertive.

Teary-eyed little boys are frequently told to “man up” and stop acting like “little girls”.

In such a context, seeking help for an emotional problem might feel particularly shameful. A Canadian study published in 2015 in the journal Community Mental Health found 56 per cent of men said they would feel embarrassed to seek professional help for depression, compared to 39 per cent of women.

In describing his depressive episodes, Rose said: “I was getting very angry, very easily. I didn’t want to go into football. I didn’t want to do my rehab. I was snapping when I got home."

Typically, when we think of depression, we envisage tears, melancholic withdrawal and sadness. Explore the term depression on Google images and you will get lots of examples along those lines.

In reality, though, anger, hostility and irritability are also very common expressions of the condition. Research at Massachusetts General Hospital found that among depressed patients, 44 per cent experienced anger attacks, sudden outbursts of anger and hostility.

This symptom is so frequent that some clinicians have proposed including "irritable-hostile depression" as a distinct sub-category of depression within the diagnostic system.

Unsurprisingly, this type of depressive presentation is commonly associated with men and young children. Perhaps our failure to see anger as the mirror image of sadness is part of the reason why women have traditionally been diagnosed as suffering from major depressive disorders far more frequently than men.

Rose’s stigma-defying disclosure has helped shine more light on this debilitating condition.

Rose is not alone in sharing his story. From the world of football, former Swindon Town manager Martin Lings, Burnley’s Aaron Lennon and Barcelona legend Andres Iniesta have all talked openly about their experiences with depression in recent years.

Beyond football, Prince Harry, Zayn Malik and Stephen Fry have also been candid about their experiences with depression, anxiety and mental torment.

And on his new album Ye, Kanye West refers to his recently disclosed bipolar condition as a superpower.

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Arguably, sharing such stories inspires other sufferers to seek help. Perhaps these stories also encourage those who are well to consider how best to stay well.

A recent survey by the UK mental health charity Mind found that hearing celebrities talking openly about their experiences with mental health issues was generally perceived positively.

A quarter of respondents said that such disclosures encouraged them to seek help for themselves and 52 per cent said that it helped them feel as though they were not alone. Sharing stories seems to help.

Tragically, some stories are only shared posthumously. Each time we walk past a Kate Spade or Alexander McQueen store, listen to a Linkin Park or Avicii track or watch one of Bourdain's many TV highlights, we might be reminded that mental anguish is real and can visit any one of us at any time.

That is why, to quote the Miller Williams poem Compassion, it is important to "have compassion for everyone you meet… you do not know what wars are going on / Down there where the spirit meets the bone".

Dr Justin Thomas is professor of psychology at Zayed University and author of Psychological Well-Being in the Gulf States

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