Q: Stories about people with depression seem to pop up everywhere today: in print media, on the web, and on morning talk shows. Give us a working definition of depression, and tell us how it is different from just having the blues once in a while.
Fr. Tom: Life is filled with many challenges and opportunities that create normal emotional ups and downs, sometimes referred to as “having the blues.” But when a person finds herself stuck in the “down” times for a long duration, she may be in the grip of depression. Sometimes considered the common cold of mental health, the severity of depression varies from one person to the next.
Depression usually affects a person’s well-being and results in three or more of the following symptoms, which occur nearly every day: chronic fatigue with little energy, as well as sleep and eating problems (either too much or too little). Depression may affect your mood, with feelings of sadness, unhappiness, emptiness, and hopelessness. Depression forces you to second-guess yourself, so you become negative and self-critical.
The working definition that my clients have taught me likens depression to an alien, negative force that tricks us into forgetting that God loves us and that we are His beloved. It deceives us into dismissing the truth that we are created in God’s image, that our body is the temple of the Holy Spirit, that within us we have the most powerful life force. I try to help people remember that they are not the problem. The problem is the problem.
Depression focuses our conversations, energy, thoughts, and life on deficits. It emphasizes what isn’t working, what’s wrong, what’s negative, what needs to be fixed. Depression insidiously convinces us to shut up, to stuff ideas, thoughts, and feelings inside. We turn feelings of pain, fear, sadness, hurt, frustration, and anger inward.
The inability to respond to these powerful emotions in caring and loving ways forces us to withdraw, creating a sense that we cannot speak freely on matters of the heart and soul. This withdrawal ultimately robs us of our energy. When we are depressed, we forget our gifts and overlook the reality that we are created in God’s image.
St. Dorotheos of Gaza says, “Know that if a person is attacked by some thought (depression, fear, anxiety) or is grieved by it and does not acknowledge it, she only strengthens it against herself, that is, she gives the thought itself more strength to attack and torment her. But if she acknowledges it (depression, fear, anxiety) and begins to struggle (and becomes genuinely curious) and resist the thought and do what is opposed to it, the passion will weaken and will have no power to attack her and bring her sorrow. And later, little by little, striving and receiving help from God, she will overcome the passion itself.”
We have to respond to depression with the inner voice of the soul, boldly claiming the conviction that we are God’s beloved and are created to become fully alive in His love, peace, and suffering.
Q: How prevalent is depression among women in our culture?
Fr. Tom: That’s such a tricky question, because the research clearly shows that women are impacted by depression twice as much as men. Women tend to do a better job seeking and asking for help, which may skew the statistics. Men generally try to handle things on our own.
Women who struggle with depression are often labeled as weak, moody, needy, lost, etc. But I believe there are just as many men who are slowly being sapped of energy, their bodies silently dying because they too have no place to speak of the inner parts of the heart silenced by feelings of rejection, inadequacy, low self- esteem, of not being respected or appreciated.
Q: The soul sicknesses of our modern times appear to be loneliness, anxiety and depression. Were these illnesses among us in ages past, or are they rooted in the soul of this present age?
Fr. Tom: Sometimes we think that today we have more violence, more mental illness, and less spirituality. The truth is that these demons have followed us throughout time: battles against the demons of depression, fear, anger, anxiety, and stress have been going on since Adam’s fall.
I remember a woman who came for help. She told me she had been depressed her whole life. Her doctor said she was depressed, her parents treated her as depressed, her school saw her as depressed, and she considered herself that way. I asked if there had ever been a time that she was not depressed. “No,” she replied, “I just told you I’ve been depressed for thirty years!”
“Could you recall a time that depression was less severe?” I asked. She said it has been all the same. As I persisted, she became annoyed. “Was there a time in the last year that you felt less distress?” Again, I persisted.
“Look, you idiot,” she shot back, “What about my story? Don’t you get it?”
I asked my final question: “Could there have been a bit of light or hope you felt in the past weeks or months?”
She became silent, paused for a moment, and shifted her body. “As a matter of fact, I felt good two weeks ago,” she said.
“So depression doesn’t have full control over you?” I said.
She smiled, and we continued to uncover times when she had stood up to depression. We continued to search for stories that spoke of her abilities, when she felt more herself. We committed to work on creating small steps in the direction she wanted her life to go.
Q: What shadows does depression cast upon other relationships, especially in families? If a family ignores a depressed member, might that person sooner or later simply “snap out of it?”
Fr. Tom: There is still a huge stigma attached to mental illness. A family might become embarrassed and try to hide the problem. They might avoid the need for help or understanding. People suffering from depression generally experiences shame and guilt, leading them into more disgrace, hiding, and isolation. It’s as if the weight of the world is on them. “Just ignore the problem,” they tell themselves, “and it will go away.” Pretending makes the depression worse by reinforcing that they are the problem. People with depression cannot merely “pull themselves together ” and “snap out of it.”
Our culture wants to find a cure for everything. It fails to understand that it is essential to care for the soul, and to let God and the afflicted person work it out. We want problems to go away. We are desperate for the magic pill. We want to do it our way, relying on ourselves, not God. Remember, Jesus was in the darkness of the tomb for three days. Sometimes we are in the darkness for days, weeks, or months before our hearts are resurrected and renewed with life. We need to take action by being kind and caring toward such a person.
As family members, perhaps we can sit with our loved ones, hold their hand (if they will let us), and just cry with them, rather than giving suggestions about finding solutions. It is so important to be available, to communicate that you care.
Q: Powerful psycho- therapeutic drugs are available to relieve depression and anxiety. Do these drugs offer permanent help, or perhaps mask underlying problems? What side effects could occur with these drugs?
Fr. Tom: I believe that when a person becomes committed to reclaim his life from anxiety or depression by seeking help from God, friends, and community, medication could help the process. There is nothing shameful about taking medication, and you may not have to take it for life. You are not weak for having the courage to do what it takes to get back on your feet. A therapeutic dose can assist someone to do what is necessary to reclaim their life from depression.
But I’ve found that when my clients begin therapy and medication at the same time, they credit the medication for feeling better. They don’t know how credit the Holy Spirit or claim their own role in this victory. So I invite them to see, acknowledge, and accept the personal steps they took alongside the medication that helped them recover from the darkness they felt trapped in. We must remember that we can do nothing without God, but once we ask for help and dedicate our lives to finding it, the power the problem has over us generally diminishes.
Q: Most people undoubtedly have family members or friends who are depressed, anxious or lonely. What might we do to help someone suffering from despair, and what actions or words on our part are not helpful?
Fr. Tom: What is not helpful is saying, “Snap out of it! Don’t be depressed! How could you be so depressed when your life is wonderful? You have your kids and lots of money. Things aren’t really that bad.” Another goofy response is “I know what you’re going through.” Hearing people say that just kills me. You don’t know what the other person is going through! Never assume what the other person is feeling.
And never assume you are the expert in another person’s life. They are the expert. Our job is to love and encourage them to put their trust in God. Watch how you give suggestions, because when someone can barely function, most of the time advice is not helpful. What could be helpful is to invite them to talk about their life, to be really interested in their story–what they are feeling and what they are experiencing.
If you get to this point, two great questions might be, “When have you felt in any way most like yourself?” or, “Have you noticed the grips of depression loosening even the tiniest bit?” Communicate that you value them. Communicate without minimizing the depths of despair, and that they will get through this dark time. You might call to let him know you are thinking about him. Send affectionate notes. You might invite he or she to Church, the movies, concerts, parties, or other events.
The key is to be guided by Christ’s love and compassion, not fear! Those suffering from depression are keenly aware of your genuine motive to embrace them in their pain, in the darkness, and to behold their beauty when they cannot. Above all, include them in your prayers, and be open and tuned in to God’s advice to you.
Q: The end result of severe depression could end in self-destruction. If someone we know or live with is depressed, what red flags should we watch for?
Fr. Tom: Again, look for red flags of hopelessness, helplessness, resignation, and lack of activity. One man screamed at me because nobody understood how deep his depression was. He could barely get out of bed. But he went to work.
I asked: “How come depression couldn’t get you to stop work?”
His response: “I needed to survive.”
“What do you think that says about you,” I asked, “that in the depths of darkness and despair, you have the courage and energy to live? What do you think it says about your abilities, your strength, your gifts?”
Many times we focus on the negative, the pain and the tears, and we don’t see how God is hidden in the pain, waiting for an invitation to help us.
Q: If you could tell a depressed person to do three or four specific things, what would they be?
Fr Tom: I would help him see that baby steps can lead to great victories. I would fish for stories that speak of his God-given gifts and abilities. I would ask if there were moments when he felt a bit hopeful, had a bit more energy. What kind of person was he before the depression got real bad? Who did he feel he was? What did he like?
I would wonder about his ideas of how depression works. I would ask him to interview other people, and find out what, with God’s grace, they had done to reclaim their life from problems like depression.
It might be helpful to suggest seeking help from a priest, friend, or counselor. Confession is another powerful vehicle of our Church to lift the burden of sin and respond to depression’s deceptions about life.
A wonderful woman in the depths of despair came to my office and spent most of the session in tears. She didn’t know how to move forward. As she told her story of pain, she briefly mentioned not having the energy to fix her eyeglass case–the Velcro had been torn away.
She looked at me and said, “See how pathetic I am–I can’t even fix this darn case!” I asked if she could find the strength to buy some Crazy Glue on her way home, to fix her glass case.
The following week she came with a smile on her sweet face and a twinkle in her eye, saying that she had fixed her glass case. A sign of life!
In closing, our faith maintains that we are unique, and that if we desire it, God will do what it takes to make us partakers of His Divine Nature. Our faith asks us to be vigilant, hopeful, and patient. Our job is to be a vessel for the Holy Spirit to direct, fashion, and shape our lives—and to be fully known by another; hence, that is the importance of a having a spiritual confessor.
A spiritual father should be able to embrace you, even when you feel empty, unworthy, and ugly. He should be able to behold your true beauty at various stages in life. When we keep our eyes on Jesus, we will find ways to keep ourselves afloat when depression comes knocking at our door.
(This interview originally appeared in The Handmaiden, a quarterly journal for Orthodox Christian women, in 2008.)