Beyond the Misconceptions About Depression

Reader E.V. sends along an interview with Dr. Aaron Kheriaty, author of The Catholic Guide to Depression. I haven’t read the book yet, but this is the second time it’s been recommended to me, and the interview is full of gems of good sense.

On overspiritualizing the problem:

I think most therapists have had the experience of Christian patients who prematurely ‘spiritualized’ what were actually more psychologically or biologically rooted problems. Perhaps this was done with the encouragement of a priest or spiritual director who was not adequately informed about the nature and causes of mental illnesses like depression.

That was me as a teen and twenty-something: so convinced of the high-falutin spiritual nature of my depression that the thought of a cure seemed tantamount to a rejection of the Cross itself. A word of caution in there, too: a priest can be as holy a man as you like, but that doesn’t mean he always knows what he is talking about.

On distinguishing depression from the “dark night” experienced by some of the saints:

With the dark night of the spirit there is an acute awareness of one’s own unworthiness before God, of one’s personal defects and moral imperfections, and of the great abyss between oneself and God. However, a person in this state does not experience morbid thoughts of excessive guilt, self-loathing, feelings of utter worthlessness, or suicidal thoughts – all of which are commonly experienced during a depressive episode.

That’s an important distinction. Being deeply aware of your own unworthiness is one thing; being obsessed with your own imperfections is another. I’ve experienced the latter any number of times, but the former is something that I’ve only glimpsed, and that in my best moments. The difference between them is as clear as the difference between breathing mountain air and trying to breathe water.

Kheriaty doesn’t consider depression totall outside the realm of the spiritual, either, though:

We must also be convinced that whatever we suffer in life — whether from depression or any other affliction — is something that is allowed by God. Suffering is a mystery, and Christianity’s answer to suffering is mysterious — because the answer is Jesus Christ on the cross. Our faith does not promise a life without suffering; quite the contrary. We should not expect that prayer, or Scripture reading, or the sacraments, will magically cure all mental disorders or alleviate all suffering. What Christian faith offers us is the hope and the strength to endure whatever crosses God allows in our life. As psychiatrist Victor Frankl put it, those who have a why to live can bear with almost any how. Frankl knew something about suffering, having been a prisoner in Auschwitz.

And some positive recommendations, with a caveat:

…prayer, religious faith, participation in a religious community, and other spiritual practices like cultivating gratitude and other virtues can reduce the risk of depression and help in recovery. This does not mean that religious faith inoculates a person against depression, nor does it mean that depression is due to a lack of faith. But it does suggest that faith may have an important role in a person’s healing.

The whole interview is very down-to-earth and very human, but with something luminous and wholesome behind it. Read the whole thing here.

12 Comments on “Beyond the Misconceptions About Depression”

  1. Christine says:

    This was great!

    At the onset of my adult depression, I definitely spiritualized it. I believed that I was enduring a spiritual dark night. I didn’t have the feelings of guilt or worthlessness, but the depression seemed centered on some unknown trauma in my relationship with God. Fortunately for me, the priest I saw for spiritual direction was better than many at recognizing mental illness. After a few months of talking to him about the spiritual problems I was having, he recommended that I see a doctor. By suggesting that, he probably saved my life.

    “We should not expect that prayer, or Scripture reading, or the sacraments, will magically cure all mental disorders or alleviate all suffering. What Christian faith offers us is the hope and the strength to endure whatever crosses God allows in our life.” This is especially good to read. One of my biggest problems with a certain Catholic organization on my college campus was that the organization seemed to think that joining a Bible study would lower suicide rates (they actually had a bulletin board set up during Lent using suicide statistics as a sign that more people needed to be evangelized, and then presented a cure for this as going through a Bible study with them). Whether joining a Bible study would actually prevent someone from committing suicide is debatable, but to my mind unlikely. I take their point that faith can save one from suicide; it certainly was my motivation to stay alive. But the thing that bothered me is that the people in the organization who talked about depression often talked about faith as a way to make you happy, when for the majority of people I’ve talked to with depression faith did not make them happier, but did provide strength to endure. So faith does help in fighting depression, but not in the way many (most?) non-depressed people think it does.

    Sorry for the rambling. As you probably know from my previous comments on your blog, talk about depression is something that always provokes a reaction in me. This post provoked a good reaction, because it seems that Dr. Kheriaty has a really great understanding of how faith and depression relate, and such a great understanding is hard to find. I may have to buy that book!

  2. Rose says:

    Thanks so much for this, Joey! Some important and helpful distinctions.

  3. JBT says:

    So I just had this awful realization about the two most terriblest terrible sonnets. You know how “I wake and feel the fell of dark, not day” ends with the word “worse” and so leads directly into “No worst, there is none,” so it makes it a clear one-two progression and you can read them in that order and then stop? Well, it suddenly occurred to me that “No worst” ends with the line “each day dies with sleep,” and, well, what do you do after you sleep? You wake. And, also, feel the fell of dark, not day. So they just go round and round forever. What a depressingly perfect metaphor for depression.

  4. Albert says:

    I love how you’re not afraid to speak your mind.

  5. Caroline M says:

    Great stuff! It sounds like it avoids the fallacy of thinking that depression is either all-physical or all-spiritual. For those of us who suffer from depression there’s a temptation to over-spiritualize our conditions because hey, look at us being all dark night of the soul, like Mother Theresa! Oh wait, maybe having suicidal tendencies doesn’t mean I’m all spiritual and special. Oops.

  6. Tiffany says:

    ahem! Missing you …

  7. Becky Duncan says:

    I’m glad you’re back. Now I hope to see all the gems your were writing while your blog was offline.

    I keep thinking that your writing deserves more profound positive comments than I can say. When I get very frustrated with my inability to express how valuable your work is I think “Oh, that’s why HE’S the writer, and I am the reader.” Know that I am reading at a deeper level than I am commenting. If that makes sense.

  8. Sheila says:

    So glad to see your blog up and running again! You’ve been on my mind. And I thought this post was exceedingly helpful. Will be sharing it with clients and friends.

  9. Becky says:

    I said that I was glad to see you back, and them you were gone again, now you’re back. To stay this time? Please don’t let it shut down AGAIN. Even if you are not writing something new, if the site is up at least we can reread the old ones.

  10. Lisa says:

    Missing you. Hope you check in soon.

  11. Linda H Maloy says:

    Thanks so much for your thoughts about depression. I don’t believe depression is an “either/or” proposition as to faith or biology. I believe it is both. I went for a long time thinking my depression was all better after I made my Cursillo, but I was wrong. A lot of bad/sad things happened to me that I marked down to Satan trying to wreck my sanity and my faith. However, all that turned out to be peanuts because the biggie was still to come! After 32 years of marriage which included about 10 years of illness so painful it made me behave goofy at times (and going through my husband’s cancer), the love of my earthly life decided he had to divorce me because he deserved to be happy! All the depression I had felt until then seemed like a day at the beach! (In this state your spouse can have a divorce no matter what you or your church says, so unless I wanted to eat cat food and live under a bridge I had to acquiesce even though I had also worked for the family business all that time.) Now, eight years later, I have more sad/depressed days than good ones. The only good news I can offer from all this is that I have any good days at all! So, as I pray for all the hurting and/or depressed people in the world, whether like me it is biological AND situational or not, I too ask for prayers that I can stand what life has become. If I didn’t have Christ in the Eucharist I am quite sure I would die.

    1. I’m sorry, Linda, that sounds incredibly painful — I can’t even imagine. I agree that in most cases depression is neither completely biological nor completely situational. I am praying for you.

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