Writing a short column about how to have good mental health is a challenge. Each reader who may benefit sees his or her problem from a different perspective. These different perspectives reflect the multi-faceted nature of a problem like depression.
Depression is a disease that is physical, emotional, and spiritual. If I am suffering from this disease, most likely I am also suffering from a distorted perception about my disease and its healing. How I look at this disease probably falls into one of four categories.
A. I am self-deceived about the problem – I don’t think I have a problem because I get out of bed every day. I think that a depressed person is probably subdued, but I very often suddenly burst out in anger. My work is unsatisfying, I hardly speak to my spouse, but if you asked me how I was doing I would say, “Fine.”
B. I am self-deceived in believing my depression is just a physical problem. Yes, I started taking an anti-depressant medication at the suggestion of my internist. And with the benefit of hindsight, I realized what a dark, depressive cloud I had been living in. I understand generally how modern non-addictive anti-depressant medications, like (SSRI) selective serotonin re-uptake inhibitors, work. That is, these medications help restore a proper neuro-chemical balance in the brain – so all of a sudden the lights are back on.
But, I have been unwilling to admit to myself that depression is more than a physical phenomenon – more than simply correcting a brain chemistry neuro-chemical imbalance. I don’t admit that most of the time there are other non-organic, emotional and spiritual factors that led to or exacerbate the imbalance. Long term mental health is restored by using the new energy that the anti-depressant gives to face underlying emotional and spiritual issues.
The issues that, because they went un-addressed, probably (along with a genetic predisposition and/or life stressors) led to the imbalance occurring initially.
For most patients, the time on an anti-depressant is the opportunity to address underlying causes and issues. To miss this opportunity is to simply increase the likelihood of depression re-occurring in the future.
C. I am self-deceived in believing my depression is just an emotional problem.
Maybe I have been going to therapy for a good while, but my life seems to be increasingly lacking in some basic way. The answer may be either in the physical and/or spiritual aspect. My brain chemistry may need that reset button of pharmacological treatment that talking therapy cannot quickly give.
Or, I may understand my issues thoroughly, in fact, so thoroughly that I analyze and obsess about them constantly, but my life is spiritually dry. Neurotic thinking is usually about the ego, feeling like I must control mentally a process (a disease) that of course cannot be controlled mentally, and then feeling the frustration of failing. Spirituality is about connection to other people, to something bigger than my own ego. It is an inner sense of connection to what gives life purpose and meaning.
If I am depressed and not nurturing my spiritual life, I am neglecting a major piece of the solution.
D. I am self-deceived in believing my depression is just a spiritual problem.
Many times people see depression as a kind of spiritual weakness. The thinking goes like this: “If I just prayed harder then I wouldn’t have this problem.”
First, I may be completely neglecting the physical nature of the illness. Anyone with depression needs to have his or her diet and exercise life evaluated. Studies have shown that regular physical exercise, such as an hour a day, five days a week, is just as effective at relieving depression as the most commonly prescribed anti-depressant medications. If you are snacking on sugar and caffeine, you are going to encourage the highs and lows of metabolic function that are more apt to push you into a depressed mood. If you aren’t eating protein for breakfast, you are going to feel a drop in energy level by ten o’clock. Your nutritional practices may be hurting not supporting your mental health.
Second, no matter how good my spiritual life, there may be emotional issues I need to deal with to put my depression behind me.
In fact, for those who grew up in alcoholic homes, or suffered abuse or trauma in childhood, there is often a tendency to try to escape into a spiritual cloud.
The desire is to transcend one’s earthly problems. This doesn’t work, but simply represses the issues that must be voiced and dealt with. Keeping the lid on by avoiding, even in the name of a higher purpose, still pushes these issues down. And the energy that goes into pushing them down, in turn, goes into keeping one depressed and emotionally pushed down.
Unfortunately, often those who treat depression are so specialized they only focus on one aspect of its proper treatment. Maybe all their education and experience is tied up in treating the pharmacological part, or the emotional piece, or the spiritual aspect. One thing our specialized medical system is teaching us is that we must each be in charge of our own treatment. The solution lies in being sure we address depression in all aspects – physical, emotional, and spiritual.
Depression has an effect on our beliefs and attitudes. Depression causes us to perceive our life in a narrow, confined way. The way in which depression shapes our thinking can be the biggest barrier to living in a solution that confronts depression on all levels. To effect healing from depression, we must start with our attitude toward it. To begin to heal, we must develop three important attitudes.
1. Honesty – to see the nature of depression clearly and to see clearly our feelings, expectations and attitudes about it.
2. Openness – to change; openness to accepting the limited way in which we have seen our disease; how we wanted to sweep it into a narrow corner.
3. Willingness – to take action on all aspects of depression; willingness to acknowledge that only with action will a change of attitude occur that will allow us to embrace our depression in all its aspects.
Finally, we must put these three attitudes to work in our relationships. We need to foster those relationships that are healing, that bring out our best, which allow us to accept our own worth and put it to useful service.
– by Don Carroll
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