DEPRESSION IS A DISEASE THAT KNOWS NO BOUNDARIES AND AFFECTS PEOPLE OF EVERY AGE; YET THE CATHOLIC APPROACH OFFERS HELP IN A WAY OTHER TREATMENTS DON’T
“In addition to the full flowering of spring, the arrival of warm air, increased sunshine and longer days, next month will also reveal a dramatic new change in how the medical community, policy planners and the population at large talk about mental illness, and especially one of the all too common types of mental illness, depression, with the release of the fifth edition of the ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM-V).
Depression is a disease that knows no boundaries and affects the old, the young, the rich and the poor with equally devastating impact. It is one of the most common reasons for absence from work; it is one of the most significant drains on health care dollars. It animates art, music, literature, and it can drive families to despair and victims to suicide. And the irony is that we argue constantly about what it is and how to treat it.
It is no exaggeration to describe the world as in the midst of an epidemic of depression. One out of every four women experience at least one episode of serious depression in their lives. With men it is one out of every seven, but many think the number is much higher and that men are simply reluctant or think it unmanly to admit to experiencing depression.
A DELICATE BALANCE
The Church is attuned to the devastation that depression leaves in its wake and is vitally concerned with finding the delicate balance that results in effective treatment of a truly complicated disease. Many of the Saints and Church Fathers who inspire and guide the faithful lived lives marked by periods, sometimes long periods, of darkness and depression. And the Church is always keen to align true science with true faith.
In 2003, John Paul II addressed the 18th International Conference of the Pontifical Council for Health Pastoral Care and spent all of his talk dealing with the rapidly increasing scourge of depression: ‘Your work, dear participants in the Congress, has revealed the different complex aspects of depression: they range from chronic sickness, more or less permanent, to a fleeting state linked to difficult events, conjugal and family conflicts, serious work problems, states of loneliness that involve a crack, or even fracture, in social, professional, or family relationships. This disease is often accompanied by an existential and spiritual crisis that leads to an inability to perceive the meaning of life.’
And it is painfully obvious that depression can touch any of us, and one’s faith, however strong, is not a certain defence against an ailment that is as varied and difficult as depression. This was made painfully clear in the story of Vancouver Archbishop Raymond Roussin, who surprised and shocked North America when he implored the Vatican to release him from his duties because he was suffering from severe depression. The Archbishop spoke publicly and openly with Douglas Todd and other journalists about how his illness had developed over the years…’It was humiliating, I thought ‘How could I possibly be mentally ill? … I didn’t come to the point of despair. Despair would be a sense there’s no hope. Some days it felt like no hope, but I knew it was there despite the hell I was going through. There was faith in the darkness.’
THE WOUNDED HEALER
Archbishop Roussin’s willingness to discuss his own illness was, he and others think, partly due to the Church’s long experience in encountering and coping with the dark dangers of depression. Roussin credits the work of Henri Nouwen, the Dutch Catholic priest and spiritual director, most famous for his work, ‘The Wounded Healer’. That book ‘helped me recognise it isn’t the power of the world that really counts in being a success. The powerful – whether in business, in school or in sports – only seem to win. But it’s not really the case in the long run. The wounded healer is the one who is able to reach out to more and more people.’ Bishop Roussin’s appeal aside, it is becoming clear that lines are hardening between approaching depression as simply something dealt with medically or something more nuanced and more complex.
The release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) comes with its own built in controversy. It became clear months before the official release of the manual that it had been decided to eliminate the ‘grief exception’ to the description and recommended treatment of depression. At the heart of this decision is the essence of the on-going vitally important argument over how to understand and treat depression. For critics of the decision, labeling grief over the loss of a loved one as mental illness, and then prescribing drugs to treat the same, is a step too far in the medicalisation of ordinary human experiences, such as sadness and loss. Supporters of the move ask why pain of any duration should be endured? It is, at its heart, an argument about what it means to be human and what it means to be depressed.
Depression is part chemical, part emotional, part physical and clearly part spiritual. It is getting to the heart of the exact mix and the appropriate response that pre-occupies so many people in the Church as they wrestle with the reality of a disease and a distress that affects so many.
“Praying that God may heal us of depression is an exercise in humility, and reminds us that we cannot be happy simply out of our own accord.”
Tim Farrington, author of ‘The Monk Downstairs’ and most recently ‘A Hell of a Mercy: A Meditation on Depression and The Dark Night of The Soul’ captures the essence of the difference between the opposing views. ‘Often depression is symptomatic of a gordian knot of social dysfunctionality, and the communal compulsion to treat the ‘identified’ patient with drugs to ‘solve the problem’ (and thus avoid examining the pathological elements of the social matrix itself) is strong.’
Farrington’s ‘gordian knot’ and John Paul II’s ‘existential and spiritual crisis’ seem to lie at the heart of the work of such groups as Catholic therapists who describe their mission as bringing ‘the healing love of Jesus Christ to those seeking psychological help and support’ as well as the numerous diocesan and parish programmes directed at those suffering depression and their families.
Walking the fine line between approaching depression as simply a chemical imbalance easily fixed with medication, and understanding the deep personal, societal and physical causes of a complex illness that manifests itself in a myriad of ways, is the life’s work of Catholic psychiatrist, teacher and author Aaron Kheriaty. His new book, ‘The Catholic Guide to Depression: How the Saints, the Sacraments and Psychiatry Can Help you Break its Grip and Find Happiness Again’, is a learned and erudite exploration of a difficult disease and the tools available to conquer the same. Describing depression as ‘physical, spiritual and mental in origin’, he takes great pains to explain that neither the tools of medicine nor a simplistic appeal to faith and perseverance is sufficient in approaching a ‘complex illness with many contributing factors’. Instead he says he wrote the book ‘as a way to bring the medical, social, and biological sciences into dialogue with philosophy, theology, and Catholic spirituality, in order to gain a fuller and more comprehensive understanding of this complex affliction.’
It is a delicate balance, as Dr Kheriaty appreciated, when he reflects on the decision to eliminate the ‘grief exception’ from the DSM-V definition of depression or even the ordinary experience of reading through his, and other books on coping with depression. Hopefully the reader doesn’t come away with the notion that all emotion, especially sadness, needs to be eliminated. And while deeply rooted in his Catholic faith, Dr Kheriaty notes that many faith traditions and even secular psychiatrists accept that ‘suffering is part of life in this fallen state and not simply something to be treated away.’
YOU ARE THAT AND MORE
So what is the proper mix of ‘Saints, Sacraments and Psychiatry’ in tackling the very real devastation that depression can and does inflict? ‘Each of these three things actually helps each of the other work better. The total result is greater than the sum of the parts, which is actually reflective of the Catholic approach to depression, which is to treat the whole person. You aren’t just chemicals, you aren’t just prayer, you are that and more.’ And it is this Catholic approach to dealing with and encountering the whole person that leads Dr Kheriaty to conclude that ‘the Catholic approach offers help in ways other treatments don’t.’
It is this Catholic approach that Aaron Kheriaty believes animated the comments John Paul II made to the members of the American Psychiatric Association and the World Psychiatric Association in January of 1993, when he said, ‘By its very nature your work often brings you to the very threshold of human mystery. It involves sensitivity to the tangled workings of the human mind and heart, and openness to the ultimate concerns that give meaning to people’s lives. These areas are of the utmost importance to the Church, and they call to mind the urgent need for a constructive dialogue between science and religion for the sake of shedding greater light on the mystery of man in his fullness.'”
– this article by Peter Kavanagh (abridged) was published in “Messenger of Saint Anthony”, issue April 2013. For subscriptions, please contact “Messenger of Saint Anthony”, Basilica del Santo, via Orto Botanico 11, 35123 Padua, Italy