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Top Ten Things to Know About a Depressed Person



Of the two, bipolar disorder and depression, the former is probably easier for people to take seriously. A person in the manic, or even less severe hypomanic, stage is clearly in the grip of something strange. A person suffering from depression, or in the depressive swing of bipolar disorder, on the surface appears to be experiencing what everyone goes through from time to time. The blues. Some sadness. Even -- for the less charitable -- laziness.

Disclaimer: is depression over-diagnosed, and are anti-depressants over-prescribed? Without question. Many general practitioners will dash off a prescription for a patient who claims to be down. This does not, however, take anything away from the undeniable reality of true, clinical depression.

The Bear has ten points in mind for dealing with people who are truly depressed.
  1. Clinical depression is real. It is both ignorant and unkind to dismiss the pain a person may be going through by calling it a "fad disease," or a "scam by the drug companies." You might as well say there's no such thing as cancer. Just because it is a mental illness you can't see doesn't make it any less real.
  2. The symptoms of depression are real. The depressed person may not be able to get out of bed, experience enjoyment, or anticipate pleasure. He or she is likely mired in a grief out of nowhere, and trapped in a leaden body. He or she is not "weak," but suffering from an illness that reaches both mind and body.
  3. These are some medical terms that apply to depression: avolition -- inability to initiate goal-directed activity; anhedonia -- the inability to experience pleasure; apathy -- the inability to care about anything; suicide -- the decision to take one's life since anything seems preferable to what one is experiencing.
  4. All the things you take for granted -- the pleasure at a loved one's voice, a hobby, looking forward to dinner, the ability to feel happiness -- are impossible for a depressed person. As the symptoms of depression go on and on, day after day, eventually, hopelessness sets in.
  5. Tough love is the last thing a depressed person needs. If you watched a person get sliced open, would you say -- as his intestines spooled around his ankles -- "just shake it off?" If you want to tell a depressed person, "I don't really care about you or what you're experiencing," use tough love. Just make sure to lock up the firearms and razor blades first. Chances are the person already thinks he's worthless. The last thing he needs to hear is that he ought to be able to somehow "shake it off."
  6. You may imagine it's like the time you got the blues, or even that it's like the time your cat died, but it's not. It's not even like that only a thousand times worse. It is as much different in kind as in degree. If you are fortunate enough never to have been clinically depressed, it is not like anything you have ever felt, not even profound natural grief, although that, perhaps, is the closest. Come to grips with the fact that you don't have the frame of reference you think you do.
  7. Don't use platitudes. "It's always darkest before the dawn." Or, "God never gives us more than we can handle." Or, "This, too, shall pass." Job's friends sat with him seven days before saying the first word. (And then they totally screwed it up when they opened their mouths.) Above all, don't ask "Why?" The why probably lies within mysteries of neurotransmitters in the brain, but for all intents and purposes, there is no why.
  8. Don't try to spiritualize depression. It's a disease. It's not "The Dark Night of the Soul," (shows a misunderstanding of St. John of the Cross) or what Mother Theresa experienced. (If it was, then surely the most saintly -- and miraculous -- thing she ever did was to keep on going through a clinical depression.) Saints such as Bernard of Clairvaux and Theresa of Avila distinguished "melancholia," from spiritual conditions.
  9. Don't suggest home remedies, or worse, tell anecdotes about someone you know who knew someone who licked depression by walking, or yoga, or drinking tea made of St. John's Wort. Again, that tends to trivialize the here-and-now pain the sufferer is in, and herbal remedies can dangerously interact with prescription medicine.
  10. Take seriously any talk about suicide. Be suspicious if a depressed person suddenly seems better, especially after having made any sort of unusual arrangements with regard to personal effects. Often, before a person attempts suicide, he will feel better after having made the decision. Finally -- in his diseased mind -- he has found a way out. Make the environment as safe as you can and keep an eye on the person. Make sure he has means to easily contact the suicide prevention hotline. And, if necessary, intervene by calling the authorities to get him the help he needs.
That's about all the Bear has to say about this serious topic. As we approach autumn, some people are more vulnerable as less sunlight triggers depression. They should ask their doctor about Seasonal Affective Disorder and a full-spectrum "happy light." For others, depression is a wraith that lurks just beyond the circle of their lives until it attacks for no apparent reason. Still others experience depression as one pole of the bipolar dance between depression and mania.

Some people recover on their own, and never become depressed again. Others face a long slog through the pharmacy, until the right combination of drugs is discovered. People who are prone to depression should not neglect therapy, either. God help those who must suffer this debilitating condition alone. 

For a more extensive treatment of suicide, read the Bear's article A Catholic's Guide to Suicide. One last thing to note: the typical suicide is not an angsty teen, but a burnt-out man in his fifties.

Comments

  1. Someone once insinuated that a good Catholic doesn't get depressed. I explained to her that if I hadn't been Catholic I might been dead by now.

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    1. For some reason I read that Bearishly, "I explained to her that if I hadn't been Catholic she might have been dead now."

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  2. That's just ignorant and cruel. That's like saying good Catholics don't get cancer. One of the most troubling things I ever heard Pope Francis say was something about Catholics having to experience joy. We experience what we experience and are not a whit less Catholic for it.

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  3. I was told that my depression/negativity, after my my spouse deserted the family while I was going through a serious illness, was a drag and was a sign of weak faith. I had to cut off a relationship with that person because I seriously wanted to punch them in the face, and hard. I thought I was doing well by not killing myself, and here I was being chastised by someone who never had to face their children's hunger or pain or their own mortality. If I didn't have my faith as a Catholic I would have ended it years ago, and even now there are days that I have to remind myself to take it by the minute, the hour, the day.

    When Pope Francis made this statement, I cried, because it was like being kicked in the stomach all over again.

    "A Christian without joy is not Christian. A Christian who continually lives in sadness is not Christian. And a Christian who, in the moment of trial, of illness, of so many difficulties, loses peace – something is lacking in him.”

    He is just a terrible, terrible person. He is Pope, but is just a terrible, terrible person.

    And this may sound terrible to some Catholics, but the most compassion I ever had from a religious was in an ER with an evangelical chaplain. He wiped my tears, he held my hand, he loved me as Christ loves us.There are no words to describe the next day's experience with the priest.

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  4. The full quote is far worse than I remembered it. That truly is awful. I had a similar reaction, as, I imagine, many people did. I suppose we have to, in charity, wonder if he would not qualify it for people who are clinically depressed -- had he not been his usual careless self. I'm happy you received some compassion when you needed it. There's nothing good about depression. It doesn't make us stronger, or teach us life lessons. It is a thief that steals periods of our life and poisons our relationships.

    Interestingly, statistically Catholics are less likely to commit suicide. Being drenched in compassion is probably not one of the reasons.

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  5. Thank you for this post. I thank God daily for my supportive family who brought me through a terrible depression. (As well as a supernatural sequence of events that led me to a wonderful doctor). I was suicidal, and do believe my Faith kept me alive. Some days all I could do was lie in bed and implore God to deliver me from my hell.

    But God is so good. I'm well now for several years, off all meds, and recognise the gift of each day of life.

    I do think our Pope is a Philistine simpleton in many respects--crude and self-absorbed. How did he get to be Pope?

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  6. Thank you for posting the touching Van Gogh painting. Never saw it before.

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  7. Bear,
    Are you OK? I got worried when I read the last sentence: "One last thing to note: the typical suicide is not an angsty teen, but a burnt out man in his fifties". I know you're under the weather, but what brought on the subject of this post? It just seemed, to me, as coming from left field. I've been in that deep, dark hole and it was my faith and the grace of God that got me through. I'll keep you in my prayers (as well as the shepherdess). P.S. You don't have to post this. I just wanted to make sure you're OK. I enjoy reading your blog.

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    1. The Bear is safe and well taken care of. This is a familiar drill that we go through about once a year. In a few weeks I'll be knocking out three articles a day. This doesn't feel like the worst of bouts. The Bear is touched by your concern.

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  8. Another thing I've been told is "What do you have to be depressed about? Other people have it way worse than you!" Great. Add a little more guilt to what I'm already feeling. Thanks Bear, a great post. I especially loved #6 because it is absolutely true.

    I didn't do anything about my depression because I was ashamed of myself, but after two suicide attempts and a couple more stays in the hospital I finally began to seek real help. You really do need to find the right combination of therapy and/ or drugs. Took me about five years, but I think I've finally found what works best for me.

    Thanks again for the post.

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    1. That's a very doltish thing for someone to say to you! There is a stigma, which is too bad, because it does keep people from getting the treatment they need. One of the reasons the Bear is pretty open about it is because people need to see that even awesome creatures like Bears can be depressed and need help. The Bear is very happy you found a combination that works for you. It can take a LOT of patience and some luck.

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  9. As a Catholic psychologist and Carmelite religious, it has been my experience that there is no situation, trial, illness, yes, even depression that cannot be used by God as an opportunity to deepen one's spiritual life, ultimately leading to a closer relationship with Him in the end. 

    However, since this journey to God is clouded in darkness and follows a road less certain, being accompanied by a compassionate and understanding guide is truly a blessing. This beacon of light can also serve as a lifeline if the storms, pain and despair become so overwhelming that, all alone, the soul's water filled boat is in danger of sinking.

    There is a way forward. First, with willingness on the soul's behalf. Secondly, with the Grace of Almighty God. And lastly, with the assistance of caring, knowledgeable and experienced guides. God Bless!

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    1. Any trial can be used as medicine for the soul. Depression strips you of everything: every comfort, every good thought, and even love. Like Job, who was covered with boils from the soles of his feet to the crown of his head, no part is left unspoiled. There is some comfort, sometimes, in knowing it is God's will.

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  10. God bless you Bear. Hopefully it's a comfort to know that you've truly made many friends of the woodland creatures, and that many prayers are ascending for you. One of my favorite stories in Scripture is the one about the paralytic on the pallet....when he couldn't walk, his friends carried him; and it was their intercession, love for their friend, and faith in Christ that moved the Master's heart to heal him.

    My Rosary for you today.

    (or as the evangelical protestant who came up to me the other day as I was praying at a pro-lie demonstration; in his effort to begin a 'dialogue' in order to 'save' me, said, "Hello....I see you have rosemary in your hand." :) Let's just say that after 30 minutes of grace-filled 'dialogue', my new friend went home with an armful of Catholic booklets in his hand and a new understanding of the Scriptural basis of Catholic beliefs :) .......don't want bit by a badger?....don't comment on her rosemary :):):) ....you have NO idea of the 'ammunition' she carries in her purse :)

    God bless and heal you my friend, and as laurel said, you don't need to post this...the message is for you.

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  11. Please get better soon Bear your public needs you. Remember time and God heals everything. I prayed for you at Mass this morning. You are a lucky Bear to have so many friends. Of course, you deserve it as "the Donald" would say about himself. Please keep us posted.

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  12. I have wondered if depression is something that can be boiled down to neurotransmitters, to something biological or psychosomatic only. I really doubt it. I think there is a spiritual component to it, as others have alluded to.

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    1. I really doubt it. I don't think it can be "boiled down to neurotransmitters," entirely, either, but that is part of the treatment model. Many people find the right medicine helpful, even lifesaving. When you depart from the that model -- and we do have brains, after all, which are pretty important -- and try to attribute it to some sort of spiritual problem, you are departing from not only medical science, but the Catholic tradition (which distinguishes melancholia from loss of consolation or spiritual dryness) the experience of many people who suffer from depression, and setting yourself up as one of Job's friends, who, you may recall, spent the bulk of the book blaming Job. I can't imagine what you mean by a "a spiritual component." Sin? Demons? Chastisement from God? Loss of consolation? Please explain.

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    2. A few points to clarify:

      1) I'm skeptical of anything that is reductively materialistic, for one thing.

      2) I don't deny that medicine can help with the experience, with the symptoms. But I do not think medicine gets at the root of the problem.

      3) There are brains, and then there are minds.

      4) "...you are departing from not only medical science, but the Catholic tradition (which distinguishes melancholia from loss of consolation or spiritual dryness) the experience of many people who suffer from depression, and setting yourself up as one of Job's friends, who, you may recall, spent the bulk of the book blaming Job."

      Well, I don't really care about departing from "medical science" as if that is dogma, should it be necessary to do so. As for Catholic tradition, I understand the distinction between melancholia from loss of consolation or spiritual dryness, and I do not think either is what we're discussing here. Some people, by their temperament, are more melancholic. Some people are more cheerful. (For me, that is what I found so superficial about Francis' remarks to nuns about "joy" and smiling. Joy is a gift of the Spirit, for one thing. But there are people who express themselves and react to all sorts of things differently. Some of that is simply a matter of their temperament.)

      So, I see mental illness as something different. Which brings me, in part, to the spiritual. I see a connection in Scripture between faith and healing. Now, I'm not saying this is an always and everywhere, Job's friends blaming him, prosperity gospel law of gravity certainty sort of thing. I am not saying that we suffer because of our lack of faith. I am saying that, as the Carmelite alluded to, God's grace can overcome issues like this (if God so wills) and heal us.

      I will not attempt here to explain the origin of mental illness because a) I don't know and b) again, I am not suggesting that it is always and everywhere a function of our sins or something we're responsible for.

      But I do think that can be a connection there at times. In my own experience, I think that has played a part, though again, I am not certain.

      There are different levels of affect, if you will. Ignatius of Loyola in teaching discernment would distinguish "feelings" as such from spiritual consolation or desolation. I can't explain this distinction but suffice to say that while they are entirely distinct from a categorical perspective, one can seemingly affect the other.

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    3. Thank you for your elaboration. I do appreciate it. It is a matter that cannot be adequately addressed here.

      I am not sure that there is any reason to carve out a special place for mental illness and faith, as opposed to any other illness and faith. I am confident bipolar disorder is an illness, in the same way colon cancer or MS or diabetes is an illness. I say this on the basis of a lifetime of experience and informed treatment.

      The reason I must insist on this point is that too many people are willing to believe almost anything except that. Also, it is easy for sufferers to question whether they have a "real" illness. Add that doubt to the torments of depression. That not only interferes with treatment in ways obvious and not so obvious, but can add to the feelings of worthlessness characteristic of depression. If it's "not quite a real illness," or "a different kind of thing than an illness," then it must be a character flaw that prevents them from getting better. If only they "tried harder," or "prayed more," maybe they would get over it. You see, deep down, depressed people have thoughts like these, which make them very vulnerable.

      I find nothing, as in zero, useful in departing from the standard medical model, and much that is potentially harmful. Maybe it isn't perfect, but it's what we've got, and the slim line to which a lot of people are holding on to, and benefitting from.

      Having said that, EVERYTHING that we experience can be said to affect us spiritually, and God can cure ANY illness, and FAITH is important to miraculous cures in the Gospel. So why don't we don't we immediately start talking about spirituality, or faith, or growth to someone whose arteries are clogged and needs by-pass surgery, or whose diabetes results in out-of-control blood sugar? Curious, that, don't you think? Sorry, but I don't see a difference in principle, certainly not one that justifies the risk of harming a vulnerable person suffering from depression.

      If I have insisted on this point, it is because it is THE crucial point in dealing with people who are depressed. Accept the disease, understand it, and then deal with it as with any other challenge. If spiritual counsel is part of that (and it may be) then fine, but be very, very careful.

      There are a couple of good books: A Catholic's Guide to Depression (which expressly deals with the mistake of spiritualizing the illness) by Aaron Kheriaty and John Cihak; and Acedia and Me, by Kathleen Norris.

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  13. Thank you for all your wonderful comments and especially your prayers. They may already be answered, because I have seen much worse and have hope that things might not get too bad.

    I didn't mention this out of some sort of exhibitionism or drama. I did it for two reasons, both related to the stigma mental illness carries. By publicly acknowledging that I suffer from bipolar disorder, it isn't some shameful secret for me. If someone wants to think less of me, then that's their problem, not mine. Were it some other, non-stigmatized illness, I wouldn't have mentioned it. The second reason is for others, who may still feel shame. I consider myself a successful Bear, even with this handicap. I have certainly had to reinvent myself over time! If I can chip away at stereotypes and misconceptions, then mission accomplished. (Also I hope the advice will be helpful for those who deal with depressed loved ones or friends.)

    The truth is, the Bear is medicated for your protection. I prefer to think of it as "dialing down the awesome." My blogging speaks for itself. I can't honestly say it's the best I can do when I try to blog on a daily basis, but it's not too shabby, if I say so for myself. God made me a wordsmith. When it comes to things outside myself, I hope that my insight is 100%.

    Then again, this is written by a talking Bear.

    So, visitors and woodland creatures, you needn't worry. The Bear is safe in the arms of lurasidone and a couple of other close acquaintances. The fact that he is here at all is the best of all possible signs. Again, thank you so much. God willing, we will resume our regular programming soon.

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  14. More hugs to you, Bear. I get real sad and hopeless too sometimes.

    Seattle kim

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  15. Your writing (as always, but much more personal today) is like the pebble and the ripple effect. You have know idea. God does. Deo gratias.

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  16. Depression IS different than every other illness that affects just the physical body alone. In turn, the approach to treatment is completely different when speaking about spirituality to someone suffering depression compared to other disabilities, cancer, diabetes, etc.. However, to infer that there should only be a medical emphasis and not include a proper spiritual component to the treatment of the illness of depression is shortsighted and shuts out the desired and always active workings of God in each and every soul. 

    Is the experience of a person suffering from depression, so special and unique, that it falls outside of God's Holy Will or His desire or ability to Act in a way that is more concerned with our Eternal happiness, which may conflict with our feelings of contentment and joy in this life? Of course not. Is it possible that, like Job, God allows this particular, dark trial as a means to strengthen our faith and trust in Him, since we "know" and "experience" our nothingness in and of ourselves? The answer is simply, yes! 

    The ultimate goal, is to persevere through this this inner scourging, this oppressive and heavy cross, and by accepting it, to die to self "ego", to humble and weaken our intellectual, spiritual pride and arrogance, so that we are more open to listen to the quiet whispering of the Holy Spirit speaking in the very ground of our being. This Word of God, Jesus Christ, even if we don't hear Him or feel Him is so very close to us, even if hidden in our darkness, just like He is hidden in the Eucharist. All we need do is live in faith, even if darkly, He IS there, just "Be still and know that I am God." (Psalm 46:10)

    If there is a determination and a spiritual discernment that this illness/aridity is not of strictly spiritual causes (i.e. Dark Night of the Soul), then with proper direction, a soul suffering from clinical depressions can come to an understanding and acceptance that God has, through NO fault of their own, allowed this heavy cross for them to "bear" for the good of their eternal soul. 

    As with any other other illness, they are to seek every medical resource, treatment and medication that is available and, at the same time, should also avail themselves of spiritual direction from someone "experienced" in supporting them to grow in faith, trust and abandonment to the Will of God. 

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    1. I don't care to argue right now. It is exactly the same, unless you decide to cut the brain out of the problem altogether, which I understand many like to do. Both poles of bipolar disorder affect the body, as everybody who deals with it knows. If you want to say bipolar disorder is one among many diseases, which, like all diseases, requires a different emphasis in spiritual counseling, then I would go along with that. But it is no more a special lesson inflicted on people by God than any other illness is. I appreciate I cannot judge your practice from comments.

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    2. Friend, a careful reading of my comments may reveal that my points actually SUPPORT your basic position. I believe that you have unfairly lumped me in with those who "want to cut the brain out of the problem altogether". My position is exactly the opposite. I stated clearly that depression or bipolar IS an illness, however, I was making a simple and careful distinction that the approach in counseling for those suffering this particular illness, when compare to those with other disabilities or physical illnesses, to be effective, must be uniquely tailored. And no, I never said that God "inflicted" as a special "lesson" this particular cross of clinical depression or bipolar on anyone!  Though God can and does use any and all trials and suffering, of every kind, for our profit, if we cooperate with Grace. 

      In closing, I honestly don't see where we disagree. I do realize and understand, from reading the tenor and vitality of all your previous responses, that you seem to have a certain sensitivity to people who seem to make light of mental illness and ascribe it's serious effects to any other purpose - which I most certainly did not. When it comes to this issue, they should not poke the bear. :-)

      Bear, regardless, if I have offended you or upset you in anyway, no matter what, I am sincerely and deeply sorry. My poor prayers go with you. 

      P.S. There is absolutely no need to publish this comment. From me to you. 

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    3. Sorry for my misunderstanding. You're right if you think i have a sore point. As I have said, it is important to protect the principle that we are dealing with real illnesses that have a real physical component. Trust me that one of the worst parts is the second-guessing that maybe it is our weakness after all, that we are seizing on bogus medicine to cover a lack of character, that God has abandoned us. That's the way we sometimes think, and for a lot of reasons, which is why I defend absolutely that (a) the illness is real; and (b) that it not be spiritualized. I believe other suffers of this Infirmity would agree with me. Also, for me, medicine is essential. I am well aware of objections. Nonetheless, lithium really does help stabilize my mood; lurasidone really does keep the lows and highs from becoming intolerable, as well as things I would prefer not to disclose; quetiapine really does make the lurasidone tolerable; and modafinil really does perk me up during the daytime. But it's not perfect. And one of the hardest things for nearly everyone suffering from these diseases is starting on their meds. The drugs are mostly unpleasant with significant side effects. It's a trade-off. Knowing this, you can appreciate, I'm sure, why we don't need to be wondering if there's really something going on with our brains, and we should stay on our meds. These are all built-in vulnerabilities that makes us hypervigilant. We've heard so many ill-informed and thoughtless comments that have done real damage. Not that yours fall into that class, but depressed people tend to perceive things in the worst light.

      I would love to receive spiritual direction, but in this day and age it is next to impossible, unfortunately.

      I don't read comments other than to check for spam, so I published yours. I saw no reason not to keep it. But if anyone has anything private to say to me, it is best to use email.

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    4. Encouraging compliance for patients to take meds, consistently, is one of the most frustrating elements in trying to help folks stay on an even keel. At the very least, it minimizes wide and uncontrollable mood swings.

      On a personal level, I experienced, first hand, the effects of not taking meds for mental illness. My older brother was diagnosed, as a young teen, with paranoid schizophrenia. He would always unplug the TV because he believed that the "man" could watch us from the screen. Meds would have helped, but he refused to take them. The result and consequences for himself and for the rest of the family were truly tragic. So, I know, not only through thirty plus years of offering counseling and spiritual direction the reality of this illness, but I have also experienced it, up close and personal, the pain and challenges it presents to all involved.

      My friend, it is interesting that you mentioned how difficult it is to find good, solid spiritual direction, that actually helps and does not hurt an already deeply bruised soul. I often tell others how dangerous it is to try to direct oneself. We are so easily deceived. At the same time, it is like finding a needle in a haystack. But, I would be remiss not to exhort and encourage you to try. Because there are no words to adequately express or convey to you how genuinely and positively you would profit by it. God only knows.

      Peace be with you!

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  17. I was in a really bad schlump once and the shrink told me to only watch comedies on TV. So if you have Netflix I highly recommend the British comedy The I.T. Crowd.If u watch and like--let me know! ;-)

    Seattle kim

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    1. Thanks. I like to watch Chuck to lighten the mood. And even passive, mindless entertainment is something; better than rotting away in bed.

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  18. Also helpful is doing some physical project like cutting lawn, fixing something, taking a walk,etc. Another is listening to classical music or jazz.

    My thought on depression is that it may have it's source, or be intensified by, deep seated anger and resentments that we ourselves do not recognize. Once this anger and resentment is dealt with depression symptoms seem to weaken. The process of getting rid of anger and resentment is one of the basics of Alcoholics Anonymous and I assume other 12 step programs.

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    1. I don't think it is a puzzle that will be solved anytime soon. You would think that neurotransmitters are hard science, and, why, you're just a quart low on dopamine. All the medicine is based on inhibiting re-uptake of different neurotransmitters (e.g. norepinephrine and serotonin) so there's more available. BUT there is no way of actually measuring neurotransmitters sitting in synapses, like you can, say, measure blood sugar in diabetes. All we know is that some people get better when treated with this kind of medicine. But the brain is plastic, meaning it changes, even changes itself, which really makes the reductionist neuroscientists frustrated. So we have a possible psychodynamic component which can affect the neurotransmitters and other elements of the brain.Then there are other treatments like ECT that are even more mysterious in their workings. (Not going to get into any debates about treatment here, so save those comments, please.) The bottom line is every person who suffers from clinical depression / bipolar must make hard choices about treatment, and this is one case where "Who am I to judge?" is exactly the right response.

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  19. And then there is poetry...

    THE DRAGON OF GRINDLY GRUN

    I'm the Dragon of Grindly Grun,
    I breathe fire as hot as the sun.
    When a knight comes to fight
    I just toast him on sight,
    Like a hot crispy cinnamon bun.
    When I see a fair damsel go by,
    I just sigh a fiery sigh,
    And she'd baked like a 'tater-
    I think of her later
    With a romantic tear in my eye.
    I'm the Dragon of Grindly Grun,
    But my lunches aren't very much fun,
    For I like my damsels medium rare,
    and they always come out well done.

    Shel Silverstein

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  20. Thanks for this, Mr. Bear. I've long been picking at older texts on depression (classical and medieval, especially), and it's interesting how the terminology and scope of the problem has changed over history. The anatomy of melancholy is nigh-protean, sometimes.

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    1. Acedia and Me by Kathleen Norris is a pretty good history of depression throughout history, although I think she gets just a bit mixed up between acedia and depression. But like you said, it's hard to separate the threads.

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  21. I think one of the things that I realised when I had depression was that it is useless to try to "think positive thoughts". To try to "think positive thoughts" assumes you have a working brain. Telling a depressed person to be happy or think positively is as ignorant as telling a paralytic to walk. If you are depressed your thoughts and emotions are broken. You have to put them in a cast and wait for them to heal just as you would with a broken arm. If you try to use your thoughts and emotions you just intensify the pain, as you would if you tried to life a weight with a broken arm.

    It is a difficult subject because it's not obvious to many people whether the person is clinically depressed (melancholia) or is committing the spiritual sin of sloth (acedia). A quick test is to see if he enjoys anything. A slothful man can still enjoy food, and sleeping, and games and whatnot. A depressed man is deprived of even the most basic pleasures which make daily life bearable. I remember on one particular day not being able to smile: I mean that, literally, I did not have the strength of will to move the muscles in my face to form a smile.

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    1. There is no explaining it to someone who hasn't experienced it.

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  22. Also, there is a part of the Book of Job, in Chapter 33, and certain Psalms of David that are suggestive of clinical depression / melancholia. They suggest that depression is something that God may visit upon a man sometimes in order to wean him off the pleasures of the world and make him learn his own nothingness:

    [14] God speaketh once, and repeateth not the selfsame thing the second time. [15] By a dream in a vision by night, when deep sleep falleth upon men, and they are sleeping in their beds:

    [16] Then he openeth the ears of men, and teaching instructeth them in what they are to learn. [17] That he may withdraw a man from the things he is doing, and may deliver him from pride. [18] Rescuing his soul from corruption: and his life from passing to the sword. [19] He rebuketh also by sorrow in the bed, and he maketh all his bones to wither. [20] Bread becometh abominable to him in his life, and to his soul the meat which before he desired.

    [21] His flesh shall be consumed away, and his bones that were covered shall be made bare. [22] His soul hath drawn near to corruption, and his life to the destroyers. [23] If there shall be an angel speaking for him, one among thousands, to declare man' s uprightness, [24] He shall have mercy on him, and shall say: Deliver him, that he may not go down to corruption: I have found wherein I may be merciful to him. [25] His flesh is consumed with punishment, let him return to the days of his youth.

    [26] He shall pray to God, and he will be gracious to him: and he shall see his face with joy, and he will render to man his justice. [27] He shall look upon men, and shall say: I have sinned, and indeed I have offended, and I have not received what I have deserved. [28] He hath delivered his soul from going into destruction, that it may live and see the light. [29] Behold, all these things God worketh three times within every one. [30] That he may withdraw their souls from corruption, and enlighten them with the light of the living.

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