Sunday, September 23, 2007

An American Epidemic?

Just lately, it seems, I've heard more people say they suffer, regularly or occasionally, from depression. I can speak only about depression in the USA, because I've never been out of the country. (I don't count that weekend foray into Nuevo Laredo more than 30 years ago.) My mind always wanders into the "why" of things. I can't help it any more than I can help breathing, even though it tends to irritate some people. Why is it that so many Americans are depressed? Is there some toxin in the polluted air that causes this? Is there some nutrient missing in the American "diet," or some element that inundates our system and fogs our brains and judgement? Is it the completely unrealistic portrayal of "the good life" in advertising? Is it the corporate expectation that everyone give their best 24/7 without room for being human and sometimes catching colds and/or just needing time to rest and re-create themselves?

While some conspiracy theorists might favor the polluted air and deficient diet thoughts, frankly, I believe that the cause of our depression lies in the expectations of the later two suggestions and their impossiblility of attainment. We believe, though, that not only are they possible to attain, they are expected. There is no room for human error or weakness in this society. Employers grudgingly give a day or maybe two (if he's generous) off if an employee gets the 'flu. Get real. Influenza is a killer, and makes its victim miserable with body aches and fevers for at least ten days. How is a person supposed to perform at all, much less at the eternally expected peak of perfection, when he is shivering from chills and fever? The employer would rather see on paper that he has good employee attendance rather than protect the majority of his workers from catching this contageous disease just because everyone is supposed to "be strong" and not "wimp out" when he is sick. How sick is that attitude?

Along with the totally unrealistic expectation of perfect health is the equally unrealistic expectation that everyone is to perform at peak skill and perfection at all times. This expectation resides not just with employers, but with the general populace at large, whether they realize it or not, and even in our own minds. If we're having a bad day at work, we're told to "snap out of it," or "get with the program," served with side innuendoes that nobody is irreplaceable. In our private lives, even our friends (and ourselves, too, truth be told) expect a "Martha Stewart" type of perfection in our homes, our hospitality, our socializing. Who has the strength to maintain that for any length of time at all, much less 24/7? Why on earth do we put so much value in what other people think of us, anyway? (But that's another story altogether.)

So, we run around like rats in a cage searching for that eternally elusive piece of cheese that will miraculously make us perfect so we can be happy. Happy about what? That other people approve of us? That we kill ourselves to promote some greedy employer's promotion of capitalism? Will we be happy that we have neglected our spouses and children and offered them up on the altar of social approval? How shallow can we be? If our happiness depends upon our being perfect in every way, and in gaining the sunny smiles of society's acceptance and approval; then it's no wonder we are depressed. We have set for ourselves an impossible task.

As an Orthodox Christian who hourly falls far short of perfection, I look at the world around me, and I'm sad. The level of suffering out there is overwhelming, and my heart literally breaks for all the people. I want to take them by the shoulders and look straight into their faces and say, "Wake up! Happiness is inside you, not outside of you." I read a little blurb recently that said, essentially, that if we are always dissatisfied with what we have, then we will always be unhappy. On the other hand, if we can learn to be satisfied with what we have, then we will be happy. That is so true. I feel so lucky to have the caring, understanding, and loving husband that I am privileged to say is mine. I feel so lucky that he has stayed with me through more "thick" than "thin" in our 37 years of marriage. I feel so lucky that he has worked when he was sick, when things at work were less than optimal, and come home to me every night to keep the bills paid, food on the table, and a good roof over our heads, and then pitched in with whatever "crisis" was going on the lives of our children. Heaven knows that there were many times that no one would have blamed him if he had thrown in towel. I am so lucky that all three of my adult children talk with me, share their lives, ask my opinion and advice on things. In spite of all my many, many faults, they have all become good, caring, productive individuals whom I am very proud to know. How can I be dissatisfied with all that and more?

Some Orthodox fathers say that depression is a result of sin, and they are right. But there is also a disease or dysfunction of the body that can, and does, cause debilitating depression. This type of depression can, and must, be managed with the help of a physician. It's not my purpose to say that all depression is "all in your head." No, not at all. I've had that one thrown at me far too many times to denigrate a person's experience that way. However, I am not qualified to address the biological side of depression. (I'm really not qualified to discuss anything about depression, or much of anything else, except my own experience of it.) For a good, comprehensive discussion of depression and modern psychology, read Fr. Stephen Fraser's essay here.

But I want to get back to this "depression is caused by sin" concept. When I first read about that, I was offended and appalled at the insensitivity of the writers. (There are many articles and books by Orthodox authors on this subject.) I didn't even finish reading the book, but put it down to gather dust. However, the idea stuck in my mind, and I've been turning it around in there for some years now. I am convinced that there is a type of depression that is biological in its genesis, and the sufferer of this type must take advantage of the services of a good doctor. However, I'm equally convinced that even this type of depression can be, and most likely is, aggravated by sin. I'm also convinced that a non-biological depression exists that most likely has sin as it's prime cause. How can this be?

I've done a bit of reading about this sin-as-cause concept, but not nearly enough to speak in any way authoritatively. I have thought a lot about it as it pertains to me, personally. My thoughts, briefly, are that the basic sin (or common denominator of all sin, if you will) is pride. There's no surprise there. To my mind, all of our unrealistic expectations about and for ourselves, whatever they may be (and they may be quite different from any expressed in this short meandering), have pride as their root cause--pride in our own capacity to govern and control our lives and feelings. We can't and don't "measure up," so we begin to think of ourselves as "not good enough," or (my favorite) "defective," or "inadequate." This type of thinking leads us to anger towards people and circumstances outside ourselves, and finally towards ourselves for being so weak, defective, inadequate, no good, etc. We become depressed. We sink into the bog and wallow until we hurt so bad we must do something about it. So, we find some poor, unsuspecting, caring soul and dump on him or her. Or, if we're lucky enough to have a good confessor (or an available priest at all), we dump it all on him. This is the best thing to do, if we can. After we've done the dumping, we feel better. The sun shines again, and we face the world with a smile on our faces. Until the constant barage of expected perfection, whether coming from our own minds or from society, takes its toll and we find ourselves in the bog of depression again. So the cycle continues. The trick is to break this cycle. But how?

Well, for an Orthodox Christian, availing ourselves as frequently as our circumstances allow of Confession and Communion is the only cure that heals, because this type of depression is an illness of the soul. This type of depression cannot be managed or healed by secular medicine or even therapy. Only the Church is the appropriate "hospital" for soul sicknesses.

In addition to availing ourselves frequently of the Mysteries, we must learn to be vigilant in our minds. We must learn to consciously become aware and recognize when these self-deprecating thoughts make their first appearance in our minds. The moment they first rear their ugly heads, we must learn to close the door of our minds and hearts to them. To do this, we simply refuse to entertain the thoughts when they appear. Metropolitan Hierotheos of Nafpaktos discusses this process very well in his book Orthodox Spirituality, or more specifically in his conclusion to this book in a section called "Praxis and Theoria."

This vigilance is no small or easy task. It's exhausting. It can also be frustrating to learn how often we allow ourselves access to destructive thoughts and feelings; which can lead to depression, because, of course, we should be better or stronger than that. As I said, it's not easy, but "practice makes perfect" as they say.

At the bottom of all this, we need to learn to rely on God and not ourselves.

"Put not your trust in princes, in sons of men, in whom there is no salvation."

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