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Dealing With Depression

Cherry Danish and Antidepressants

I was recently praying with a group of women, ages 19 to 40. Well, visiting with and then praying with — we usually do coffee and maraschino-cherry danishes, and chatting — and then we pray. (The cherry danishes and chatting, of course, help us know what we need to be praying about!)

To make a long story short, one woman mentioned that she was adjusting to a new medicine her doctor had suggested she take — an antidepressant. And in the course of the conversation, it emerged that more than two-thirds of the women present were taking, or had in recent years taken, an antidepressant.

This, I think, is one of the untold stories of our generation: Many of us are walking around with something that feels like low-grade depression. And many have advanced beyond that into depression that may require medication.

Yet, in part because depression seems so suddenly pervasive, it's very confusing. How do I know if I, or my friend or roommate is depressed? Is there anything I can do to fend off depression? And who gets depressed, and why?

Encountering Depression

I remember one of my earliest encounters with clinical depression: It was the summer after my sophomore year of college, and I found myself living about two hours from a high school friend, whom I'll call Karen. I tried to set up a date to go visit her and a few other friends who lived in her town. Karen kept evading my efforts to visit, saying things like "I just can't predict in advance if I'll be able to meet you that day; I'll explain when you get here."

Not yet knowing that Karen had plunged into a clinical depression, I was miffed: Was Karen just too busy to see me? When I finally did go visit her, she explained that in the last four months she had been weighed low by depression. She'd finally gone to see a doctor after another friend, watching her lie on the floor sobbing for three hours, gently suggested that she might need some help. She was now in therapy, and working with her doctor to find the best medication for her. Some days were better than others. Though she hadn't reached feeling great yet, at least on some days she was functional.

This was the first time I really understood that something medical could be going on in people's brains when they were depressed. Since I'm not a doctor or a scientist, I didn't, and still don't, understand exactly what was going on in Karen's brain, but I know that Karen — who, when she's healthy, is one of the most energetic and high-functioning people I know — was experiencing something that was out of her control.

If you've not experienced depression yourself, or watched someone you love grapple with depression, it can be hard to imagine how paralyzing depression can be, and how demoralized, helpless, and lifeless a person suffering with it can feel, how utterly and completely the depressed person is not "choosing" to be depressed. Because many great writers seem to have struggled with depression, modern literature has produced a wealth of powerful descriptions of what it is like to suffer from depression.¹ Jane Kenyon, a Christian and a poet who suffered from depression for much of her adult life, captured this in her poem "Having It Out with Melancholy":

Often I go to bed as soon after dinner
as seems adult
(I mean I try to wait for dark)
in order to push away
from the massive pain in sleep's
frail wicker coracle.²

In other words, when she was depressed, staying awake for 10 hours was a big accomplishment. Kenyon did all she could to simply stay awake, and then she went to bed as soon as she could get away with it, trying, but not always succeeding, to stay vertical until sunset.

Women and Depression

Did you know that women tend to have higher levels of depression than men?³

Why are we ladies more prone to depression? Well, there are lots of theories: hormonal changes at various life stages — puberty, pregnancy, and so forth — may attribute to women's higher rate of depression. Although depression is a problem of brain chemistry, life circumstances often trigger depression.

Doctors and sociologists have hypothesized that in America, women may be more frequently depressed because women's lives are often more stressful. (More stressful? you might ask. Yep. Studies show that women tend to have more on their plate than men — women are more likely than men to have responsibilities in professional, familial and domestic realms.) Women who are at home full-time may sometimes feel overwhelmed and isolated, starved by a lack of adult contact (of course, being home full-time doesn't have to lead to depression, but it can be important for stay-at-home moms to build in time with other adults!)

Depression can be triggered in college students — women and men — by the insane pressures, academic and social, of student life. Time pressure — the sense that there aren't enough hours in the day — is thought to be one possible trigger of depression. Another, which may especially threaten college-aged women, is, in social scientific jargon, "negative experiences in affiliative opportunities" — or, in plain English, drama-rama with your friends.⁴ Close friendships are in many ways quite good for us, of course: They fill our lives with meaning, teach us to love, stave off loneliness, and may, in many ways contribute to our physical and emotional well-being. The intense emotional engagement that women's friendship calls forth, the passionate ups and downs that sometimes (especially during college) accompany those friendships can also be extremely stressful, and that stress may prompt depression.⁵

Depression Debates

One reason depression can seem confusing is that there is debate about depression even in the medical world. Even the question of women being more prone to depression is debated: Some specialists have suggested that women are simply more likely to get diagnosed, because they are more likely to talk about their feelings, and thus provide evidence of their depression.⁶

We all feel down periodically. And certain life events — such as the death of a friend or relative, or even a breakup — can plunge us into a deep, but temporary, grief.

Depression, the kind of fight to stay upright that Kenyon captures in her poem, is something quite different. Indeed, this is one place where trained professionals — counselors and doctors — can help: They are able to more clearly discern when someone is experiencing grief, and when someone is clinically depressed.

Depression and Spirituality

Life circumstances do have something to do with depression, but, in dealing with your own depression or a friend's depression, it is vital to remember that depression is a medical problem. Despite the tireless efforts of mental health advocacy groups, there's still something of a stigma attached to depression.

Sometimes we sniff at depression and wonder why a depressed person doesn't just exert some willpower, control her mood, get out of bed — in other words, snap out of it. In the church, we often stigmatize depression by spiritualizing it, suggesting, for example, that if only the depressed person would pray harder, her depression would lift. Or we suggest that if you're depressed, you must have unresolved guilt from some sin — or you have not sufficiently placed your hope in God.

This is not to say that prayer can't help depression. But just as we would expect that a person suffering from, say, Multiple Sclerosis would pray and seek professional medical help, so too God can use doctors, psychologists and medicine to help heal people with depression.

So What to do About Depression?

As society we can work to minimize some of the social pressures — like people always feeling too busy — that may contribute to depression. On an individual level, we can become educated and informed about the symptoms of depression, so that we can recognize them in ourselves or our friends. Fortunately, on college campuses, there are lots of folks trained to help depressed people — your health services center no doubt has a staff of counselors and psychologists. (By the way, suicidal ideation should always be taken seriously — if you or a friend are fantasizing about suicide, call up your campus health services pronto.)

If you have a friend who struggles with depression, helping her get professional help may be the biggest assistance you can offer. Patience with what may feel interminable and tedious is important too — it can be very trying to walk with a friend through depression.

And gently cajole your friend back into life — taking her to he gym, inviting her to come spend an hour planting tomatoes at the community garden — may not cure her, but the occasional community garden field trip might brighten an afternoon. At the same time, judicious understanding of the afternoons when she simply can't accompany you to the garden, just as a person with a chronic physical illness is simply laid low some days, helps, too.

C O F F E E  S H O P

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Do you or someone you know struggle with depression?

Join the discussion!

Finally, we should try to recognize our own preconceptions about depression. Some people, especially those of us who are independent and believe in the value of self-determination, may tend to view depression as "the blues," a minor problem, and that people dealing with depression should be able to just "snap out of it." We need to recognize that depression is a real medical problem. By doing so, and by responding to depression with compassion, we may find life-giving opportunities to help others.