Listening to Depression

by Juanita Ryan

Carol had been divorced for six months when I first met her. From what she shared of her experience it was obvious that the six months since her divorce had been difficult. Recently, however, she learned that her ex-husband was planning to remarry. Carol had never fully given up the hope that she and her ex-husband might get back together. His intention to remarry made the finality of her loss fully and painfully clear.

A few days after hearing of the wedding plans, Carol lost her appetite. She began having trouble sleeping. She found herself easily irritated by the children. She refused invitations from friends with the excuse that she didn’t feel well. She could not concentrate. Getting anything accomplished became more and more difficult. She often found herself pacing, or sitting and staring. Sometimes she cried and cried and at other times she felt as if she had no emotions at all. Inside she was a confusion of sadness, anxiety and restlessness.

She saw herself not only as a failure as a wife, but also as a failure as a mother, a failure at work and a failure as a Christian. It wasn’t so much that she believed she failed at certain specific things, rather she believed she was a failure. Carol talked as if she had no hope for future happiness. Carol was depressed.

Carol’s depression is similar to the experience of many of us who struggle with depression. When we get depressed, we have difficulty eating and sleeping, we have trouble concentrating on any work, we withdraw from social activities, we cry, pace anxiously or stare off into space with little expression. And we express thoughts about our own worthlessness and hopelessness.

Job described depression in very similar terms:

"I am overcome with terror;
my dignity is gone like a puff of wind.
God seizes me by the collar.
He throws me down in the mud;
I am no better than dirt.
My days have passed; my plans have failed;
my hope is gone.
My only hope is the world of the dead,
where I will lie down to sleep in the dark.
Instead of eating, I mourn,
Everything I fear and dread comes true.
I have no peace, no rest,
and my troubles never end."

As the experience of Job and the experience of Carol suggest, depression is an experience of deep sorrow which is related both to negative thoughts about ourselves and to a sense of hopelessness about our future.

Listening to Depression

I experienced depression one Saturday morning when I woke up to find that it was raining. Normally, I enjoy the rain. But we had planned and long anticipated this family picnic. The rain made the picnic impossible. It took me some time to figure out why I was so sad as I went about making breakfast that morning. I finally realized that I had experienced a loss. I thought we really needed that time together as a family. We had planned it and we had anticipated a special time together. Now our plans had to be changed. That was a loss to me and, as a result, I was mildly depressed.

This very ordinary example can serve to illustrate how we can "listen" to depression. Listening helps us discover the personal meaning of the depression and this can be the key to the healing and growth we need. The sequence of feelings which lead to depression begin with the experience of some kind of loss. This may be a tangible loss or it may be the loss of some intangible thing. In the picnic example the loss was of an anticipated enjoyable experience. The perceived loss which is the beginning of depression is usually associated with a threat of some kind. Because I had been so busy recently I felt responsible for the fact that we had not been able to spend enough time together as a family. That is the reason why this particular picnic was so important to me. My self-esteem and sense of competence as a wife and mother were somehow involved in this picnic. Other people in our community may have been planning picnics which they had to cancel. But the cancellation probably did not have the same meaning for them. For me, having to cancel the picnic seemed to threaten my sense of adequacy as a wife and as a mother. The threat I perceived when it started to rain was that I was a failure.

A number of emotions are always associated with any perceived threat to self-esteem or future happiness. It is particularly common in depression to experience anger at other people or at the situation. If this anger is not recognized and acknowledged it may be turned into anger against ourselves. In the cancelled picnic example, I was angry at the rain. And I was angry at everyone in my family because I thought they expected too much of me. How could I be a good wife and mother and still do everything else I was supposed to do? And I may have been angry at God. "Why does it always rain when I plan a picnic?!"

In retrospect, of course, this anger seems quite unreasonable. It also seemed unreasonable at the time. This is a particularly important point. I had experienced a loss, and a threat to my self-esteem and I had experienced anger. But since the anger seemed to me to be clearly unjustified, I concluded that there must be something wrong with me. As a result, I turned the anger against myself. Intense feelings which seem unjustified, unreasonable, unsharable, unacceptable, or just plain scary are easily internalized as anger at ourselves.

Internalization of anger poses an additional and intensified threat to our self-esteem. I was no longer imagining someone else saying "You are not a competent mother," rather I was hearing myself say, "I am not a competent mother." This internalization accounts for some of the staying power of depression. If the threat were simply external, I could have asked the people in my family what they really thought, I could have collected more information. The internalization of the threat leaves fewer options for response. It is this kind of self-accusation which leads to the helplessness and hopelessness of depression.

The cancelled picnic story is clearly an example of a relatively minor battle with depression. It was short-term and easily resolved. Alternative indoor plans were made for the day. When I realized how I was feeling about my schedule and priorities I began to cut back on activities in order to have more time for my family. When I recognized my anger at my family we were able to talk together about my feelings and to negotiate more reasonable expectations. These adaptations made me feel better about myself as a wife and mother, and allowed me to feel more hopeful about the future.

The experience of depression can, however, be a much more overwhelming and difficult experience. In a crisis situation, for example, the perceived threat to self-esteem and future happiness can be much greater. The damage caused by a loss may seem irreparable and the depression experienced as the result of some losses can last for days, weeks, months or even longer.

For Carol, her husband’s plans to remarry finalized the profound losses she had experienced when her husband left her: the loss of companionship, of love and acceptance, of financial security, of help in parenting, and of identity as a wife. These losses were associated with major threats to Carol’s self esteem and expectations for the future. Because of the losses she had experienced and the meaning of these losses, Carol had a great deal of anger. She was angry at her husband for all the pain and rejection. She was also angry at God for having allowed this to happen.

Her anger, however, was very difficult for Carol to recognize or acknowledge. She wanted very much to think of herself as a kind and forgiving Christian. As a result of this desire not to be an angry person, she took total responsibility for what had happened. She turned the anger against herself, blamed herself, and saw herself as a total failure. This internalization of the threat to her self-esteem intensified the helplessness and hopelessness which she experienced. Because Carol’s self-esteem and her hope for the future were shattered, she became very depressed.

Depression and early loss

My lost picnic and Carol’s lost marriage are examples of depression which grow out of a situation in the present. Much of our depression, however, has its roots in early childhood losses. Childhood loss may take many forms: the death of a parent or a sibling, divorce, emotional neglect, abandonment, physical, emotional or sexual abuse, chronic illness or disability. Because losses in childhood have a direct and dramatic impact on our developing sense of self and on our developing trust and hope in others, including God, they can have a powerful impact later in life.

Sometimes when depression is triggered by a present-day event, it may tap into these deeper, earlier losses. Sometimes, however, there may not even be a present "trigger" event. We may simply find ourselves depressed "for no reason." While depression "for no reason" can be primarily genetic or biochemical in origin it can also be related to losses which we experienced so early in life that we did not yet have the ability to grieve. If this is the case, then listening to our depression may help us discover these early losses and to begin the process of acknowledging them, honoring them and appropriately grieving.

Being depressed about being depressed

Christians who are depressed often experience an added spiritual struggle which complicates depression. Because of the painful emotional realities connected with depression, Christians may feel rejected by God, or unworthy of God’s love and care. Or a Christian may see depression as a sign of spiritual weakness or failure. Christians often feel that they should be full of hope and joy, ready to accept everything as God’s will. Depression doesn’t fit neatly into our expectations of what good Christians should be like. As a consequence we may find ourselves questioning our spiritual well-being. We may privately think "If my faith were stronger, I would not be taking this so hard. I would not feel so depressed. There must be something wrong with me. I am sure God is not pleased. I need to stop feeling like this." Or we may worry that other Christians will reject us for being depressed.

Depression is a very difficult experience. And being depressed about being depressed is even more difficult. Self-condemnation, worrying about our spiritual well-being, feeling rejected by God, and fearing that friends will not understand are all complicating issues that can further decrease our self-esteem and decrease our hope and therefore increase our depression.

Depression involves many intense emotions which we would prefer not to experience. The fact is, however, that depression is a normal part of resolving a loss. As we begin to realize what we have lost, we will necessarily experience many painful emotions. These are part of the hard work of becoming aware of the significance of the loss. This hard but necessary work can be thought of as "grief work." Grief work involves identifying our losses, experiencing the strong emotions that accompany the losses and slowly letting go.

Simply stated, then, when we listen to our depression, we will often discover that it is an experience of sorrow in response to a loss or a potential loss which threatens our self-esteem or future hope. It is often complicated by unrecognized anger which is turned against ourselves. In addition, depression may be complicated by spiritual struggles and by self-condemnation.

What we can do when we are depressed.

When we feel trapped in the deep pit of shattered self esteem and hopelessness, it can be extremely difficult to imagine that there is a way out. But there is a way out. There is no simple formula that we can follow which will guarantee a recovery from depression. And there are no magical incantations to help us avoid the hard work that needs to be done. But there is a way out. Recovery is possible. There are several guidelines we can follow which will set us on the path to recovery.

First, it is important to recognize that we are depressed. It is possible to have a drastic decrease in our energy and our interest in life, to have major changes in sleeping and eating patterns, to find ourselves unable to concentrate or to remember, to watch ourselves acting more irritable and anxious, and to feel like we just don’t care about much-without realizing that we are depressed. Knowing some of the classic signs of depression, and observing ourselves closely enough to read these signs is the first step on the pathway out of depression.

Once we recognize that we are depressed it is important to make room for the depression. This may seem like upside down thinking ("Why make room for the things you want to get rid of?") but it is an essential part of the healing process. The reality is that depression drains our energy. We simply cannot do and go at the pace to which we are accustomed. C.S. Lewis experienced this after his wife’s death. He wrote: "I loath the slightest effort. Not only writing, but even reading a letter is too much. Even shaving. What does it matter now whether my cheek is rough or smooth?"

Depression is like having the flu in this sense, but it is worse than having the flu because it often lasts longer and we are less likely to give ourselves a break. We are less likely to be compassionate with ourselves and more likely to be judgmental. But when we are depressed we need a break. We need to cut back on our expectations of ourselves. We need to find ways to be kind to ourselves and to nurture ourselves.

At the same time, we need to be aware that reducing our expectations of ourselves and giving ourselves a break can be taken too far. Sometimes when we are depressed we want to go to bed, pull the covers over our heads and never get up again. Doing this will, of course, only increase our depression. So, as we give ourselves a break and allow ourselves to do less than we normally do, we also need to push ourselves to stay as engaged as possible with life. Some of the things we might do to stay engaged include beginning (or continuing) a regular exercise program (even if it means just a walk around the block), spending time with friends doing simple social activities (going out to lunch, sitting in a park) and talking with someone about what we are experiencing (whether it is a friend, a prayer partner, a pastor, a grief group or other support group or a therapist).

When I worked as a nurse with post-surgical patients I would try to explain a similar balance that was needed to recover after surgery. I told patients that they would find themselves tired, even exhausted. They would need to take naps – something they may never have done before. They needed to do this because it is during rest that the body repairs itself. But they also would need to stay as active as possible. They needed to be up and about and walking many times a day. Their recovery depended on giving themselves a break (expecting less of themselves, and doing less), yet staying as active as possible. Recovery from depression requires a similar balance.

Another important part of our recovery from depression is to do the painful psychological and spiritual work that is involved in grieving. Recovery from depression can be thought of as "grief work." It is a time in which we are called on by the circumstances of life to face a loss or a potential loss and to acknowledge the meaning which this loss has for us. Whether the loss is the loss of our physical health, or the loss of a marriage, or the loss of a job, or the loss of our youth, or the loss of a dream, or the shattering loss of trust that an assault can cause – whatever the loss or the potential loss, the meaning it carries is highly personal, and very important to explore.

Depression comes to us with a message. Depression signals to us that something has happened or is threatening to happen that touches a very deep part of who we are. Depression is like an alarm system calling us to pay attention. In the relatively simple story of my depression over a canceled picnic, the depression was pulling at my sleeve, pointing out to me how important my family was to me and how much I needed time with them. It was also showing me that I was trying to be superwoman, and that I needed to develop more reasonable expectations of myself. More deeply, it was whispering to me that I was trying to find value in doing because I did not believe there was value in my being. If I had denied or minimized my depression, I would have missed these important messages.

When we are depressed we need to recognize that we are depressed, we need to give ourselves a break, we need to stay as engaged as possible and we need to explore the meaning of the loss or the potential loss that faces us.

Perhaps the most important thing that can be said about recovery from depression is that we can not go it alone. When we are depressed most of us want to withdraw. We tell ourselves that no one would want to be around us when we are like this. And besides, we don’t want to be around anybody anyway. But we need God and we need other people loving and supporting us in order to heal.

When we are depressed we may believe we are not lovable or valuable. At its deepest level, this is one of the wounds that depression reveals to us – our need and longing for love is one of depression’s most important messages to us. All of us need to know that we are loved and valued by God and by others.

At the moment when we feel least inclined to reach out or to take a risk of any kind, we most need to do so. We need to ask for loving support from others. Even one person is a start. It might be a friend. Or a pastor. Or a therapist. It is important to remember that the greater the depression, the more support we will need. A mild, short-lived depression may be resolved in a conversation with a friend, or in a time of prayer. A more significant long-lasting depression may require the support of several friends, a therapist and possibly appropriate medication. A depression that leaves us actively suicidal will require the support, at least temporarily, of a hospital staff in addition to friends and a therapist.

When we are depressed we need a special kind of help from God. We need to know God is close to us, loving us, caring for us. Yet, when we are depressed, we often believe God is distant, disapproving, punishing or unreachable. Again, we are faced with a powerful struggle. When we need God most, we are in a position of feeling least able to risk asking for God’s help. This is a time to ask others to pray for us, because we may not be able to pray for ourselves. It is a time to keep our prayers simple: "Help!" or "God have mercy on me." are examples of the sum total of what we may be able to pray. This may be a time for reading the psalms so they can give voice to our sorrow and shed light in our darkness. Psalm 34:18 offers us the reassurance we need when the darkness of depression closes in on us: "The Lord is close to the brokenhearted and saves those who are crushed in spirit." May the tender, healing presence of the Lord sustain you when your heart is broken and your spirit is crushed, so that you will have the strength to listen to your depression and the grace to receive God’s unfailing love.

Juanita Ryan is a therapist in private practice at Brea Family Counseling Center, Brea, California