Depression and Suicide: A Catholic Perspective

As a psychiatrist, I had been aware, prior to his death, that Robin Williams struggled with a severe mood disorder – major depression and bipolar disorder, depending on the source of the reporting – along with related problems and drug dependence.

The vast majority of suicides are associated with some form of clinical depression, which in its more serious forms can be a sort of madness that drives people to despair – leading to a profound and painful sense of hopelessness and even delusional thinking about oneself, the world and the future.

I knew all of this, and yet this death still shocked and surprised me, as it shocked and surprised so many others. Williams seemed to be the consummate humorist, the funny man who would be just so much fun to be around. Unlike some comedians who trade only on irony and cutting humor, Williams appeared to us as a warm, big-hearted, endlessly fun, brilliantly quick, incredibly talented man. Though he was a celebrity, he was the kind of person that people felt like they knew – like the cousin, everyone just adores and hopes will show up at the family reunion.  Williams was the kind of guy that people wanted to be friends with, the kind of person that one wanted to invite to the party.

This is not the typical stereotype of mental illness, which why the typical stereotype must be relinquished: Quite simply, it is false.

Mental illness can afflict anyone, of any temperament and personality. In the wake of his death, the strange truth gradually began to sink in: In spite of outward appearances, Williams’ mind was afflicted by a devastating disorder that proved every bit as deadly as a heart attack or cancer. He suffered in ways that are difficult for most people to imagine.

Why couldn’t Williams see himself as other saw him – as a person of immense gifts and talents, a man who stood at the pinnacle of achievement in the world of comedy and entertainment?

Why couldn’t he see himself as God saw him – as a beloved child, a human soul of immense worth, a person for whom Christ died?

This is the tragedy of depression, which is so often misunderstood by those who have not suffered its effects.

Novelist William Styron – whose memoir Darkness Visible represents one of the best first-person attempts to describe the experience of depression – complains that the very word “depression” is a pale and inadequate term for such a terrible affliction.  It is a pedestrian noun that typically represents a dip in the road or an economic downtown. Styron prefers the older term “melancholia,” which conjures images of a thick, black fog that descends on the mind and saps the body of all vitality.

Indeed, the title of his book – Darkness Visible – comes from John Milton’s description of hell in Paradise Lost. We’re not talking about hitting a rough patch in life or the everyday blues that we all experience from time to time. We are talking about a serious, potentially fatal, disorder of mind and brain.

Fortunately, in most cases, depression is amenable to treatment. Because the illness is complex – involving biological, psychological, social, relational and, in some cases, behavioral and spiritual factors – the treatment likewise can be complex. Medications may have a very important role, but so do psychotherapy, behavioral approaches, social support and spiritual direction.

In some cases, hospitalization may be necessary, especially when an afflicted individual is in the throes of suicidal thinking or when one’s functioning is so impaired from the illness that he or she has difficulty getting out of bed or engaging in daily activities. For the severely depressed, even brushing one’s teeth can seem like an almost impossibly difficult chore.

This level of impairment is often puzzling to outsiders – to the spouse or parent who is trying to help the loved one. Unlike cancer or a broken bone, the illness here is hidden from sight. But the functional impairments can be every bit as severe.

I recall one patient, a married Catholic woman with several children and grandchildren, who had suffered from both life-threatening breast cancer and from severe depression. She once told me that, if given the choice, she would choose cancer over the depression, since the depression caused her far more intense suffering. Though she had been cured of cancer, she tragically died by suicide a few years after she stopped seeing me for treatment.

Depression is neither laziness nor weakness of will, nor a manifestation of a character defect. It needs to be distinguished from spiritual states, such as what St. Ignatius described as spiritual desolation and what St. John of the Cross called the dark night of the soul.

Tragically, even with good efforts aimed at treatment, some cases of depression still lead to suicide – leaving devastated family members who struggle with loss, guilt, and confusion.

The Church teaches that suicide is a sin against love of God, love of oneself and love of neighbor.  On the other hand, the Church recognizes that an individual’s moral culpability for the act of suicide can be diminished by mental illness, as described in the Catechism: “Grave psychological disturbances, anguish or grave fear of hardship, suffering or torture can diminish the responsibility of the one committing suicide.”

The Catechism goes on to say: “We should not despair of the eternal salvation of persons who have taken their lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.”

Robin Williams’ death – like the death of so many others by suicide who have suffered from severe mental illness – issued from an unsound mind afflicted by a devastating disorder. Depression affects not just a person’s moods and emotions; it also constricts a person’s thinking – often to the point where the person feels entirely trapped and cannot see any way out of his mental suffering. Depression can destroy a person’s capacity to reason clearly; it can severely impair his sound judgment, such that a person suffering in this way is liable to do things, which, when not depressed, he would never consider. Our Lord’s ministry was a ministry of healing, in imitation of Christ, we are called to be healers as well. Those who suffer from mental-health problems should not bear this cross alone. As Christians, we need to encounter them, to understand them and to bear their burdens with them.

We should begin with the premise that science and religion, reason and faith are in harmony. Our task is to integrate insights from all these sources – medicine, psychology, the Bible, and theology – in order to understand mental illness and to help others to recover from it. In cases where recovery proves difficult or impossible, we pray for the departed and never abandon those who still struggle.

Aaron Kheriaty, M.D., is associate professor of psychiatry and human behavior at the University of California-Irvine School of Medicine. He is the co-author with Msgr. John Cihak of The Catholic Guide to Depression.

God and Depression

“Does God care about me?”

“Why do I suffer so, Jesus?”

“Please help me, God”

“Where are you? Do you even exist?”

People suffering from depression ask these questions in the silence of their hearts. They cry out to God just as others have for millennia when faced with great sorrow:

“My tears have been my food day and night.” Psalm 42:3.

Beyond therapeutic and psychopharmacological bromides, we all seek loving comfort. Sometimes we get it from others – – sometimes we don’t.

We’ve reached our limit to cope, to keep it all together. We’re worn out by the battle.

We’re searching for answers: “Why me?”we ask. Even when we get answers (e.g. it’s “biochemical” or too much negative thinking) from others, the pain may not abate. And so we ask more existential questions about the nature of our suffering.

Barbara Crafton, an Episcopalian Minister and depression sufferer, writes in her book, When Jesus Wept: When Faith and Depression Meet, about this mystery:

“In several ways, above and beyond the genetics, family upbringing and “slings and arrows” of our existence that has brought us to this point in our lives, there is a real mystery to suffering. Why do some people suffer tremendously while others not so much? Why do some people with a certain makeup come down with depression while someone with a similar history do not? It’s a mystery. Often, while people who get treatment and help come to find out some of the reasons that they’re depressed, it often isn’t enough. The answers don’t always heal us.”

lincoln

Abraham Lincoln, who struggled with depression his entire life, was quoted in the book Lincoln’s Melancholy: How Depression Challenged a President and Fueled his Greatness:

“I have been driven many times upon my knees by the overwhelming conviction     that I had nowhere else to go. My own wisdom and that of all about me seemed insufficient for that day.”

Much like Lincoln, we can feel powerless to stop our depression. It is BIG and we are small. Anything other than the crushing experience of depression feels unreal. We’re not in the normal stream of life that everyone else is swimming in: we’re drowning.

I had never encountered any pain greater than depression. Other types of pain I could deal with and recover from: a burst appendix in college and blown out ligaments in my knee years ago. But depression? There wasn’t any surgery I could have, no caste that could be fitted. I felt like I was dying. In the book Unholy Ghosts: Writers on Depression, writer Susanna Kaysen captures this experience:

“The worst thing about depression – the thing that makes people phobic about it – is that it’s a foretaste of death. It’s a trip to the country of nothingness. Reality loses its substance and becomes ghostly, transparent, unbearable. This perception of what’s outside affects the perception of the self, which explains why depressed people feel they aren’t ‘there.’”

So in the face of so much pain, we look for power outside of ourselves. We place our hope in Someone bigger than our depression – – God.

It’s tough to pray when we’re depressed

Praying when in the throes of depression is a challenge. We might not be able to muster the energy, feel like it isn’t making a dent in our depression; or, worse yet, our faith falters and we stop believing.

We grow despondent.

We give up hope.

We give up on God.

We want salve on our wounds, but depression just keeps throwing salt in them. We yearn so badly for God’s direction (“Show me the way out of this darkness”), but it always doesn’t come.

Barbara Crafton writes:

“It makes every bit of sense for a person to whom faith is a matter of importance – even one who doesn’t think that all human sorrow can be magically prayed out the window – to hope that it will somehow illuminate the darkness of depression. We understand that nobody ever promised us a rose garden, but could we perhaps have a little light?”

Depression is a terrible liar

In a sense, depression is a temptation. It calls us. It whispers in our ear that all is lost and that we’ll never find our way back home. It’s a terrible liar, really.  It spins the yarn that we’re worthless and there’s no point in living.  And these messages repeat themselves over and over again in our minds and souls.  And they all seem so true and unchangeable.

John Piper wrote in When Darkness Will Not Lift: Doing What We Can While We Wait for God – And Joy:

“…We should all fortify ourselves against the dark hours of depression by cultivating a deep distrust of the certainties of despair. Despair is relentless in the certainties of its pessimism. But we have seen again and again, from our own experience and others’, that absolute statements of hopelessness that we make in the dark are notoriously unreliable. Our dark certainties are not sureties.”

Who do You say I am?

One of the most powerful scenes in the Bible is when Jesus turns to Peter and says, “Who do you say I am?”

I like to imagine Jesus standing across from me. He’s looking directly into my eyes. I reach out to Him. and say, “Lord, who do You say I am?” It clearly isn’t what my depression judges me to be. Jesus is always affirming, always loving, always telling us just how precious we are. THAT is the voice we need to listen to and embrace.

A Light in the Darkness

Mother Teresa once wrote:

“If I ever become a saint—I will surely be one of ‘darkness,’” After her death, Many suggest that she suffered from clinical depression and long periods where she sought to understand God’s absence in the face of so much inner pain.

motherteresa

Therese Borchard writes:

“I spent a week with Mother Teresa and her Sisters the winter of 1994. I stood beside her for about two hours as we distributed Christmas gifts to orphaned children. I sensed sadness in her. But her light overshadowed it. Unlike a person wrapped in severe depression, wearing the expression of despair, she exuded light and hope. When she prayed, her deep love for God was visible, even contagious.

This saint of darkness has much to teach me about how to live with inner anguish.

First of all, I should stop referring to my depression and anxiety as the “Black Hole,” (singular and capitalized), and call it, as Mother Teresa described her difficult places, the “dark holes.” Because the darkness is never black, or without any light at all. Her legacy is proof that hope and faith and love prevail, even in the dark night.”

A few years ago, I composed this prayer.

Dear God,
I am on my knees, because I don’t have the strength to stand up.
My strength is gone. I can’t deal with my depression by myself any longer.
I am lonely.
I call on You.
I have faith that Your strength is bigger than my depression,
that Your mercy and healing white light will show me the path home.
I am not alone.
You’re rod and staff comfort me as I walk through the valley of the shadow of depression
and there is nothing I shall fear.

Amen

So don’t lose hope. Don’t lose God. He’s working somewhere in the pain to heal you.

As Pope John Paul, II wrote:

“Do not abandon yourselves to despair. We are the Easter people and hallelujah is our song.”

By Daniel T. Lukasik, Copyright 2015

 

 

 

 

I’ll Be Eating Humble Pie on Christmas

Bow, stubborn knee — Shakespeare

I walked into an old church downtown yesterday.  Its edifice was old and craggy, its stones walls worn by a century of wind, pelting snow and acid rain.  I walked through its medieval-like doors, the smell of melted wax, a dollop of frankincense and recently fallen snow wrapped around my newly chapped face.

No one was there. I sat in a well-worn pew near the front.  I looked up at the vaulted ceiling full of stars, angels and saints.  I thought of the tens of thousands of souls over the past hundred or so years that had worshipped here, sought answers and sought peace.  Now here I was.  

A conundrum of faith is that we never really know.  That’s why we must rely on faith, I guess.  It seems like we’re given just enough light to see our next footstep in life, but never full illumination to see the entire journey ahead of us. It’s not reason to despair; it is reason to feel humble before the mysterious grandeur of all we don’t know.

It’s okay to have doubts.  One of Jesus’ disciples, a guy aptly known as “Doubting Thomas,” had his for sure.  But the opposite of faith isn’t doubt – it is fear.  We’re all on some kind of existential thin ice wondering if and when it’s going to crack and our lives fall apart.  It isn’t odd or strange to feel this way.  It’s part of the human condition. 

Henri Nouwen wrote:

“As we look at the starts and let our minds wander into the many galaxies, we come to feel so small and insignificant that anything we do, say, or think seems completely useless.  But if we look into our souls and let our minds wander into the endless galaxies of our interior lives, we become so tall and significant that everything we do, say, or think appears to be of great importance.”  

We have to keep looking both ways to remain humble and confident, humorous and serious, playful and responsible.  Yes, the human being is very small and very tall.  It is the tension between the two that keeps us spiritually awake.

I think real faith, is humble faith.  To be otherwise is great hubris; a belief in one’s certitude to the exclusion of others.

Sister Joan Chittister writes:

“The opposite of humility is arrogance, something we are all guilty of at one time or another.  Arrogance corrodes our awareness of the power of interdependence and leaves us to die incomplete.  It reduces the creation of others to dust. It makes it impossible for us even to see our own knees.”

Many, many people around the world – good folks – have no one, are alone or are living under very difficult circumstances. They are the poor, both in body, spirit or material goods. A man seeking a donation in Charles Dickens A Christmas Carol, says to the grouchy crank:

“At this festive season of the year, Mr. Scrooge,” said the gentleman, taking up a pen, “it is more than usually desirable that we should make some slight provision for the poor and destitute, who suffer greatly at the present time. … We choose this time, because it is a time, of all others, when Want is keenly felt, and Abundance rejoices.”

We should feel humble before such a reality; cognizant of all the blessings we’ve been given and maybe determined, perhaps for the first time in a while, to share our blessings with others in want as we speed toward the New Year.   

The bible is usually tough for me to read.  I don’t get a lot of the historical facts and how they play into what I am supposed to learn from the teachings. Maybe it’s in admitting that I don’t really know much that I become more open to everything.  The Zen call it “beginner’s mind;” a state where we let go and empty ourselves of ourselves. There is something authentic in our coming to life on our knees rather than our heads that try to figure everything out.  As U2’s Bono wailed, “If you want to kiss the sky you’d better learn how to kneel.”

It’s when I meet real people who have lived these words that I feel a greater sense of the reality of the in the bible – it’s the reality of word made flesh.  That was the whole point about Jesus, wasn’t it? It wasn’t enough for God to send prophets with plumes of grey hair firing out of their heads and scary wooden staffs.  No. God had to crank up the volume loud enough so we could hear. And the message was intimate and personal.  He sent Jesus into our troubled world so “. . . that the people who walked in darkness [could] see a great light.”

In my own brokenness, sometimes I listen too closely to the voice of depression; the sad parrot on my shoulder that tells me I will always feel crummy and never really feel good about myself.  Then I think about that part in the bible where Jesus says to one of his followers, “Who do you say I am?”  The disciple replies that he is the Christ, the savior.  Similarly, I think we can all ask Jesus “Who do you say I am?”  The response is surely not the one depression would con us into believing. It’s a loving and authentic voice, one that says we are cherished and belong.

Jesus’ birth was a humble birth, indeed.  As Thomas Merton once wrote, “There were only a few shepherds at the first Bethlehem. The ox and the donkey understood more of the first Christmas than the high priests in Jerusalem. And it is the same today.”

Sister Joan writes again:

“It is our need for one another that teaches us our need for God.  It is our down-deep incompleteness that cries out all the days of our lives to be complete – by those around us, by God.  We must pray for the humility it takes to find our wholeness in our littleness.”

Beyond the gifts, the feasts and the holly and the ivy, remember to be humble.  It is this humility, this lack of ego that allows us to be part of the healing mysteries at Christmas time.

As for me, I’ll sit around my Yuletide table.  And after the turkey and mashed potatoes, eat some humble pie.

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