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.

Why It’s Important to Join a Depression Support Group

“What can I do to help my depression?”

Well, there are many things you go do, really:  therapy, medication, etcetera, etcetera.

But one idea you might not have given much thought to: join a depression support group.  There are many benefits.   I have belonged to one for the past seven years. Here are some of my thoughts about why it’s good for you and how to find one.

Why It’s Good For You

One of the worst aspects of depression is the loneliness that sufferers endure.  There are several reasons why this is so: they don’t feel up to being with other people, others simply don’t understand, or they feel a sense of shame and hide.  While it may be a good idea to take “timeout” from others to enjoy some peace or not share with others that we have strong reason to believe won’t understand, these strategies are often maladaptive and only serve to maintain and/or fuel one’s depression.  Here is a bit of hard-won wisdom I’ve learned:  when I feel the worst is when I most need to be with other people and share.

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Being with others is even more critical when you’re in pain.  You need to communicate your distress and know that your “tribe” will listen and care.  When this doesn’t happen, you feel alone, distressed and even abandoned.  You wander in the wilderness of pain by yourself and endure it as best you can.  But don’t you deserve better than that?

Having a place to admit and share your story

Andrew Solomon, author of the best-selling book The Noonday Demon: An Atlas of Depression, writes:

Depression is a disease of loneliness. Many untreated depressives lack friends because it saps the vitality that friendship requires and immures its victims in an impenetrable sheath, making it hard for them to speak or hear words of comfort. Worldly success does little to assuage that agony, as Robin Williams’ suicide makes clear. Love, both expressed and received, is helpful, not because it  ameliorates the symptoms of depression (it does not), but because it gives people evidence that life may be worth living if they can only get better. It gives them a place to admit to their illness, and admitting it is the first step toward resolving it.

Besides the psychological salve that support can bring to the wounds of your loneliness, there are important physiological reasons for being part of a support group.

Positive experiences can also be used to soothe, balance, and even replace negative ones.  When two things are held in the mind at the same time, they start to connect with each other.  That’s one reason why talking about hard feelings with someone who’s supportive can be so healing: painful feelings and memories get infused with the comfort, encouragement, and closeness you experience with the other person. (Buddha’s Brain: The Practical Neuroscience of Happiness, Love & Wisdom, Rick Hanson, Ph.D. with Richard Mendius, M.D.)

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I’ve talked to hundreds of folks about depression over the years and often found that a good chunk are resistant to joining a support group.  They feel tired and unmotivated to do so or feel hopeless that anything, even this, will help their depression. They have to meet this resistance and push forward because as depression expert Richard O’Connor, Ph.D. once told me, “Depression isn’t your fault.  But it is your responsibility to get better.”  And a support group, together with treatment, is one of the best ways for you to take responsibility for getting and staying better.

Small steps are best.  Before going to a group, get in touch with the contact person for the group and speak with them by phone, or, better yet, meet them for coffee to see if the group would be a good fit for you.

How to Find a Support Group

It isn’t as hard to find a support group as you may think.  Here’s my list:

The Depression & Bipolar Support Alliance

The National Alliance for the Mental Ill

Anxiety and Depression Association of America

Mental Health America

If you are a lawyer, check in with your local and/or state ABA’s Lawyers Assistance Program.

If there isn’t a support group in your community, my next blog will address how to create one.

No Magic Cure-all For Depression

From The Tampa Tribune, psychologist, Ann Rosen Spector, writes, “There is no happy pill. Prozac was never a cure-all.  Way too many doctors, pharmaceutical companies and health-insurance entities would rather you take medicine then go repeatedly to a qualified psychotherapist.  Read the News

The Death of Robin Williams, Depression and Suicide

Our hearts are broken. This funny, kind and gentle man is gone. He, like the 30,000 other souls that commit suicide each year in this country, was struck down by depression.

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Many people find it incomprehensible that someone so talented, beloved, good and wealthy could take his own life. One commenter from Fox, Sheppard Smith, (not surprising, I guess) called him a “coward.” What a cowardly thing to say from a man who has, most likely, never suffered from the grind of depression as Robin did. However, this commenter isn’t alone in his ignorance. One poll found that over forty percent of all Americans viewed depression as “a lack of willpower.”

Rather than cowardly, I believe Robin’s well-documented life-long battle with major depression and addiction was heroic. As someone who had lived in the trenches of major depression over the years and known hundreds of fellow soldiers like Robin, I feel that people who struggle with depression are my heroes.

chris reeveIronically, Christopher Reeve, Robin’s long-time friend who studied acting and roomed with him at Julliard, defined what a hero is:

“I think a hero is an ordinary individual who finds strength to persevere and endure in spite of overwhelming obstacles.”

Given his brilliance, fame and wealth, one could say that Robin was anything but “ordinary.” Yet, he was a flesh-and-blood human being, just like you and I, who suffered tremendously. And he, tragically, decided he just couldn’t take it anymore.

Until he committed suicide, he had somehow found the strength to persevere over the course of his life despite his poor mental health. I’m sure that there was many times that such perseverance involved pushing through the pain of depression on a daily if not moment-to-moment basis. The pain, known all too well by sufferers, must have been so dreadful that he was holding on by his fingertips.

A loss of hope was at the bottom of Robin’s decision to end his life, a loss that no amount of love, support and guidance could assuage.

As Elizabeth Wurtzel wrote in Prozac Nation:

That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end.

Psychiatrist Kay Redfield Jamison, a professor at Georgetown University, herself a sufferer from depression, had this to say about suicide in her seminal book on the subject, Night Falls Fast:

When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.

Rest in Peace, Robin. Thank you for all the gifts you freely gave to the world. Your suffering is over.

 

 

 

 

 

 

 

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