Authors: Andrew Solomon
“I think that I repressed a lot of the memory of it. I can’t get at it; it’s impossible to remember because it doesn’t make sense. But I can remember certain parts of the apartment, and how bad I felt there. And I can remember the stage that came next, when I thought about money all the time. I would start to fall asleep and then wake up worried; I couldn’t shake that. It wasn’t very rational—I wasn’t in trouble financially at the time. I’d think, what if I don’t have very much money ten years from now? There’s no relation whatsoever between feelings of fear and anxiety in my normal life and the kind of fear or anxiety I was having at that time. It’s of a completely different quality, not just quantity. Man, those were terrible times. I finally had the good sense to switch doctors. And then I got the Xanax. I’d take a half milligram or so and I felt as if the heel of a giant hand came and settled itself on my hip and the rest of the hand pressed my side, the fingers on my shoulder. That whole hand just pushed me about two inches down into the bed. And then I would finally fall asleep. I was terrified that I’d get addicted, but the doctor assured me that I wouldn’t—I wasn’t taking anywhere near enough for that—and said that even if I did, he would get me off it when I was better able to handle life. So I thought, okay, I’m not going to think about it; I’m just going to do it.
“You don’t think in depression that you’ve put on a grey veil and are seeing the world through the haze of a bad mood. You think that the veil has been taken away, the veil of happiness, and that now you’re seeing truly. You try to pin the truth down and take it apart, and you think that truth is a fixed thing, but the truth is alive and it runs around. You can exorcise the demons of schizophrenics who perceive that there’s something foreign inside them. But it’s much harder with depressed people because we believe we are seeing the truth. But the truth lies. I look at myself and I think, ‘I’m divorced,’ and it seems like that is the most terrible thing. While I could be thinking, ‘I’m divorced!’ and feel great and free about it. Only one remark was really helpful through all of this. A friend said, ‘It won’t always be like this. See if you can just remember that. It’s like this right now, and it won’t always be like this.’ The other thing she said, which also helped, was, ‘That’s the depression talking. It’s talking through you.’ ”
Therapy and medication are the most accessible treatments for depression, but another system has helped many people to cope with their illness,
and that is faith. Human consciousness may be seen bound by the sides of a triangle: the theological, the psychological, and the biological. It is enormously difficult to write about faith because it trades in the unknowable and the indescribable. Further, faith in the modern world tends to be highly personal. Nonetheless, religious belief is one of the primary ways that people accommodate depression. Religion provides answers to unanswerable questions. It cannot usually pull people out of depression; indeed, even the most religious people find that their faith thins or vanishes during the depths of depression. It can, however, defend against the complaint, and it can help people to survive depressive episodes. It gives reasons to live. Much religion allows us to see suffering as laudable. It grants us dignity and purpose in our helplessness. Many of the goals of cognitive and psychoanalytic therapy are accomplished by the systems of belief that underlie the world’s primary religions—the refocusing of energy outside the self, the discovery of self-regard, the patience, the breadth of understanding. Faith is a great gift. It provides many of the advantages of intimacy without being contingent on the whim of a person, though God too is, of course, famous for his whims. There is a divinity that rough-hews our ends, shape them though we will. Hope is a great prophylactic, and faith in its essence offers hope.
You survive depression through a faith in life that is as abstract as any religious belief system. Depression is the most cynical thing in the world, but it is also the origin of a kind of belief. To endure it and emerge as yourself is to find that what you did not have the courage to hope may yet prove true. The discourse of faith, like that of romantic love, has the disadvantage that it carries the potential for disillusionment: depression is for many people an experience of being cast out by God or abandoned by Him, and many who have been depressed say they are unable to believe in a God who inflicts such cruelty so uselessly on the members of His flock. For most of the faithful, however, this rage against God lifts as the depression does. If belief is your norm, you return to it as you do to any other norm. Formal systems of religion lie outside my upbringing and experience, but I find it hard to stave off the sense of intervention that characterizes one’s decline and one’s rise. It is a matter too deeply felt to be a godless act.
Science resists the close study of religion and mental health mostly for methodological reasons. “When you get to things like meditation or prayer, what is the appropriate comparison standard for a double-blind test?” asks Steven Hyman, director of the National Institute of Mental Health. “Praying to the wrong God? It’s the fundamental problem with testing the therapeutic richness of prayer.” The prelate is, in addition to all else, the more acceptable face of the therapist. Indeed, Tristan Rhodes,
a priest I know, said that he had for some years treated a psychotically depressed woman who refused psychotherapy but came to confession every week. She told him her stories; he then shared essential information with a psychiatrist friend; and then he reported back the views shared with him by the psychiatrist. She received in the most explicit terms the psychiatric support of the religious context.
For Maggie Robbins, faith and illness have coincided. She has become a High Church Episcopalian—at times a very devout one. She goes to church constantly: evening prayer most weekdays, sometimes two masses on Sundays (one for Communion and one just to listen), a Bible study class on Mondays, and a variety of parish activities the rest of the time. She is on the editorial board of the parish magazine and has taught Sunday school and painted backdrops for the Christmas pageant. She says, “You know, Fénelon wrote, ‘Depress me or raise me up; I adore all your purposes.’ Quietism may be heresy, but that idea is one of the central tenets of my faith. You don’t have to understand what happens. I used to think that we had to make something of life even though it was meaningless. It is not meaningless. Depression makes you believe certain things: that you are worthless and should be dead. How can one respond to that other than with alternative beliefs?” All this being said, in the worst stages of depression, religion did little to help Maggie Robbins. “As I got better I remembered, ‘Oh, yeah, religion—why didn’t I use that to help me?’ But it couldn’t help me at the low points.” Nothing could.
Evening prayer slows her down and helps to keep the chaos of depression at bay. “It’s such a strong structure,” she says. “You get up and say the same prayers every night. Someone has delineated what you’re going to say to God and other people say it with you. I’m laying down these rituals to contain my experience. The liturgy is like the wooden slats of a box; the texts of the Bible and especially of the Psalter are considered to be an extremely good box for holding experience. Going to church is a set of attentional practices that move you forward spiritually.” In some ways this seems pragmatic: it is not about belief but about scheduling and could be accomplished equally well with an aerobics class. Maggie admits that this is partly true, but denies the break between the spiritual and the utilitarian. “I’m sure one could achieve the same depth with some other religions and with some other things than religion. Christianity is just one model. It’s just a model, and when I discuss my religious experience with my therapist, or my experience of therapy with my spiritual director, those models turn out to be quite similar. My spiritual director recently told me that the Holy Spirit uses my unconscious all the time! In therapy I learn to erect ego boundaries; in church, I learn to drop them and become one with the universe, or at least part of
the body of Christ. I am learning to keep erecting them and dropping them until I can do it like that.” And she snaps her fingers.
“According to Christian doctrine, you’re not allowed to commit suicide because your life is not your own. You are the steward of your life and your body, but they are not yours to destroy. You don’t end up battling everything out inside yourself; you think you’re battling it out with these other characters, with Jesus Christ and God the Father and the Holy Spirit. The Church is an exoskeleton for those whose endoskeleton has been eaten away by mental illness. You pour yourself into it and adapt to its shape. You grow a spine within it. Individualism, this breaking of ourselves away from everything else, has denigrated modern life. The Church says we should act first within our communities, and then as members of the body of Christ, and then as members of the human race. It’s so non-twenty-first-century American, but it’s so important. I take from Einstein the idea that humans are laboring under an ‘optical delusion’ that each of them is separate from the others, and from the rest of the material world, and from the universe—when in fact we are all entirely interconnected parts of the universe. For me, Christianity is the study of what real love, useful love, consists of—and of what constitutes attention. People think that Christianity is against pleasure, as it sometimes is; but it’s very, very pro-joy. You’re aiming for joy that will never go away, no matter what kind of pain you’re in. But of course you still go through the pain. I asked my priest, when I wanted to kill myself, ‘What’s the purpose of this suffering?’ and he said, ‘I hate sentences that have the word
suffering
and the word
purpose
in them. Suffering is just suffering. But I do think that God is with you in this, though I doubt you can sense him at all.’ I asked how I could put something like this in God’s hands, and he said, ‘There’s no “put,” Maggie. That’s just where it is.’ ”
Another friend, the poet Betsy de Lotbinière, has also struggled with faith from within depression, and she used belief as her primary conduit to recovery. In the low part of her depression, she says, “I hate the mistakes of myself, of course, and as I lose tolerance, I lose generosity and hate the world and the mistakes of those around me and end up wanting to scream because there are spills and stains and fallen leaves, parking fines and people who are late or don’t return calls. None of this is good. Pretty soon the children will be crying, and if I ignore that, they’ll end up very quiet and obedient, which is worse because the tears are now inside. Fear is in their eyes and they go silent. I stop hearing their secret hurts that are so easy to right when things are good. I hate myself like that. Depression takes me down and down.”
She was brought up in a Catholic household and married a man of
strong Catholic faith. Though she is not so regular a churchgoer as he, she turned to God and to prayer when she felt her grip on reality slipping, when she saw how her despair was destroying her pleasure in her children, and their pleasure in the world. But she did not stay entirely within Catholicism—in fact, she tried twelve-step programs, Buddhist meditation, firewalking, visiting Hindu temples, studying Kaballah, and pretty much anything else that seemed spiritual. “When you say a prayer at a moment of anxiety, of overstriving, it can be like pushing a button and letting out parachutes to stop you from crashing, full force, into a brick wall, or falling down so hard and so fast that all the bones in your emotional body will crush,” she wrote to me in a rough time of my own. “Prayer can be your brake. Or, if your faith is big enough, prayer can be your accelerator, your amplifier in sending out into the universe a message about the direction you would like to go. Most religions of the world involve a form of stopping and accessing the inner being—so there is kneeling and there are lotus positions and there is lying flat on the floor. They also use movement to dislodge the everyday and reconnect with bigger ideas of Being—so there are music and ritual. You need both things to get out of a depression. People with a degree of faith before they reach the gutting darkness of the Abyss have a route out of there. Finding your balance in the dark is the key. This is where religions can be helpful. Religious leaders have practice in giving people some stability as they tread well-worn paths out of darkness. If you can get the hang of this balance outside you, then maybe you’ll manage to achieve balance within. Then you are free again.”
Most people cannot emerge from really serious depression just by fighting; a really serious depression has to be treated, or it has to pass. But while you are being treated or waiting for it to pass, you have to keep up the fighting. To take medication as part of the battle is to battle fiercely, and to refuse it would be as ludicrously self-destructive as entering a modern war on horseback. It is not weak to take medications; it does not mean that you can’t cope with your personal life; it is courageous. Nor is it weak to seek help from a wise therapist. Faith in God and any form of faith in yourself are great. You must take your therapies, all kinds, with you into the struggle. You cannot wait to be cured. “Labour must be the cure, not sympathy—Labour is the only radical cure for rooted sorrow,” wrote Charlotte Brontë; it is not the
whole
cure, but it is, still, the only one. Happiness itself can be a grand labor.
And yet we all know that labor on its own cannot bring about joy. Charlotte Brontë also wrote, in
Villette,
“No mockery in this world ever sounds to me so hollow as that of being told to
cultivate
happiness. What does such advice mean? Happiness is not a potato, to be planted in mould, and tilled with manure. Happiness is a glory shining far down upon us out of Heaven. She is a divine dew which the soul, on certain of its summer mornings, feels dropping upon it from the amaranth bloom and golden fruitage of Paradise. ‘Cultivate happiness!’ I said briefly to the doctor: ‘do
you
cultivate happiness? How do you manage?’ ” Luck plays a significant role, bringing on us as if by chance those dews of happiness. Some people respond well to one treatment, some to another. Some people remit spontaneously after a brief struggle. Some who do not tolerate medication can in fact achieve much through talking therapies; some who have given over thousands of hours to psychoanalysis get better the minute they take a pill. Some people drag themselves out of one episode with one treatment only to descend into another that requires a different treatment. Some people have refractory depression that never lifts, no matter what they do. Some people have dismaying side effects from every form of treatment, and some people never encounter the slightest trouble from hideous-sounding therapies. There may come a time when we can analyze the brain and all its functions, when we will be able to explain not only the origins of depression but also the reasons for all these differences. I am not holding my breath. For the time being, we must accept that fate has given some of us a strong vulnerability to depression, and that among those who carry such a vulnerability, some have treatment-responsive brains and some have treatment-resistant brains. Those of us who can get substantially better in any way must count ourselves, no matter how dire our breakdowns may have been, among the lucky ones. We must, further, treat those for whom there can be no recovery with forbearance. Resilience is a frequent, but not a universal, gift, and no secret in this book or elsewhere can help the unluckiest ones of all.