by Jayson M. Brunelle, M.Ed., CAGS

Clinical depression is a very serious, potentially life-threatening medical problem that afflicts persons from all walks of life.  Few people realize just how debilitating this particular mental illness is.  In order to provide some idea of how crippling depression can be, I will cite the symptoms as they are listed in the DSM IV TR (Diagnostic and Statistical Manuel of Mental disorders).  In short, the criterion for a diagnosis of Major Depressive Disorder is, essentially, the presence of a single Major Depressive Episode.  This involves the manifestation of five or more symptoms that “have been present during the same 2-week period and represent a change from previous functioning:  at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.”

There are nine distinct criteria used to make a diagnosis of a Major Depressive Episode.  They include:  “(1) depressed mood most of the day, nearly every day, as indicated by either subjective report or observations made by others; (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day; (3) significant weight loss or weight gain; (4) insomnia or hypersomnia nearly every day; (5) psychomotor agitation or retardation nearly every day (feelings of restlessness or being slowed down); (6) fatigue or loss of energy nearly every day; (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day; (8) diminished ability to think or concentrate, or indecisiveness, nearly every day; (9) recurrent thoughts of death (not just fear of dying), recurring suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.”

As a mental health clinician, I have worked with a number of individuals who are afflicted with this potentially lethal disease.  I think the most important thing I have learned is that one of the worst things that can be said to a victim of depression is, “snap out of it.”  This unsolicited advice springs from both a fundamental ignorance of the disease coupled with the faulty notion that the victim is simply “feeling sorry for himself.”  I submit that from time to time, we all “get the blues” and experience “feeling sorry for ourselves,” but this is not what clinical depression is.  Rather, depression is a complicated disease of the brain, thought to result from a complex chemical imbalance (specifically, the depletion of serotonin, norepinephrine and dopamine, essential neurotransmitters that contribute to an individual’s overall sense of wellbeing).  Popular anti-depressant drugs such as Prozac, Paxil and Zoloft are related to each other in that they are all either SSRI’s (selective serotonin re-uptake inhibitors) or SNRI’s (serotonin and norepinephrine re-uptake inhibitors).  Essentially, these drugs work by preventing the re-uptake of excess serotonin and/or norepinephrine into the original neuron from which it was released, thereby allowing these neurotransmitters to remain active in the synaptic cleft (the space between two neurons).  This pharmaceutical treatment, based on what is referred to as the “biological-amine hypothesis” of depression, has been shown in myriad studies to work quite effectively amongst certain populations, especially when coupled with weekly talk-therapy with a mental health professional who employs a strategic and eclectic approach to the treatment of depression.

Often, Cognitive Behavior Therapy, a psychotherapeutic technique whereby the therapist helps the client to replace irrational, negative, defeatist and overly pessimistic self-statements with more rational, positive, life-affirming and more hopeful and optimistic self-statements, has proven to be very effective in the treatment of depressive and anxiety disorders.  It seems to be characteristic of persons suffering with depression to think of life, themselves and others in an “all or nothing,” “black or white” fashion.  For instance, such persons make blanket self-statements such as “I’m a loser,” or “I’m no good at anything.”  Objectively speaking, such statements are, in fact, irrational.  The therapist may counter such a self-defeating self-statement with the question, “Is it really true that you have never once been successful at anything?”  The goal, then, is to try to help the client identify the irrational, overly negative and self-defeating “tapes” which one plays over and over again in one’s mind, correct such faulty and irrational thinking, and then replace it with rational, self-affirming self-talk.

To further illustrate this point, depressed clients often tend to minimize their own accomplishments and achievements while overestimating or magnifying other person’s achievements and accomplishments.  Again, the therapist can help to identify the irrational nature of such thinking and help the client to develop a list of rational, positive and life-affirming statements that can be repeated to one’s self.  The psychological term for this process of replacing negative and irrational self-talk with positive and rational self-talk is called “Cognitive Restructuring.”

Moreover, throughout the therapeutic process, it is essential that the therapist and the client build rapport, mutual trust and a reciprocity of respect.  Thus, it is imperative that the client feel that he/she is prized, respected and unconditionally accepted.  Without a foundation of mutual trust and respect, it is highly unlikely that talk-therapy will lead the client into a state of wellness and ego-syntonia, regardless of the psychotherapeutic intervention employed.

As a Christian counselor, I consider it a privilege and an obligation to both assist individuals as they attempt to deal with the tremendous anguish of this malady and to educate the general population about how profound and disabling this condition is.  It saddens me that more hasn’t been done to raise awareness of this malady in particular, and of mental illness in general.  Society tends to promote awareness of many illnesses, but it seems to this author that collectively, we have done a relatively poor job of raising awareness about mental illness, and this, I believe, is likely a consequence of the stigma and misunderstanding surrounding mental illness, lethal as it can be.  Thus, I encourage all who read this post to do whatever the Holy Spirit may be prompting you to do to work toward raising awareness of this ubiquitous social problem.

From a Christian perspective, you who struggle with this profound illness should realize that Christ has specifically chosen you to participate in a wholly singular and unique fashion in His ongoing work of redemption.  It is not by chance that you have been chosen to participate in the mysteries of Christ’s agony in the garden and His crowning with thorns.  You have been chosen to suffer a martyrdom of the heart and soul for the glory of God and the salvation of souls that few others could endure.  Your vocation is sublime, for God would not have chosen you for this exalted mission if he knew you would not have been capable of enduring it through Him, with Him and in Him, in the Immaculate Heart of your Mother Mary.  You may be called to wear Christ’s crown of thorns while on earth, but you can be certain that if you patiently offer your many sufferings and humiliations on the altar of Mary’s Immaculate Heart through, with and in Christ, for the greater glory of the Eternal Father and for the salvation of souls, that painful crown of thorns will one day be transformed into an eternal crown of glory, and you shall rejoice for all eternity in a special place chosen for you in the glory of paradise with all those souls who have merited eternal life through your selfless life-offering.

I encourage all who have been chosen by Our Lord to endure this martyrdom of the heart that is mental illness to officially unite your sufferings with those of Our Lord and Our Lady by making the “Life Offering” that is located on this site.  For, your suffering and mental anguish, united with Christ’s, can truly save countless souls.  Simply click here to be taken to the “Life Offering.”

Prayer Against Depression: St. Ignatius of Loyola