Depression has been a life-long problem for me. In the 70’s and 80’s there was no Prozac so my mom had to deal with my mood problems without meds. The best advice she had during my down times is something I use to this day. Her standard advice was to “do something nice for someone else”. My mom is a pragmatist, not overly religious or sentimental. She would hug me, kiss me, maybe take me shopping or to lunch and then basically tell me to stop thinking of myself for a few minutes.
As a family physician I firmly believe that it is necessary to treat neurotransmitter imbalances in the brain to help people with depression, anxiety, bipolar, schizophrenia, etc… Often those imbalances need to be righted before any other strategies can be effective.
From my own personal experience and from 16 years experience in Family Practice I also firmly believe that depression has a spiritual aspect that can not be addressed in a 10-15 minute office visit. The main spiritual issue present in depression is that of all-consuming self-obsession. I’ll use myself as an example since that’s the head I live in and know best. Here’s how it goes:
Events in life conspire to overwhelm me – kids, work, marriage, unfulfilled dreams, wrecked plans, bad bangs, etc…I may rage outwardly for a while or argue or try to fix things myself. But when nothing seems to be working and hopelessness creeps in, I withdraw. In withdrawing, I cease conversing with the outside world and begin talking with the committee in my head. At first the committee seems supportive and gives some constructive criticism. But since I (we) are talking in an echo chamber and not sharing the ideas with the real world, destructive criticism soon overtakes the conversations. I begin to listen to their negative assessment of my life, my body, my relationships, my parenting skills, my homemaking skills, my choices, my career, my eyebrows. Sometimes people on the outside reinforce these thoughts with actions, words and attitudes. Over weeks, months and years, those conversations become a continuous loop recording in my brain that I cannot shut off. Further withdrawal occurs, further focus on the self-condemning conversations occurs. Then my social interactions and ability to see reality deteriorate.
That’s where mom’s advice comes in. She would let me stew in self-pity for a day or two to see if it would pass. If it didn’t then she encouraged me (strongly and persistently) to get out of myself and DO something for someone else. Even if, God forbid, I didn’t feel like it! I was not allowed to dwell in my self-obsessing, wishful-thinking, non-reality based brain for too long. DOING had to occur in the real, physical world.
Now it’s important to note that grudgingly folding my husband’s laundry or angrily seeing a patient who came in late for their appointment DO NOT COUNT as self-less acts able to lift me out of my self-preoccupation!!! My motive has to be pure with no expectation of reciprocation. My deed also has to be tangible. I can fold my husband’s laundry because I want to help him out. I can deliver a brownie to my neighbor because she needs cheered up. I can write a letter to my grandmother because she lives alone. Those few minutes OUT of my head are healing. It’s a tough task, especially when the wet blanket of depression is suffocating my initiative. But healing is difficult and painful. Ask any cancer or head-injured patient.
Release from the negative, self-obsessed, isolated and haunting internal prison of depression is ONLY possible by escaping that world. And, unfortunately, the only person who can open the door and walk through is me. A doctor, a counselor, a pastor, a spouse cannot open that door and drag me through it. Well, they can. But without it coming from my own heart, chances are I’m going to punch them, crawl back into my prison and slam the door in their faces.
So today I faithfully take my Prozac and I look for opportunities to bless someone who comes across my path every day. And depression no longer has power over me. Thanks mom!