The Mind, Heart & Soul of Depression

Do you think you are depressed? If so, reading and completing the written exercises in this journal can help you expand your mind, heal your heart, and reach into the depths of your soul. Depression is a common but serious illness that can become a chronic condition. It’s no secret that, in our stressed society, more and more Americans are living with major depressive disorder (MDD). What is depression? Severe depression can be characterized by intense and prolonged sadness, loss of pleasure and concentration, low energy, feelings of worthlessness, and eating and sleep disturbances. If depression worsens, suicidal ideation or homicidal acts can occur. Who might be depressed? Old men, young women, preschoolers, teens, victims of abuse, military veterans, athletes, truck drivers, and so on. Anyone can suffer from MDD. Depression by the Numbers • Nearly 7 percent of adults (16 million) experience depression, according to a report from the National Alliance on Mental Health. • Women are almost 70 percent more likely than men to experience depression during their lifetimes. • MDD is the leading cause of disability in the US for persons aged 15–44, according to the Center for Disease Control’s report. • Persons aged 19–24 report depressive symptoms more than other age groups. MDD is often misconstrued, minimized, and even mocked by the people the sufferer loves most. To make matters worse, people diagnosed with any mental health disorder often feel a great deal of guilt. It’s a social stigma that I refer to as “hiding under the cloak of shame.” Family members, coworkers, supervisors, friends, and partners often make comments to people suffering from depression, such as, “You’re just depressed,” or “Get over it,” or “Just get out of bed.” They might say, “You’ll feel better if you go to the gym,” or “It’s menopause, and this happens,” or “Go to work and get your mind off it.” xiii Being misunderstood and trivialized can lead one to experience more intense feelings of inadequacy, loneliness, helplessness, and rejection. Then there is the constant challenge of trying to behave normally among others, which can lead us to suffer more internal pain. This quiet suffering can be exhausting and cause deeper emotional wounds that become rooted in our psyches, in our hearts, and even in the depths of our souls. Depression is a lonely disease. At times we isolate ourselves and become socially invisible when we should be reaching out to others who do care about us. In an era where our “friends” on Facebook see where we dine, what we wear, and how we travel, we often confuse the intimacy of sharing our statuses on social media with the authenticity of sharing our real selves with others. Often we look for unhealthy ways to soothe the pain. Mental illness is often disguised by substance addiction, gambling, or domestic violence and may not be acknowledged until it’s too late. The tragic deaths of some celebrities (Philip Seymour Hoffman, Amy Winehouse, Whitney Houston, and her daughter Bobbi Kristina Brown) show that depression doesn’t discriminate. Depression doesn’t care how wealthy, smart, or successful you are. Another reality is that nowadays the doctor-patient relationship is strained. Many primary care physicians and some others in the medical field have preconceived notions, negative biases, and limited understanding of how MDD affects a person’s life. They may identify it only as a physical problem caused by an imbalance of neurotransmitters, although it can be much more than that. In response, they prescribe medicine as a primary treatment and only refer the patient to the mental health community if the patient is deemed “too difficult.” Other doctors appear uninterested in the patient’s problems. Some medical professionals have little time to listen to the patient because of the pressures of insurance company mandates. Furthermore, the range of therapies and the number of sessions that mental health providers can provide are often limited by rules governed by insurance companies. Consequently, many therapists will prematurely conclude their services with patients and refer them back to general practitioners, other psychologists, or psychiatrists for further medical treatment. Complicating matters, there are not enough mental health practitioners available, causing some health care workers to be overburdened and unable to accept new patients who need help. Just imagine how frustrating it can be for a patient who is dealing with constant depression to be stuck in the labyrinth of bureaucracy. These obstacles can make a patient feel dehumanized and even more hopeless. With these roadblocks in our path to authentic mental health, what can we do to help us understand ourselves and gain the clarity to get well?