Depression is a common experience. Statistics will confirm that. Dealing with it personally and/or as an elder is also normal. But common and normal does not make it easy. Depression remains complex and resistant to easy fixes.
What we need to know about depression
I am not a medical professional or counselor. I have learned a thing or two along the way. Here are a few of learnings I believe are helpful:
1. The biology of depression is complex. The relationship of biochemistry to brain patterning to neurology is only beginning to be understood. ( This was re-affirmed to me when I read What the Body Remembers) Add to this genetics and we get a complex set of relationships not easily understood. Because of the complexity, we constantly hear of many possible remedies: pills, vitamins, exercise, sun, fish oil (the latest report in the newspaper) and many other therapies seem to help some people some of the time. But depression is not easily remedied. We need to accept that the complexities leave many mysteries that defy satisfying explanations.
2. With depression, patterns of thought and behavior can be linked to the experience of depression. This is why cognitive- behavioral therapy can help. Re-ordering our thoughts and patterns of behavior can often provide some relief, but the process is not easy especially when depression undermines the brains processing capacities.
3. A person’s context plays a role (including experiences, environment, support community) in the depression. Experiences can trigger, create pre-dispositions, or mitigate. The support community can lift a person in depression or make the depression more difficult.
4. Clinical depression is usually diagnosed by recognizing the intensity and duration of symptoms. Everyone feels down sometime. But the feelings that qualify for clinical depression are more intense than what is reasonably expected and last longer than we anticipate.
In the end we need to recognize that depression is resistant to easy explanations. Many times the very practices that normally worked to overcome the moments of feeling down, no longer work. The person’s capacity is more limited.
Mystery is not Hopeless
There is much mystery is depression. But just because it is poorly understood does not mean it is hopeless. Parker Palmer writes:
…depression [and anxiety] demands that we reject simplistic answers, both "religious" and "scientific," and learn to embrace mystery, something our culture resists. Mystery surrounds every deep experience of the human heart; the deeper we go into the heart's darkness or its light, the closer we get to the ultimate mystery of God. But our culture wants to turn mysteries into puzzles to be explained or puzzles to be solved, because maintaining the illusion that we can "straighten things out" makes us feel powerful. Yet mysteries never yield to solutions or fixes- and when we pretend that they do, life becomes not only more banal but also more hopeless, because the fixes never work. Palmer, P. Let Your Life Speak: Listening for the Voice of Vocation. San Francisco: Jossey-Bass, 2000, 60.
Depression is not simply something to be fixed. It is part of our humanness – the way in which we in our wholeness respond to the experiences of life. I like the suggestion that in depression we enter into some of the deep things of life. In the end no one is left the same. The hope is that in this experience we may see more clearly and love more deeply. This begins with accepting our humanness – even the humanness we wish would go away in the depth of depression.
It is a mystery how the reshaping of our lives happens. Trying to fix things or make them go away seldom works. But perhaps if we are willing for a moment to see the possibility of new life after the days of hardship, perhaps if we are willing to imagine that even this darkness is not too dark for God, perhaps if we can visualize that Christ can take this misery and redeem, then through all the darkness of depression there remains hope for renewal.
Role of a Community to Support Capacity
Many times support communities work amazingly well. They provide what a person cannot provide on their own. They may get tired (caregiver fatigue), but usually most everyone recognizes the need and when we put our efforts to it, the support is wonderful. If someone has cancer, people will take time off to drive to the clinic, provide meals, or care for children. Afterwards I hear wonderful testimonies of support.
Depression is different. The person does not appear physically incapacitated. At first, people expect the depression to be “like theirs” – which means “I forced myself to do things and after a while it got better, you can too” (a form of denial). Depression is confusing so support can come slowly and after while fade away.
Support is necessary when a person lacks a capacity. This definition is very broad. Intentionally so. Such a definition makes it clear that all of us in some way need the support of others. The problem usually comes in two ways: First, we are unaware that someone lacks a capacity and second, we do not believe that the person lacks a capacity. In depression often both problems are evident. We don’t know where the need is and we make a judgment that the person is not so incapacitated as to need our help.
It is important to recognize that in depression, certain capacities are diminished. Many have a hard time processing information. They feel overloaded. Many have difficulty remembering. Many struggle with getting out of bed and getting motivated to do what they know to be good (for example, proper nutrition and exercise). Hope is hard to come by. And in the depth of trouble, they can no longer remember they are loved and appreciated. These are diminished capacities or indications of them.
Support communities do what a person cannot do on their own.
- When a person has a hard time with hope, our words can confess hope for them.
- When a person has a hard time with being loved, we can reaffirm love.
- When a person has a hard time getting up in the morning, we can arrange to join them for morning coffee.
- When a person has a hard time exercising we can choose to join them.
- When a person has a hard time eating right, we can provide nutritious meals.
- When a person has a hard time praying, we pray for them.
- When a person has a hard time with self-worth, we give them something worthwhile to do.
In other words, support stands in the gap. Support is a ministry of being alongside a person without trying to fix the problem. This is not a problem for fixing; it is a situation in which we live alongside a sufferer. We give them space and support at the same time.
How can elders help?
Elders can play a significant role in the support of persons with depression. Here are a few suggestions:
Resist judgment. Depression has many moments when our first response is “why doesn’t he/ she just get up and do something.” It is better to listen than judge. At times we need to just be with a person and be prepared for the silence. Friendship can go a long way in helping a person find his or her way through the dark times. Non-judgmental listening is a central part of this way together.
Support qualified counselors and doctors. Because both medical therapy and cognitive/ behavioral therapy can help, supporting such therapies is important. These are not the only things necessary, but they do help in times of deep depression.
Encourage the community to be alongside. Providing support (where capacity seems to be lacking) requires many people. Providing meals, exercising together, helping with work around the home, and many other activities are an important part of our life together.
Support caregivers. Caregivers are often more burdened than first appears. Find out what they need and support them. Listen to them unburden themselves.
Allow the psalms to speak. For instance, Psalm 42 speaks out of the depth of darkness. Such psalms give suffers of depression permission and language to speak of their suffering before God.
Speak words of hope and affirming God’s love. Many depressed persons wonder about being loved. Many are on the edge of giving up hope. The words of love and hope that come from elders can help. The words are powerful reminders when it is easy to forget.
Speak words that celebrate the strength of a depressed person. When it takes enormous energy to get out of bed, it takes strength to engage with others and do ordinary activities. Recognize that fighting the illness is a constant battle. It takes strength… when you see it celebrate it.
Pray. Depression is filled with mystery we cannot control. But we know a God who providentially cares for all – in good times and bad. His love does not fail.
For the elder: The Compassionate Congregation.