This is an article in my Catholic Healing Series, where I talk about the most prevalent mental health issues of our time, who the best thinkers are, what the theory is, and how to heal the issue. If you enjoy this, feel free to check out other articles or videos!
The Issue
Depression is characterized by persistent feelings of sadness, hopelessness, and loss of interest in pleasure or activities. It can have a significant negative impact on people’s daily life, relationships, and overall well-being. As Catholics, we are called to live with hope and to give hope to others. Depression proves to be an obstacle to this mission of hope, and can have a profound negative impact on people’s ability to achieve life goals.
The Thinker
Dr. Chris Aiken, MD is a psychiatrist and psychotherapist who became a leader in the field after encountering friends who suffered from depression. His personal experience led him on a lifelong journey of helping people with depression and mood disorders to heal. His personality is very telling in terms of understanding what is required to heal from depression and mood disorders. He is very calm and methodical. A lot of what is required to heal these issues involves taking a systematic approach that focuses on what is effective. There needs to be a healthy skepticism of thoughts and emotions in the world of depression and mood. Not all of a person’s thoughts and emotions can be trusted, and in many ways, thoughts and emotions need to be interviewed to see if they are helpful. Aiken favors an approach that is mindful. This approach fosters awareness and also can focus on behavioral activation to help people engage in more effective behaviors—in many ways, less “affective” and more “effective.”
Healing Depression
Disclaimer: these are just some of the tools that can be used to heal Depression. Also, I cannot guarantee healing or benefit. This entire article represents my opinions and applications of the tools, nothing more and nothing less. This article does not constitute medical, mental health, psychological, or other advice.
Determining the Underlying Cause
The underlying cause of depression has a lot to do with what is involved in the healing process. Some people struggle with depression in the wake of trauma. In the event that depression results from trauma, then a trauma healing process needs to occur. To learn more about that, please check out my article on healing trauma.
However, many cases of depression do not result from trauma. Depression often runs in family and is genetic. Having levels of serotonin in the brain that are too low often causes depression. For people in this state, depression can be like a black cloud that comes and goes. Often, it just is there when people wake up in the morning. Some people have episodes of depression that last for two weeks or more and then go away. Some people have much more persistent depression that can remain for years at a time. Regardless of the case, depression is a cross that these people may need to carry and manage throughout their lives.
Wellness
Wellness gets its own section when it comes to depression. Practicing great wellness does amazing things when it comes to overcoming depression! This begins with diet. Of course, if a person has unique dietary needs, that person should consult a nutritionist or dietitian.
In general, the following really help with gut health and in turn predispose a person to overcoming anxiety.
1 spoon of fish oil daily
1 spoon of olive oil daily
Daily Multivitamin
Yogurt, kombucha, kefir, or probiotic supplement daily
At least 4 to 6 portions of fruits and vegetables daily
These supplements promote a healthy gut that generates serotonin. It is likely that the serotonin then goes to the brain and helps to reduce depression. Eating a healthy, balanced diet, and keeping portion sizes at health levels also helps with depression.
In terms of exercise, regular exercise also helps with depression a lot! It releases endorphins, stimulates GABA production (GABA is a neurotransmitter that helps to calm the brain), generates serotonin in the brain, improves sleep, reduces muscle tension, activates the brain, builds resilience, improves concentration, and boosts self-esteem. Integrative exercising is extra helpful, because it aids connectivity in the brain. Examples of integrative exercises are SoulCore and pilates.
In terms of sleep, it helps to reorganize brain connections and restores the prefrontal cortex, which helps with emotional regulation. Also, it lowers cortisol levels, improves cognitive function, and emotional resilience. Sleep helps to ward off sleep deprivation, which drastically increases anxiety. Good sleep tips include to aim for about 8 hours of sleep per night, to be early to bed and early to rise, and to practice good sleep hygiene, which involves staying away from screens and exercise in the evening, using a weighted blanket, and having good lighting for sleep.
Of course, as Catholics, prayer is the most important wellness category of all! If we can trust God and surrender to Him, then we can find peace amidst the storm of depression. Turning to Mary gives us the graces that we need to be successful, because she is full of grace! If an apple a day keeps the doctor away, a Rosary a day keeps the depression (and the devil) away. And even if it doesn’t keep the depression away, it gives a person the graces needed to manage it and endure.
Mindfulness
Mindfulness involves paying attention to the present moment and focuses on accepting how one feels at the time. It begins with a healthy sense of awareness. Toward that end, it can help to track how a person feels multiple times per day and why. It helps to scale from 1 to 10, with 1 being the least depressed and 10 being the most depressed. If a person rates herself or himself quickly about 4 times per day and notes why over the course of several weeks, there is tremendous power in that in terms of awareness. The average of all ratings over that period gives a person a sense of baseline depression. That is, on average, how depressed a person feels every day. Wherever numbers are high, those likely are trigger areas where something triggers depression to be higher. Once awareness occurs, ask these questions. What can a person do to take the baseline depression down by one number? What can be done to reduce depression in trigger moments? Additionally, having a really intentional sense of schedule is really helpful when it comes to mindfulness. Also, needs are very important. What can be done to meet a person’s needs daily? What can be done to meet a person’s needs weekly? Depression can be very needs based. A great example is postpartum depression, which can be heavily influenced by biology and hormones, but also can be very influenced by needs. What can the woman do to meet her needs more? What can the husband do to meet her needs more?
Cognitive Behavioral Therapy
Thoughts have a major impact on people when it comes to depression. Thus, Cognitive Behavioral Therapy, which is very thought focused, can be quite helpful. Common depressed thoughts include “don’t trust” thoughts. I have noted in particular with teenagers with depression that there commonly are thoughts telling the teenager not to trust a parent, especially the mother. For depressed people in general, many negative thoughts are guided by cognitive distortions. Those are ways of thinking that are particularly distorted and unhelpful. For example, a person who catastrophizes takes the first thing that goes wrong and transforms it into the end of the world. Someone who is black and white with thinking can swing from thinking things are all good to all bad very quickly, when the reality is gray and in between. Someone who personalizes takes anything that is bad in a situation and makes it about herself or himself. Knowing the type of cognitive distortion that a person struggles with helps a person know what to challenge and how to challenge it.
What is a person to do about problem thoughts? Saint Ignatius weighs in on that with the discernment of spirits. Each thought brings us closer to peace and Christ or leads farther away. First, identify the thought that a person is having. Then, interview it. Will the thought bring a person closer to peace and Christ or will it lead farther away? If farther away, what is the better thought (alternative consolation) that a person can focus on?
Acceptance Commitment Therapy
Sometimes, thoughts are “sticky.” Sometimes, they refuse to leave. They fuse to the prefrontal cortex, the conscious part of the brain. One of the best ways to address that problem is to be honest with the conscious mind about the thought and feeling that accompanies it that are there. Visualize making space for the depressed feeling in the body. It can be helpful to envision a container in the body where a person places the negative thought and feeling. Then, the person can refocus on positive activities.
Behavioral Activation
In the case of severe depression, sometimes the world of thought and feeling is overwhelming. It is like a black cloud that envelops the person, and no matter what a person consciously does, the thought and depressed feeling remain. Behavioral activation is a powerful tool for these overwhelming situations. Behavioral Activation focuses on breaking cycles of avoidance and isolation by focusing on positive behaviors. I often think of Pavlov’s dog. Pavlov’s dog was shown meat and it salivated. Then, the dog heard a bell ring and was exposed to meat. It still salivated. Then, after repeated rings of the bell and exposure to the meat, the meat was removed. Only a bell was rung, and the dog still salivated. Behavioral Activation empowers a person to treat herself or himself like Pavlov’s dog. She or he is in control and she or he can focus primarily on a system of punishment and reward that changes behavior in positive ways.
First, a person needs to identify why she or he avoids certain interactions and situations. Often, the reason is that it keeps the person safe from uncomfortable situations or other perceived threats. A key realization is that isolating is effective in protecting the self from uncomfortable situations and perceived threats, but isolation itself causes increased depression and anxiety. Thus, the cost of isolation is too high.
Next, a person needs to push herself or himself into uncomfortable situations. It is important to note that, as a person does this, emotion follows action. A person will feel uncomfortable at first and then during an event or activity, the person will feel increasingly comfortable. It is very helpful for a person to utilize positive reinforcement. On days when a person engages in positive, challenging activities that person should offer herself or himself a reward, like reading an enjoyable book. Also, a person can utilize negative reinforcement by identifying and removing aspects of activities that make them uncomfortable.
Medications
The more genetic and the more severe depression is, the more helpful medications can be. To be clear, medications are a valid option to consider for anyone experiencing depression. To discuss medications, it is helpful to discuss them with a psychiatrist. The most commonly prescribed medications for depression are Selective Serotonin Reuptake Inhibitors (SSRIs). As the name indicates, these medicines increase the level of serotonin in the brain. Since depression likely is caused by levels of serotonin being too low, SSRIs can be helpful. Especially in cases of more severe or persistent depression, it is particularly helpful to have the expertise of a good psychiatrist. In such cases, everything from Ketamine to Tricyclics to Monoamine Oxidase Inhibitors can be prescribed.
In terms of what to expect with medications, it is important to note that it usually takes about 4 to 6 weeks for the positive effects of medicine to show. Also, it is important to keep an eye out for bad side effects. They often show soon to the start of taking the medication. If there are bad side effects, discontinue use immediately and return to the psychiatrist. If there are not bad side effects, it often is a good course of action to start at a very low dose and do a follow up with the psychiatrist after 6 weeks to readjust. Another thing to consider is what withdrawal symptoms are like if a person is planning on getting off the medication. Some SSRIs do have bad withdrawal symptoms.
When it comes to medication, I am medication agnostic. I am in favor of it where it helps and I am against it where it does not. I have heard from people that medication has saved their lives. I have heard from people that medication did not have an impact. I have heard from people that medication had side effects that were not tolerable. So, I treat medications as a valid option, and medication certainly is something that I would consider if I had severe and persistent depression.
In terms of finding the right psychiatrist, I think that is a really important piece of things involving medication. I recommend that people approach psychiatrists as customer service providers. A great psychiatrist is collaborative, cares, and accepts input from clients/patients and any family members involved. If a person meets with a psychiatrist and the psychiatrist demonstrates those qualities, it could be a good fit. If a person meets with a psychiatrist and the psychiatrist does not demonstrate those qualities, I recommend trying a different psychiatrist until a fit is established.
Conclusion
What do Abraham Lincoln, Dwayne “The Rock” Johnson, and Vincent Van Gogh all have in common? They all have struggled with depression. People who struggle with depression often have unique, powerful gifts. In managing and overcoming depression, these people are beacons of light to the world. As Catholics, we need to bring the Light of Christ to anyone who is struggling with despair when it comes to the darkness of depression.
Healthline has good resources for overcoming depression:
https://www.healthline.com/health/depression/how-to-fight-depression
Looking for assistance in managing and overcoming depression? Reach out to the Catholic Healing Institute and Tom Weishaar for therapy from a Certified Mood Disorder Professional
www.catholichealinginstitute.com
Tom Weishaar, MA LPCC CCTP-II CMDP is the President and CEO of the Catholic Healing Institute. He lives in Steubenville, OH with his wife and three children.