What is depression?

Like many people around the world, the news of the death of award-winning actor and comedian Robin Williams shocked and surprised me. His public persona always shone with humor and laughter. When his family reported that he battled with depression, I understood his actions. I have difficulty connecting that wild, manic, over-the-top love of comedy with extreme sadness. Yet I also know how debilitating and paralyzing depression can be.

Depression is a medical illness that affects one’s emotions, thoughts, and actions. You do not feel like yourself, think like you usually do, or act like others who know you well would expect. You feel altered, like you are someone else. Approximately one in ten adults are affected by depression each year. Statistics show twice as many women as men are affected. Depression does not discriminate against age or race. On average, the illness first appears during a person’s late teens to mid-20s.

According to the American Psychiatric Association, the most common symptom of depression is “a deep feeling of sadness or a marked loss of interest or pleasure in activities. Other symptoms include:

• Changes in appetite that result in weight losses or gains unrelated to dieting
• Insomnia or oversleeping
• Loss of energy or increased fatigue
• Restlessness or irritability
• Feelings of worthlessness or inappropriate guilt
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide or attempts at suicide”

Since depression is an illness, it must be diagnosed by a physician or psychiatrist following a thorough evaluation. Those who are concerned for themselves or someone they love should contact a physician.

More than sadness

Each of us experiences loss during our lives: the loss of a job, the death of a loved one, or the end of a relationship. Grief and sadness are normal in those stressful times. The differences between sadness and depression are length of time and severity. Sadness will lessen over time, while depression will continue for months or even years. The illness can be a life-long condition that swings between times of wellness and episodes of depression.

People living with depression report “marked differences between normal sadness and the disabling weight” of depression. The key word is disabling. Depression marks a sense of hopelessness, helplessness, and paralysis. The way forward seems impossible to navigate.

According to the American Psychiatric Association, there are several factors that “can play a role in the onset of depression.” First, chemical levels in the brain may create symptoms of “anxiety, irritability and fatigue.” A second factor is genetics, since depression is known to run in families. Third, personality may make someone vulnerable to depression. Specifically, low self-esteem, feeling overwhelmed by stress, and general pessimism can create vulnerability. Finally, environment can contribute to depression, including “violence, neglect, abuse or poverty.”

Medical treatment

Thankfully, depression can be treated. For some people, depression can be controlled or greatly diminished with diet and exercise. Even regular rest, relaxation, and vacations can help. However, for many people, lifestyle changes simply are not enough to treat this medical illness. After a thorough evaluation, a doctor may recommend medication, psychotherapy or “ talk therapy, ” other medical interventions, or a combination of treatments.

The majority of people diagnosed with depression who seek treatment will overcome it. Yet according to the National Alliance on Mental Illness, only half of adults in the United States affected by depression will receive treatment.

Depression’s effect on others

Since depression affects emotions, thoughts, and actions, it also affects the relationships in our lives. Therefore, the people in our lives are impacted by depression, including family members, friends, and coworkers. Loved ones of a depressed person may feel frustrated, helpless, fearful, and guilty. Depression has no quick fix. Medications and therapy can take weeks or months to demonstrate any outward signs of effectiveness. For some, depression lasts for years, adding to the frustration of the patient and loved ones. Guilt comes in a variety of forms. Spouses or parents may blame themselves for their family member’s depression.

Loved ones may feel guilty for feeling happy or content rather than depressed like their family member. Loved ones may also feel fearful if suicide becomes a real possibility. Those who live with someone struggling with depression are at a greater risk of becoming depressed themselves.

For many people, the first instinct is to avoid someone who is suffering from depression. However, having a support network of loved ones can help a person cope with the symptoms of depression. If you know someone who is living with depression, consider these tips for helping him or her cope. First, get the facts on depression. Educate yourself on the symptoms, causes, and treatments. Second, ask your loved one what he or she needs from you. Encourage open and honest conversations. Offer to help with everyday, practical things that may overwhelm the patient. Third, understand that you cannot be the only person helping your loved one. It is not healthy for you or the person who is depressed. Solicit assistance from a close circle of family and friends. Be sure that your loved one is seen by a physician or psychiatrist. Finally, take care of yourself and know your limits. You cannot do everything for the person, nor should you. The best gift caregivers can give is to take care of themselves.

The stigma of depression

Depression is a mental and medical illness. However, many people believe depression is a sign of personal weakness. A stigma exists around those diagnosed with depression, as with other mental illnesses. Some people believe depressed people need to just “snap out of it.” Others believe circumstances could not be that bad for the person. For example, two people coping with the same loss react in two different ways. One may become depressed while another moves on easier or quicker. Some Christians believe that depression is a sin, since it negates trust in God’s providence. Many people believe that antidepressants are overprescribed, lending credence to the idea that depression is not a real illness.

This stigma likely explains why some people do not seek medical assistance for coping with depression. The first step in overcoming the stigma is to educate ourselves and others about the facts of mental illness. The second step is to speak up in solidarity with those living with depression and their loved ones. Many people with depression hide their illness out of fear. When they cannot speak up for themselves, others must. When someone with depression bravely speaks up, we should offer that person love and gratitude.

What faith communities can do

Faith communities recognize that people living with depression and their loved ones need support. People with depression need many things, including listening ears, help with simple tasks, and intercessory prayer. For many, the greatest need is reassurance of God’s love, mercy, and grace for them. They need to know we love them and have not forgotten about them. Their loved ones also need support groups, assistance with simple tasks, and prayer. Some people do not seek medical treatment due to financial expenses. Explore whether your faith community might partner with a local clinic to help provide monetary needs for medications and therapy.

In 1992, The United Methodist Church adopted the Caring Communities ministries, a program connecting congregations and persons with mental illness in covenant relationships. Caring Communities engage in education about and advocacy for issues related to mental illness. These faith communities intentionally welcome persons with mental illness and their families into the life of the congregation. These churches also “think through and implement the best ways to be supportive” of mentally ill persons, their families, and caregivers. Consider whether your faith community may choose to be a Caring Community.

Congregations need to be aware that pastors suffer from depression at higher rates than national averages. In a recent study, 28 percent of surveyed pastors reported symptoms of depression, compared to 12 percent of the control group. Also, six percent of the pastors surveyed were diagnosed with depression, compared to three percent of the control group. In the same way that faith communities may reach out to members with depression, congregations can support their pastors in ways to combat depression and actions to reduce stress and anxiety.

Depression is a common medical illness marked by debilitating and paralyzing sadness. It affects the people surrounding the patient, too. Thankfully, depression can be treated with lifestyle changes, medication, and talk therapy, among other medical interventions. More likely than not, your faith community includes people who are living with depression and their families. As messengers of God’s love and grace through Jesus Christ, we are called to offer support to all those struggling with mental illness.

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