Courtney McGrailThe Catholic Guide to Depression
by Aaron Kheriaty MD, with Fr John Cihak
(Sophia Institute Press, £12.94 print, £7.46 e-book)
Donal Anthony Foley
The Catholic Guide to Depression is divided into two parts. The first is entitled ‘Understanding Depression’, and comprises four chapters covering the types of depression and their causes, how it affects the spiritual life, related disorders, and how it relates to suicide.
The second part, entitled ‘Overcoming Depression’, deals with ways of treating depression, including medication and psychotherapy, with two final chapters looking at spiritual help for depression, and an overview on our status as sons and daughters of God, and the virtue of hope.
Dr Kheriaty begins by acknowledging the complex nature of depression, and makes clear that he is not essentially dealing with minor mood swings in this book, but rather with full-blown depression.
As to its causes, these are complex, and he says that a combination of ‘nature’ – how we are made up genetically—and ‘nurture’, that is, our life experiences, can contribute to causing depression. So depression can run in families, and it is also true, as the author states, that “insecure attachment relationships early in life tend to lead to depression later in life,” and that this type of depression is best treated by psychotherapy.
He is careful to point out that feelings of guilt can be expected if we do something morally wrong, and are actually psychologically healthy; the remedy is confession and absolution. But there is also pathological guilt which does need to be treated medically.
Depression is a form of suffering, and the author believes that Christianity, and specifically Catholicism, provides the best answers to the problem of suffering, but he also says that belief does not of itself immunise a person against depression or mental illness.
While we should understand that, “all forms of suffering, including mental infirmities such as depression, trace their ultimate origin to the Fall,” the author also maintains that belief in Christ redeems depression, and that instead of indicating separation from God, “suffering can became a vehicle by which one is brought into deep intimacy with him”. So the person suffering from depression does not have to give in to despair.
Critical
Dr Kheriaty is strongly critical of the psychiatric systems erected by Freud and Jung, seeing them as subversive of religion, and likewise he is critical of the behaviourism of B.F. Skinner. He particularly criticises Freud’s view that “religious belief itself is intrinsically neurotic,” and in fact states that Freudian psychoanalysis is, as a form of therapy, “largely passé”.
He is, however, supportive of the work of Ashley Beck, the psychologist who developed cognitive therapy, a system which seeks to help depressed people by correcting faulty and negative patterns of thinking. Speaking of it he says: “The idea is that if we can bring our habitual thoughts more in line with objective reality, our moods will then follow.”
It appears that cognitive therapy is good for treating mild to moderate depression, and in addition, good diet, exercise, and adequate sleep can all help to prevent or diminish the effects of depression.
While medication is also part of the answer to depression, it is not usually the whole answer, especially as it often takes time to become effective, and we should also understand that no medication – or therapy for that matter – can make us completely at ease in the world, since this world is not our ultimate home.
The book has a particularly revealing section on suicide. Dr Kheriaty discusses the phenomenon of people jumping off the Golden Gate bridge in San Francisco, of which very few survived. But those who did survive were interviewed, and all of them said that they regretted jumping, since during the four seconds it took to hit the water, they realised that all their problems were actually capable of solution.
There is also the impact on relatives and friends left behind by a person who has committed suicide. This can be absolutely devastating, and in his experience, “suicide is not something that family members and close friends eventually ‘get over’ in the same way that people can grieve over other forms of death and loss”.
The author cites new research into forgiveness therapy, which seems to show that many of the unhealed emotional wounds and conflicts which drive depression can be most effectively addressed through facilitating the process of forgiveness. That is, unresolved anger, bitterness or resentment can often lead to depression. As he says, it isn’t true that time, of itself, heals all wounds, and so a process of healing is necessary.
Dr Kheriaty sees one of our most important spiritual tasks as accepting the family, friends, job, and so on, wherein God has placed us – which he has done with good reason – rather than becoming unsettled and seeking pastures new unnecessarily, or continuing to have unrealistic expectations about life.
Similarly, becoming a workaholic invites depression, and we should rather strive to live a balanced life with proper rest and recreation, and adequate time for prayer.
On the other hand, it is important, too, to have meaningful work, and the author stresses the value of doing charitable works as an antidote to depression.
He particularly counsels mental prayer or meditation, especially “imaginative” meditation which utilises the emotions, as being a very effective form of prayer. Apart from the importance of spiritual reading, confession and spiritual direction, the author is insistent about the crucial nature of Mass as the centre of our spiritual lives.
It should be understood, though, that The Catholic Guide to Depression is for educational purposes only, and is not a self-help manual, nor a substitute for professional care. But having said that, since very many people do suffer from depression, it will undoubtedly be of great help to anyone so afflicted in understanding what they are going through, and also as regards seeking help.
Donal Anthony Foley is the author of a number of books on Marian apparitions, and maintains a related web site at www.theotokos.org.uk