Depression and Spiritual Growth

A. THERAPY

1. Medication and Psychotherapy

To provide background, I must say a few words about the medical treatment of depression and mania, and the choice between medication and psychotherapy as modes of treatment. By ``psychotherapy'' I mean only the modern (post-Freudian) approaches. In my view this is not an either-or situation. The two approaches to therapy have complementary strengths and functions. My experience is that both play an essential role in helping the victim of depression, or a manic state, back to a more normal condition. When either the depression or mania is extreme, there is clear indication of abnormal brain function, which is best dealt with by medication. But once the main force of the physical illness is broken, there is a wonderful opportunity to gain insight from psychotherapy. Opportunities to better understand oneself: ones needs, goals, desires, limits, hopes, strengths, and weaknesses; how ones long-term behavior patterns may have been structured by the illness; and how one may develop new and more successful patterns for the future. In fact, one can be open to spiritual insight and growth even before medication begins to take effect. It is in this process that the most profound changes in ones internal ``landscape'' can occur. I will return to these matters at greater length below.

The most common metaphor used by people who have CMI (Chronic Mental Illness) to describe an especially severe episode of depression or mania is ``a crash''. It is apt because it feels right: ``going down in flames'', ``crumpled wreck on the ground'', and so on. Perhaps it also hints at the magnitude of the task at hand if one is ever to ``fly'' again. My experience, and what I have learned from other people with CMI, is that one never really recovers. This is actually a positive remark, because ``recovery'' means literally a return to the original state before illness, and there probably were serious problems with that state already. Recovery is also the wrong metaphor because: 1) These illnesses are not cured, but are brought under control, put in remission. (For a very strong remission, such as mine, the difference is invisible and unimportant to the outside world; but it is very important to me because I need to manage my affairs rather differently in remission if I am to remain well.) 2) Rather, what one does is ``put out the flames'', reconstruct what one can using parts from the ``wreckage'', and then use new parts crafted in the processes of psychotherapy, healing, and spiritual growth, to rebuild further. Thus one has the opportunity to end up in a better state than one started!

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In a sense one dies and is reborn; you are not the same person afterward. Whether you like the new person better or worse than before depends on how much relief you get from the ravages of the illness (with medication), and how successful you are in making a new ``you'' in the rebirth experience.

I wish also to mention that there are alternative approaches to therapy. I believe that they work best in addition to the standard methods described above, rather than as a substitute. One is meditation. In rebuilding from my 1986 depression, I learned a powerful meditation technique from the discipline of Neuro-Linguistic Programming, which I found eliminated paralyzing attacks of intense anxiety (panic attacks) for me, and allowed me to discard the tranquilizer I had been prescribed. When I described the process to my doctor, she was quite emphatic: ``If it works, use it! You don't need to know why it works.'' I also discovered that meditation provided a channel for me to feed back, into my subconscious, acknowledgments of messages received from it, and also updates on the current state of the ``outside world'', i.e. the state of my conscious world. I could, in effect ``tell it'' that ``The crisis is over. Things are different now, and going quite well. You can cancel the state of high alert you have been in.'' Again, I have no idea how this process works; but it worked very well indeed during a year of very effective psychotherapy, which included interpreting deep and powerful images offered up by my subconscious in response to the structural changes we were making in my conscious belief system, and my emotional posture. Today I look back at that time, often fraught with difficulty and discouragement, as one of the richest and most rewarding times of my life. Similarly, after my excursion into serious mania in 1996, and the rebuilding needed after my mania-induced auto accident in 1997, I found it essential to have specific personal guidance, and a strong support group. Owing to the limited resources available in Champaign-Urbana, where I lived at the time, I had to join an Alanon group, which, despite the fact that neither I nor anyone close to me has a problem with alcohol, provided a group of sensitive people dealing with many of the same issues I was. I was also extremely fortunate to meet a wise and experienced colleague with whom I met weekly for discussions which were far more effective for me than any professional psychotherapy had ever been. The point is: the resources are out there. Use them!

Yet another alternative is to draw upon the riches of religious experience. Quakerism, being based on direct experiential knowledge, both of our own spirituality and of God, is an excellent example. We shall discuss this powerful approach in sections C and D below. Another religion that leaps to mind here is Buddhism. Their central idea of leading life, at all levels, in a meditative state of uncritical acceptance of what is, and their disciplines of mindfulness (i.e. deep awareness of our connectedness to the entire, incredible, Universe), and detachment (i.e. the ability to distance ourselves from an ephemeral external reality, and separate our needs from mere wants or desire), are also extremely effective in bringing about the kinds of inner changes that can facilitate growth for a new life in the rebuilding/restructuring process. For people with a Judaic or more conventional Christian background, there are the tremendously powerful, rich, and majestic resources of the Bible. For example, one need only read the first three verses of Isaiah 43, where God makes a promise of lasting guardianship of each us:

But now thus says the Lord,
he who created you, O Jacob,
he who formed you, O Israel:
``Fear not, for I have redeemed you;
I have called you by name, you are mine.
When you pass through the waters,
I will be with you;
and through the rivers,
they shall not overwhelm you;
and when you walk through the fire
you shall not be burned,
and the flame shall not consume you.
For I am the Lord your God,
the Holy One of Israel, your Savior.

to be comforted in a way that can open one to life with a totally new perspective.

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