Tag Archives: depression

The real cost of idleness

In mid-March when there was rampant talk of how a national home lockdown would protect the populace from unrestrained spread of COVID, we wondered. Then came stunning announcements that churches would close indefinitely – with no gatherings, no public Masses, no sacraments – and it gave deeper cause for alarm. Daily TV and radio public service jingles rang like grating propaganda … “stay home, wash your hands, we’re all in this together.” It seemed worse than Orwellian. But ol’ George got it right with his dystopian prophecy.

Christine Valentine-Owsik

With months of many not going to work, to school, to play sports, to socialize, to visit family, to beaches or parks, or even to church, the fuse began to burn.

Nightly TV updates on the virus ‘progress’ were further anxiety causing, with constantly escalating tabulations flickering in the screen-corner, coupled with reports of economic plunge and depression rise.

What was worse than the avalanching job losses, closed schools, empty commercial districts, and traffic-less streets was the hidden idleness of so many youth. It made no front-page news, there were no photos, video clips, or interviews.

But idleness is like a geyser. Eventually it explodes.

Then we saw it. The perfect storm gave rise to tidal waves of riots – surges incited by the Minneapolis police brutality. ‘Peaceful protestors’ – bored kids, really – everywhere morphed into violent terrorizers, together for hours each night carousing for their cause, with a new night-out agenda after usual routines were yanked.

A parallel problem with youth idleness has been the lack of a civil moral code. The godlessness of the ‘nones’ birthed a moral anarchy – they flaunted causes like creeds to be imposed on all. The dearth of Godly confidence in their lives instead got usurped with flash-mob mania. Those authorities enabling horrific criminality only made it worse.

This is why the Catholic Church needs to remain continually present to all – health scare or not – so the faithful can spiritually recharge to shine as exemplars of the order of Christ, and others can come back, or for the first time. Lonely, under-fathered, unaffirmed kids need friendship, mentoring, and help from those who can offer hope. Elderly who are isolated need companionship, reassurance of God’s will for their lives, and practical assistance. The unemployed need immediate shoring up – financially, socially and spiritually – so they won’t default to withdrawal, abuse, despair, or suicide.

Kids thrown off normal routines need new ones – exhausting ones – in their place: rigorous coursework, manual labor, and tiring jobs – with an enforced discipline code. Parents with odd jobs that need doing can commission them to bored kids, even if they must first teach them the arduous process.

Busy, productive people are typically happy, fulfilled people willing to remain accountable for their lot. It’s not rocket science, just the nature of healthy soul and psyche. Finally, when we encounter someone reeling from raw disappointment and hardship, it’s the time to reacquaint him with the fatherly surety of Christ – our enduring Friend who extends His help, protection, and calming rightorder … simply for the asking.

CHRISTINE VALENTINE-OWSIK is Legatus magazine’s editor.

Grappling with depression and anxiety

Depression affects more than 264 million people globally and is a leading cause of disability, says the World Health Organization. Although a 2013 Johns Hopkins Bloomberg School of Public Health study suggested that depression is overdiagnosed and overtreated in the United States, most health professionals today say it is highly underdiagnosed and undertreated. Without professional intervention, depression can have a significant negative impact on a person’s social, physical, and mental well-being, and places an enormous burden on society.

There are multiple reasons for this. Depression is often dismissed as ordinary sadness or mood fluctuation. Anxiety is mistaken for everyday spikes of stress or worry. Intensity and duration transform both conditions into serious health issues. Yet because mental disorders carry a stigma, sufferers delay seeking professional help and instead attempt self-help or self-medication.

The stakes are high. Besides lost work and productivity, severe depression and anxiety disorders often trigger substance abuse. They also are a known risk factor for suicide. In the United States, where some 48,000 suicides occur annually, an estimated 60 percent of victims suffer from a major depressive disorder.

Ironically, depression is among the most treatable of mental disorders. Nearly 90 percent of patients eventually respond well to treatment, according to the American Psychiatric Association, and practically all gain some relief from their symptoms through prescription drugs and/or counseling.

The role of the spiritual life

Yet depression can encompass biological, psychological, social, and spiritual causes as well as effects. Because the human person is integrated as body and soul, the state of an individual’s interior life can play a significant role in mental health. 

“The relationship between mood disorders and our spiritual life is complex,” according to Aaron Kheriaty, a California psychiatrist and co-author of the 2012 book The Catholic Guide to Depression, published by Sophia Institute Press. “Often it is hard for a person to know whether he or she is simply going through a difficult time — a dry spell in prayer, a period of demoralization in life due to external circumstances — or whether these ordinary trials and challenges may have led to, or may have been caused by, depression.”

While a “pray it away” approach might suffice for the former condition, a more holistic and broad-based approach is often necessary for the latter. 

“Christians who suffer from depression, or those close to them, can make the incorrect assumption that their lack of energy and dejected mood are caused exclusively by a spiritual problem,” Kheriaty said. True depression is not a matter of mere sloth — spiritual laziness — nor is it strictly a spiritual trial akin to the “dark night of the soul” described by St. John of the Cross. Sometimes well-meaning friends and family suggest prayer, Confession, or other pious acts as the panacea for what ails them.

Although attention to the interior life is helpful, one ought not rely on spiritual measures to the exclusion of professional therapy any more than for a serious physical condition. “When science or medicine can help cure medical or psychological afflictions, we should not avoid those helps and instead grasp at religious practices as though they contained magical powers,” he explained.

Yet depression, like all disorders of human nature, has its ultimate origin in the fall of Adam, in original sin. Therefore, given our holistic view of the human person, “[A] Catholic approach would not consider overcoming depression apart from the spiritual life,” said Kheriaty.

At the same time, however, a strong religious faith and practice does not inoculate a person from mental health struggles, he pointed out. And although the roots of depression are spiritual, that doesn’t mean its immediate cause is a spiritual matter. Complicating matters further is that deep depression often makes it difficult to pray or even to feel God’s presence in his or her life, he added — hence the need for a holistic approach to therapy to clear away such obstacles. 

A ‘Catholic’ way?

 Along with carefully prescribed and titrated pharmaceuticals, mood disorders can be managed successfully through psychotherapeutic methods. Cognitive-behavioral therapy (CBT), for example, seeks to change negative habitual patterns through rational thought and an act of the will.

Kheriaty sees particular value in the methods of psychodynamic or depth psychotherapy, which often involves probing for old unhealed emotional or psychological wounds in order to effect healing. Such healing most effectively takes place through forgiveness therapy, whereby the therapist helps the patient identify his deep-seated anger or resentment, overcome the defenses that insulate these wounds, make the intellectual decision to forgive, and then extend that forgiveness at the emotional and behavioral levels.

Forgiveness therapy relates to positive psychology, a newer movement started by psychologist Martin Seligman. In positive psychology, the emphasis is not on treating mental disorders, but in building the positive habits and virtues that lead to mental health, happiness, and human flourishing. These six central virtues are identified as wisdom, justice, temperance, courage, humanity, and transcendence. Each of these covers particular character virtues including forgiveness, mercy, prudence, humility, self-control, integrity, love, and hope.

Those virtues correlate well to the Catholic understanding of our universal call to holiness and growth in the virtuous life. It is perhaps here that psychology and spirituality intersect optimally. “The virtues practiced in positive psychology are all good practices,” said Kevin Majeres, a psychiatrist at Harvard Medical School, and co-founder of OptimalWork. com. “The Faith gives them an even greater effectiveness by showing how they are a path to God.”

He offers the example of mindfulness, a technique in positive psychology that focuses on the present moment.

“Mindfulness simply means attending to ‘what is,’” said Majeres. “Being mindful of one’s breath can be a powerful means of silencing worries and breaking temptations, and can help people ‘digest’ anxiety and cravings without giving in to them. In this way, mindfulness is an integral part of the virtue of patience, which helps us grow in every virtue.”

And if we have a desire for God, we will always be seeking Him, he added.

“For a Catholic, mindfulness is always pervaded by hope: we experience God upholding and supporting us, giving us our breath and life and being, right now,” he explained. “Hope leads us to pierce through the veil of things, discovering God upholding them. Hope turns mindfulness into prayer.”

Gratitude is another example of how positive psychology and the Catholic faith can work together, Majeres said.

“Positive psychology has amassed a number of studies showing the effectiveness of gratitude practices in improving our quality of life,” he said. “The Faith only makes this practice more powerful, by showing us whom to be grateful to, and for many more reasons.”

The theological virtues

The ideals presented in the Catholic faith, Majeres affirmed, are capable of transforming our psychological struggles.

He gave the example of a person who, when facing personal challenges that appear threatening, attempts to escape the challenge either by thinking his way out of it, worrying about it, or avoiding it altogether. Such strategies tend to get a person “stuck,” he said.

Instead, the psychological solution to these strategies is called “reframing,” or discovering the hidden opportunity for growth and practice that the challenge presents. It’s a technique that dovetails well with the theological virtues.

“Reframing is the basis of what’s called cognitive therapy — and it’s powerfully strengthened by faith,” Majeres said. “Having faith in God helps us to see every challenge as actually being perfect for us, because it is coming to us from the Providence of our loving Father. Even more, we can see every challenge as the Cross, to be loved and embraced in each hour of the day. What would there be left for us to dread or complain about? Through reframing, faith can make a constant impact on our lives.”

Similarly, “psychology often uses mindfulness as a way of holding our attention in the present moment, bringing silence to our minds,” he said. “Hope strengthens this, and allows us to experience the eternal help of God in this present moment.”

And charity, Majeres explained, “strengthens our will in building every virtuous cycle and gives us the energy to break every vicious one.”

These theological virtues “have the power to transform our attitude, our attention, and our actions,” he said. “They truly can set us free.”

 GERALD KORSON is a Legatus magazine editorial consultant.

Finding the right therapist

How should a Catholic go about seeking a therapist when needed?

Dr. Kevin Majeres said that if there are sensitive moral issues at play, then it’s best to get a recommendation from another Catholic who has worked with the therapist.

“It’s important for everyone to know that therapists are not trained to give advice about faith or morals, even if they happen to be Catholic,” he advised. “The most important factor in choosing a therapist is that they are good at therapy. If in the course of therapy any difficulty occurs, let the therapist know right away, and, if needed, consult a trusted spiritual director.”

Trustworthiness of the therapist is a key factor, concurred Dr. Aaron Kheriaty. A therapist’s advice “will be colored by the therapist’s own worldview, and may be distorted by the therapist’s own biases,” which is something that has resulted in bad experiences by many who have sought mental-health treatment.

“Many Christians who suffer from depression naturally have a preference for finding a therapist who shares their religious convictions,” Kheriaty said, but “shared religious and moral convictions alone do not guarantee a trustworthy therapist.”

When therapy is warranted and a competent Christian therapist is not available, “[A] skilled therapist who respects and honors the patient’s religious and moral convictions is, in my opinion, preferable to no therapist at all,” he said.

The Catholic Guide to Loneliness: How Science and Faith Can Help Us Understand It, Grow from It, and Conquer It

Kevin Vost, Psy.D.
Sophia Institute Press, 161 pages

Kevin Vost offers expert advice for battling loneliness and its effects through practical and spiritual means. Through “adaptive social thinking,” we can train ourselves to approach social situations more rationally and avoid self-destructive behaviors. He recommends the four cardinal virtues as “hinges” by which we can overcome the “distress” of loneliness, and stresses the importance of friendship. We can also look to Christ’s experience of human loneliness, particularly by reflecting on his “seven last words.” Each chapter offers a five-step “action plan,” and Vost concludes with 30 ways we can alleviate our loneliness by focusing less on ourselves and instead simply loving our neighbor — who may just feel lonely himself.

Parenting a child with depression

Depression is on the rise in American teens and young adults. Adolescent girls seem most vulnerable, per research published in the Journal of Pediatrics. Data collected between 2005-2014, by Johns Hopkins University School of Public Health, concluded that “the 12-month prevalence of major depressive episodes in adolescents increased from 8.7% to 11.3%.” The reasons remain under discussion. However, cyberbullying is hypothesized to be a trigger, particularly for girls.

Susan Locke

Susan Locke

How can parents support their child or adolescent suffering from depression? Here are some general guidelines:

Observe your child’s behavior for changes. Children with depression may demonstrate low mood, irritability, anger, fear or anxiety, mood swings, disruptive or risk-taking behavior, disobedience/ defiance/ illegal behavior, isolation, lack of self-care/ hygiene, decreased interest in previously enjoyable activities, decreased energy, increased or decreased sleep, increased or decreased appetite, and changes in friendships or family relationships. Some children turn to drugs or alcohol. Others turn to the internet for support or socialization. School performance may deteriorate, or attendance may decrease due to physical complaints or blatant truancy. Some children engage in self-harming behaviors or talk of death and dying.

Engage your child in daily conversation or other activities to open communication. Gently ask questions about your child’s change in mood, daily life/issues. Find ways for your child to communicate his or her feelings.

If your child expresses suicidal thoughts or wishes, please take him or her to the local emergency room for further evaluation.

Talk to your pediatrician or family doctor about your child’s mood or changes in behavior. They can arrange timely assistance for your child and provide you with qualified mental health professionals.

Monitor and limit phone, computer and electronics time. Watch internet history, texting, and social media. Kids often scout in the wrong places and meet the wrong people.

Ascertain healthy and consistent sleep schedules. Children and teens need about 8-10 hours of sleep per night. A regular presleep routine that does not include electronics, along with a scheduled bedtime/wake-up time encourage healthy sleep habits.

Encourage healthy eating habits. Observe behaviors at meals, such as restricting calories,  or leaving the table to go to the restroom and hiding/throwing food away. Watch for weight loss, excessive exercising, or obsessive concerns with body image that may indicate an eating disorder.

Be consistent and firm with limit-setting. Maintain the same or even slightly more stringent rules with your child to maintain structure. Treat all children in the family equally. Be aware of your child’s whereabouts and safety at all times.

Safety-proof your home. Lock up all medications, alcohol and OTC medications. Secure anything that could be used as a weapon, particularly firearms.

Ensure that you are taking care of your own well-being and mental health. Depression can run in families. Resist the urge to tell your child that you know how they must feel or that you were once, or are currently, depressed. Practice listening attentively and reassuring your child that you will get them whatever help is needed. Be sure to get help for yourself as well.

Identifying child and adolescent depression and dealing with it can be overwhelming. The key is to reach out for assistance and allow others to provide their support and expertise, so that a team approach can be utilized to its fullest.

By Jennifer L. Shoenfelt, MD
Board Certified Child, Adolescent, and Adult Psychiatrist
Lindner Center of HOPE (a partner to Healthnetwork Foundation)

SUSAN LOCKE is Healthnetwork Foundation’s medical director.
HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Myths and realities of depression

Millions of Americans suffer from forms of depression, but help is available . . .

Dr. Susan Locke

Dr. Susan Locke

An estimated 19 million American adults are living with “major depression.” Depression can be caused by life events, biochemical components or a combination of both. Whatever the trigger, it’s never easy for the person struggling.

Most people suffering from depression want to feel better, but the nature of the disease makes it difficult for them to find the motivation to take the necessary steps.

How can you know if you or a loved one is depressed or just feeling down? To help, here are some symptoms of different depressive disorders.

Major depression: The diagnosis of major depression requires five of the following symptoms, at least one of which is depressed mood or loss of interest. The symptoms must be present for at least two weeks and must cause clinically significant impairment in social, work or other important areas of functioning almost every day.

  • Depressed mood most of the day
  • Diminished interest or pleasure in most activities
  • Significant unintentional weight loss/gain or significant increase/decrease in appetite
  • Insomnia or hypersomnia
  • Agitation or psychomotor retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Diminished ability to think or concentrate, indecisiveness
  • Recurrent thoughts of death

Dysthymic Disorder: This disorder is distinguished from major depression. The diagnostic criteria require a depressed mood most of the day for more days than not, for at least two years and the presence of two or more of the following symptoms which cause clinically significant impairment in social, work or other important areas of functioning.

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

Bipolar disorder: Recurrent major depressive episodes commonly occur in bipolar disorder. To make a diagnosis of a major depressive episode as part of bipolar disorder, the individual must have had at least one manic or hypomanic episode.

Manic episodes are characterized by a distinct period of abnormally and persistently elevated, expansive or irritable mood lasting at least one week. During the period of mood disturbance, three or more of the following symptoms have persisted (four symptoms if mood is irritable).

  • Increased self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative/pressured speech
  • Flight of ideas/racing thoughts
  • Distractibility
  • Increase in goal-directed activity/psychomotor agitation
  • Excessive involvement in pleasurable activities that have a high potential for painful consequences.

Adjustment disorder with depressed mood: This is a psychological reaction to overwhelming emotional or psychological stress resulting in depression or other symptoms. These symptoms do not reach the level of severity of major depression and do not last as long as dysthymic disorder.

Substance-induced mood disorder: Disturbance in mood is the direct physiological effects of a substance such as prescriptions and over-the-counter medications. Depression may also result from use of an illegal substance. Alcohol does not tend to cause depression, but can significantly worsen existing symptoms.

Mood disorder due to a general medical condition: Some underlying medical conditions cause mood disorders like Parkinson’s disease or hypothyroidism.

Depression is a treatable disorder and you should call your primary care physician if you concerned about your symptoms. Healthnetwork may also be able to assist with treatment centers for more severe cases of depression.

Susan Locke, MD, is Healthnetwork Foundation’s medical director. An abridged version of this article appeared in the December 2012 issue of Legatus magazine.

Healthnetwork is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org