Lately I’ve been thinking (yet again) about depression, and particularly about the ways in which it gets discussed. I periodically run into disputes between those who are convinced that depression is at its core a biological illness, and those who are convinced that it’s a spiritual one. I find myself uncomfortable with both positions, because they both arise from a dualist understanding of the human, one in which spirit and body are qualitatively different things and not really connected to each other. If you take this perspective, you’re likely to conceptualize depression as either a spiritual problem or a physical one–and I’m not crazy about either version.
For those who see depression as purely a spiritual problem, the proposed solution is likely to involve spiritual practices: prayer, scripture study, priesthood blessings, church attendance. If these don’t help, it’s likely to be attributed to a lack of faith. Some might even assume that despair must be a result of sin, and therefore point to repentance as the cure. Medication is seen as suspect, perhaps even as a kind of cop-out. I think this attitude is becoming less common, but once in a while I still hear a comment in this vein. (A secular version of this might be “The Power of Positive Thinking” approach.)
However, I don’t think that defining depression solely as a physical problem is really a better alternative. From this point of view, depression is nothing more than a “chemical imbalance.” But the problem with looking at it only through the lens of the medical model is that it ignores the meaning it has for the person experiencing it. Taking medication, for example, is far more than the simple physical act of swallowing a pill–it touches on difficult questions of identity. Everyone I know who’s tried antidepressants has wrestled with the issue of what it means for their sense of themselves that they’re taking meds. To define depression solely in terms of brain chemistry is to overlook the human who’s experiencing it, and also to overlook the real ways in which depression can in fact affect things like spirituality.
In recent years, I’ve also sometimes encountered a kind of either/or view which divides the depressed into those who have “real” depression (e.g., a chemical imbalance), and those who just need to exercise faith or a positive attitude and pull themselves out of the dumps. However, I’m not sure that this is any kind of improvement. I also find it somewhat ironic that the fiercest advocates of viewing depression as a kind of spiritual illness, and the strongest proponents of a strictly medical model approach, seem to agree that the two are mutually exclusive.
But it’s actually rather difficult, I think, to draw clear lines between physical and spiritual. Not only does your brain chemistry influence the way in which you see the world, after all, the reverse is true as well–your experience of the world alters your brain chemistry. It makes little sense to conceptualize the two categories as isolated and unrelated components of a person. Spirituality isn’t some ethereal aspect of our lives that has no connection to our embodied selves; our entire experience of life, includings its spiritual aspects, is shaped by the fact that we are corporeal beings. (Seraphine has written some good posts, here and here, on this issue of embodiment.)
I’m sometimes astounded by the fervency with which people proselytize for their personal depression cure, be it medication, therapy, faith healing, some amazing book, herbal supplements, or whatever else. More than once, I’ve seen people get called to repentance for not selecting what someone else deems to be the one true treatment. As I see it, we have a number of potential resources for treating those who suffer from depression–and putting these resources into competition, telling people that they have to choose between them (e.g. “you can either trust God or you can trust meds”), simply doesn’t make sense.
My experience with depression, which includes having observed its devastating effects both in my own life and in the lives of a number of people I care about, is that it defies easy categorization and one-size-fits-all answers. I find it difficult to neatly label my own depression as being just a physical illness, a spiritual one, or even an emotional one, because it touches on so many areas of my life. I’m still in the process of finding the ways to cope with it which work best for me, a process which may last the rest of my life. And I find myself equally uneasy with the notion that this is simply a matter of faith, and the notion that it’s simply a matter of finding the correct drug.