By Sara Zarr
Diagnosis: Generalized anxiety disorder, mild to medium major depression (you read that right—it’s not an oxymoron), and a pinch of obsessive-compulsive personality disorder.
I received this summary after speaking with a psychiatrist for an hour, a few weeks ago, finally ready to surrender to the idea that maybe, maybe, I didn’t need to endure days-long crying jags, uncontrollable fixation on painful thoughts, and a constant, pervading sense that I should be probably be doing something other than what I was doing and if I made enough lists and plans and journal entries, I’d figure out what exactly that was.
That I am depressed and anxious and obsessive wasn’t news to me. I’ve written a little bit about it here, and I have the genetic history and the environmental background. But until recently (and sometimes still), I’ve felt that I had enough good days and functioned well enough that to call myself “depressed” made a mockery of friends who truly battle the darkness at depths I can’t even imagine.
Yet, something hasn’t been right. And it’s been less and less right as I’ve gotten older, and finally, this past holiday season, I reached the point where the pain of living with whatever my brain was doing was worse than the potential pain of doing something about it.
The holiday season is a busy one for mental health care professionals. There were about three and a half weeks between when I called and the day of my appointment. During that time, I thought many times about canceling. I’d have a good day, and think, If I just do whatever combination of things I did today—lots of prayer, good nutrition and exercise, mental discipline—if I just do that every day, and perfectly, I’ll be fine.
Then I’d have a bad day. Why can’t I stop crying? I should pray harder.
Many times I felt convinced my issues were spiritual. And I’m not saying that they’re not, in some aspect. The misfiring of the synapses of my spirit does cause mental upset, and is helped by prayer. But to constantly think that “try harder” or “be better” were the answers to my biochemical handicap started to seem akin to attempting to save myself completely through good works rather than availing myself of grace.
Another metaphor: last year I learned that my diabetes had been misdiagnosed as type 2, when in fact I have a kind of slow-onset type 1. It’s an autoimmune disease; the body attacks itself. I knew, then, that though there would be a window of time when perfect execution of a very strict diet and exercise program would give me enough blood glucose control to get by, I would eventually need insulin. I was tired of needing to be perfect to survive.
Though it felt like a kind of surrender I’d been avoiding, I started insulin, and it changed my life. I know it’s protecting my organs for future longevity and improved quality of that longevity.
Similarly, I can see mood disorders as the brain attacking itself, that for whatever reason there’s something going on chemically that makes the body work against itself. Yet for people with a certain kind of religious background, and because of the belief that we are souls—not just brain chemistry and biology—there can still be a tendency to blame what feel so much like soul-problems on our own lack of virtue or effort.
Brian Volck wrote here a couple of years back about Acedia and Me by Kathleen Norris, a book about the idea of spiritual sloth—a book that I found both helpful and true, about certain aspects of my depression. Brian, who is a doctor, concluded:
“Not only are there no pills for acedia (the desert fathers—and mothers!—recommend work and the patient cultivation of joy and gratitude), the word itself is out of place in a conversation about selective serotonin reuptake inhibitors. Like parallel lines stretching to infinity, there is no point of intersection.”
I did and do work on cultivating joy and gratitude. Those things, along with prayer and fellowship and letting my friends help bear my burdens, do help tremendously. There is no question. But just as I would never tell a sick loved one that maybe she just needed to “try harder” for a while, I had to stop saying that to myself.
I do wonder how the antidepressants I’ve started will affect my spiritual life. In my near-daily despair and weeping, I cried out to Jesus constantly. There were many moments of feeling him near, feeling carried, feeling faith that though things seemed awful now, they wouldn’t always be this way. My prayers were honest and brutal and angry and demanding, and I still felt accepted and loved.
If the meds ease my pain and anxiety, does that mean I’ll turn into the kind of person described in the book of James, who, “looks at his face in a mirror and, after looking at himself, goes away and immediately forgets what he looks like”? Will healing my brain cause me to forget my need for a savior?
There’s a quote from Augustine’s Confessions I’ll make a hash of here. It’s a prayer, really, in which he asks God to not allow him to find comfort or help in anything but God. That everything else would be stripped away until God was all he had left. I’ve prayed it, myself, and at times thought maybe my recent struggles are spiritual, and an answer to that prayer. But I’ve seen what depression has done to people I love, and am trying to see my situation with the eyes through which I see theirs.
It’s impossible to know what the fathers and mothers of our faith would say in this era of increased understanding of brain function and mental health, or about all of the options for help modern people have. For now I view my pills as grace and provision, just as I see the circumstances, pain and all, that brought me to the point of this particular kind of surrender.








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In other words: There's a clinched, arid solitude to depression. You know? It is so difficult -- sometimes breathtakingly impossible -- to see outside of our own agony, while in the throes. Medical treatment can't cure the fundamental broken-ness of the human condition. But what treatment (talk, meditation, medicine) *can* do, I think, is allow us to more with slow and careful steps toward the comforts of this world and of, perhaps, other worlds.
I can't speak for anyone else, obviously. But I personally could not truly feel/receive love -- from family, from friends, from Anything else -- in the most terrible aspects of depression. Treatment has given me a breathing room, that's all; a sense that, though broken, I am not shattered.
- Mike
Thank you.
I am incredibly grateful for antidepressants, having lived with people who have benefited from taking them... Prozac plus Jesus rather than versus. Though I was not the one taking them, the antidepressants made my life better as well.
I hope you'll continue to write about health and faith and illness. For those of us who seek to understand what our loved ones are going through, writers like you do vital work.
Jane Kenyon's poems have also been helpful to me in seeking to understand depression.
Your writing was very honest and I think helpful to so many others. And be someone who owns her own collection of the Church Fathers I feel confident in saying that they would say you are doing the right thing. Everyone needs to take care of their body and their soul. And I think that you will not forget Jesus or how he carried you. Now you will be able to not just talk about the pain with him but the joys. And I am sure the joy you bring to so many others will bring others to Jesus.
You just sharing your gift of writing with so many who need to hear what you wrote is a grace filled and sacramental experience for you and for all of us. So thank you!
Wonderful post - stay strong, this will get better. It's all a series of cycles - just because you need medication to heal the synapses in your brain doesn't mean you'll need them forever. And when you don't need them anymore, it's a huge comfort to know they exist.
Wishing you peace and happiness.
Thank-you for your thoughtful, honest, and courageous words. It cannot be said often enough--Depression is a real disease, a disease with causes and interventions, a disease that needs to be faced and not stereotyped.
I have come to view both my writing and my medical practice as sacramental acts. I have also received specific writing and medical gifts, gifts that were the result of the giver's faithful honing of craft and each in their unique way life-saving. You are correct when you identify your treatment as "grace and provision."
Why I, and so many of my patients, have difficulties accepting the goodness of some gifts and not others, is always a surprise. Perhaps, I might find it easier to accept the gifts of others (medicine crafted through the scientific imagination or insights encrusted on the honed words) if I spent less time and worry pursuing our fathers and mother's "wisdom" (scientific or otherwise) and more time leaning into God's good creation--acknowledging all that I have is His.
Again, thanks
Good words, SL.
I enjoyed your essay. The opening line made me giggle, too. :)
I take Paxil for OCD, and went to therapy for a few years to help me round off the sharper edges of things. It worked well. I hope the same holds true for you as you venture into uncharted, chemically-altered waters.
I once had a pastor who told me suffering was overrated - that Jesus had taken the brunt of it for us. That needless suffering is exactly that.
But I definitely know what you mean about it being something that drives you to God. You just have to find a new prompter for prayer. Who says we must only come to God in our suffering, after all? You can be intentional about this.
Look me up on my site or shoot me an email. We should banter. :) Be well, and peace be still.
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