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Good Letters

prozac-vs-jesusDiagnosis: 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.


The Image archive is supported in part by an award from the National Endowment for the Arts.

Written by: Sara Zarr

Sara Zarr is the author of five novels for young adults, most recently The Lucy Variations, which the New York Times called “an elegant novel.” Her sixth, a collaborative novel with Tara Altebrando, came out December 2013. She’s a National Book Award finalist and two-time Utah Book Award winner. Her books have been variously named to annual best books lists of the American Library Association, Kirkus, Publisher’s Weekly, School Library Journal, The Guardian, the International Reading Association, the New York Public Library and Los Angeles Public Library, and have been translated into many languages. In 2010, she served as a judge for the National Book Award. In fall 2014, she received a MacDowell Colony Fellowship. She currently lives in Salt Lake City, Utah, with her husband, and online at www.sarazarr.com.

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