SERMONS 

Darkness Visible: A Theology of Depression

According to Andrew Solomon’s National-Award winning book, Noonday Demon: An Atlas of Depression, research leading up to 2001 showed that about 3 percent of Americans – some 19 million people – find themselves in the clutches of chronic depression. More than 2 million of those are children. Manic-depressive illness (or bipolar depression) afflicts 2.3 million and is the second-leading killer of young women, the third of young men. Depression is the leading cause of disability in the United States and abroad for persons over age five. Worldwide, depression accounts for more of the disease burden than anything but heart disease. It claims more years than war, cancer, and AIDS put together. When one considers that other illnesses such as heart disease and alcoholism often mask depression, depression may be the biggest killer on earth.

When people start talking about depression they often – I think rightly - begin the discussion with qualifying language that distinguishes depression from its cousins, sadness and grief. We know too well that part of the human condition is that we will all have days when we feel sad and disconnected. Sometimes the events of our normal everyday lives sow the seeds of grief and pain: the death of a loved one, the ending of a relationship, financial struggles, and the list goes on. The grief and pain that follow these struggles are a difficult but natural process of moving through life. To be sure, sometimes grief and pain are the catalyst for depression’s awful coming. Andrew Solomon suggests that we can distinguish between the two by assessing how we are after the fact. He writes: “Grief is a humble angel who leaves you with strong, clear thoughts and a sense of your own depth. Depression is a demon that leaves you appalled.” Although it is sometimes difficult to name the collapse point where grief or sadness gives way to the freefall of depression, as Solomon notes, “when you get there, there’s not much mistaking it.” It is the stuff of breakdowns. The fact is that clinical depression can come with or without explanation, rolling in like thunder, or more subtly – like a snake in the grass.

The actual condition of being depressed can be described only in metaphor and allegory. It is a state almost unimaginable to anyone who has not known it. Some of you may have recognized that I borrowed the title for this morning’s sermon from novelist William Styron. In 1990 he published a powerful book entitled Darkness Visible: A Memoir of Madness chronicling his own struggle with clinical depression. Very near the beginning of his book, Styron points out what he describes as “an essential though difficult reality…the disease of depression remains a great mystery.” As Unitarian Universalists we appreciate the contributions that secular science has brought to our understandings of ourselves and our lives. And science has certainly made some strides in helping us wrestle with clinical depression. But in the end the reality remains. Science does not really know what causes or constitutes major clinical depression.

And so we are left with metaphors and the inadequacy of language to try and shine light into depression from the periphery. Solomon suggests one of the best metaphors of depression I have heard. In the metaphor, the depressed person is a very large oak tree that is covered by a huge vine – clinical depression. The vine is nearly suffocating the tree, having intertwined itself with the tree so completely that it is difficult to see which parts are tree and which are vine. Only upon very close examination can one see that among the thousands of vine leaves, a few desperate oak leaves are also reaching toward the sun, trying to nourish the tree through the process of photosynthesis. The metaphor is helpful because it helps us see an important aspect of clinical depression and its effect. You see, depression is simultaneously a birth and death, a presence and an absence. The vine is present, but the tree as it is meant to be – healthy, robust, full of green leaves – is absent.

Depressed people sometimes talk about how depression seems to have a life of its own. Solomon writes of his own experience of depression as a sort of regression from the world. “At the worst stage of major depression, I had moods that I knew were not my moods; they belonged to the depression…Every second of being alive hurt me…The very worst pain is the arid pain of total violation that comes after the tears are used up, the pain that stops up every space through which you once metered the world, or the world, you…Eventually, you are simply absent from yourself.”

This past fall represented an anniversary for me. It was ten years ago – the fall of 1993 and the early spring of 1994 – that I almost died of clinical depression. I was 20 years old and in my junior year at Vanderbilt University. It wasn’t the first time I had been in depression’s grip – in fact you could argue that I had been in and out depression's cave for much of my life. But this time was worse than anything I had experienced in the past. Despite the struggles of my childhood, by most standards, I had been successful. I made good grades, very rarely got in trouble, had friends, and was active in my church. I had been present.

At the beginning stages of my bout with depression in 1993 I found myself simply indifferent to life. I quit wearing my seatbelt, drank too much alcohol, considered very casually, almost matter of factly, what it might be like to cross the double lines on the highway. As the months wore on, I became more and more agitated as I was increasingly engulfed in an ocean of deep despair. Most people who are suffering from depression sleep significantly more than usual and they often overeat and gain weight. My experience was exactly the opposite. I lost my appetite, eating just enough to sustain myself. My nights were spent tossing and turning. My days were spent in a haze. I could not concentrate on anything and as a result my grades suffered mightily. There were conversations with other students when I would start a sentence and then lose my train of thought, trailing off and then walking away embarrassed. There were whole days when I stayed in bed, wide-awake but utterly unable to gather the wherewithal to pull on clothes, much less interact with other people. I was a shell of a person parasitized by a sadness that seemed to constitute my very flesh. I had become absent.

Returning to Solomon’s vine and tree metaphor, the functioning, laughing, social self I had known up to that point was simply gone. The tree was alive, but barely. It had only a few leaves left and the roots were shallow. The thousand pounds of vines hung on my shoulders, slowly tightening their grip on my neck as the depression moved relentlessly through my veins.

Solomon suggests that to come out of depression, one must address both the presence and the absence that constitute the disease’s grasp on our souls. The first step for many is to address the vine’s presence – or medical component of the disease. In my life, the vine’s growth was at least stifled by antidepressant medication. The drug therapy helped clear my mind so that I could function well enough to get by in my life. The pain was not completely crippling as the drugs began to hack away at the vines. If I had done nothing more than take medication, I might have been O.K. That is, I might have pulled myself away from the pain of depression, but I am convinced that I would always have been a scraggly tree.

I needed to deal with the absence. Once the vine began to wither, I needed to learn how to photosynthesize again, how to develop a root system that could tap into the nutrients of the soil. For me, the real salvation came with psychotherapy. Solomon notes that “rebuilding of the self in and after depression requires love, insight, work, and, most of all time.” At the height of my illness I participated in group therapy once a week, individual counseling at least twice a week, and met with the psychiatrist who managed my medication once a week. In retrospect, I called these mental health professionals my team. And there is no doubt in my mind that those men and women literally saved my life.

During painful sessions of therapy I was able to reconstruct myself as a person who could move through the world in a healthier way, making choices that affirmed life rather than denies it. I had to examine difficult relationships with my family and others as a way to get a handle on the systems that indirectly ended at the dead end of my depression. I learned how to live in the present in the face of whatever reality faced me, rather than bogging myself down in a painful past that was full of disappointment and bad choices. I learned how to be vulnerable, to drop my guard and really look at myself, the good and the bad. My therapists worked with me to heal places in my soul that I did not even know were wounded. Depression had left me a wrack of bones and my task was to build a self that could be sustained. Borrowing Solomon’s words again, “I hated being depressed, but it also in depression that I learned my own acreage, the full extent of my soul.”

In a small book called Finding God, minister Thomas Lewis focuses on the spiritual dimension of depression. We often hear of the medical and psychological components of depression and its treatment, but too often the spiritual is ignored when we talk about the disease. Lewis is a Christian, and one of the ways he describes depression's effect on our lives is to show how the disease works to destroy the life-affirming spiritual gifts of faith, hope, and love.

It is almost cliché to say that depressed people feel hopeless, but hopelessness if central to depression’s infrastructure. Hope is the centerpiece of much of religious life, and depression affects one’s spirit by virtually eliminating the capacity to hope because it eliminates the capacity to desire. That is, you cannot hope for something if do not desire anything. And once desire is gone, a depressed person no longer cares if they get better or feel joy again.

Closely linked with hope, especially for religious liberals, is the concept of faith, or trusting in the benevolence of the universe. Lewis notes that “faith is counting yourself ‘in’ on God’s promises.” Christians might say that depression destroys the belief that we are created in the image of God and that we are created good. Without faith, Unitarian Universalists could not say with conviction that we affirm the inherent worth and dignity of every person.

Perhaps the most damning consequence of depression’s work on the human soul is the way it drains our ability to love. Depressed people lose the ability to love themselves, friends, family, and the larger world. Andrew Solomon makes this point when he writes: “Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades one’s self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself. Love, though it is no prophylactic against depression, is what cushions the mind and protects it from itself. Medications and psychotherapy can renew that protection, making it easier to love and be loved, and that is why they work.”

And so the work of coming out of clinical depression is quite literally a labor of love. Although some people who struggle with depression never recover, those who do, one way or another, use love as the antidote. In my life, the many hours spent in psychotherapy were – at their core – about loving myself and others in a balanced and healthy way. Obviously, such a project is the work of a lifetime, and I certainly do not claim to have mastered it. But I do hope that I am at least on the right road rather than the aimless wilderness of ten years ago.

As Unitarian Universalists, many of our religious insights boil down to a deep appreciation for the sacred and healing power of religious community. By joining this group of fellow sojourners, we have each cast our lot with a battered tribe. Like the Jews who wandered through the Sinai, some of us are happy, some angry, some kind, and some are probably even depressed. And during the course of our lives we will likely experience all of these feelings and a thousand others. But by participating in this community of covenant, no matter what lies ahead, we have agreed to walk together, to do our very best to stay connected, to love one another. And if we are community that loves one another, we are a community that can pick up those among us who have become broken and disconnected and need to be carried for a time. We are a community that can wipe the sweat from our brow, the mud from our hands, and the tears from our eyes and say to one another that we are willing to make one more circle around the sun together.