– Then another question arises related to the theme of “depression and faith”. We read the words: “The world lies in evil” (1 John 5:19), at Ecclesiastes we read that everything is perishable (Eccl. 3:20), everything passes, and we understand that all the flowering that we see around us when it will stop and these beautiful flowers will fade, our beloved faces will grow old, and the prospect of moving to a cemetery awaits everyone anyway. Does not the realization that all joys are transient and departing lead to a depressive state?
– What you just said is a logical continuation of what happens when a person begins to think a lot alone, having neither an interlocutor, nor a spiritual friend, nor an understanding confessor, nor proportioning himself to the gospel.
And who can be a better interlocutor than Christ from the pages of the gospel ?! All the arguments you have gloomily drawn are broken up into the only saying of Christ, which explains everything: “in the world you will have sorrow” (John 16:33). Have? We have.
And further: “But take courage, I have conquered the world.” And I heard that in some translations instead of the word “take heart” the verb “go for it” is used. It would seem close in meaning, but to take heart means to endure, and to dare is to make breakthroughs. And breakthroughs are precisely through the automatisms of everyday life. Breakthroughs, so as not to pass by the beggar, but to do something.
The more you do good, the less likely you are to get depressed. Because depression, like any disease, limits a person. And by doing something, you enter into interaction and expand your capabilities. A gloomy system of values, if desired, can be dug up in any religion. “Here are the monks, the first noble truth. Everything in the world is suffering, ”Buddha began his sermon. True, then he discovered some more noble truths … A non-depressive person does not close his eyes to the suffering of the world. But he is trying to help alleviate this suffering, both in himself and in others.
– In patristic works we find at least three concepts that are pretty close to the medical and psychotherapeutic description that we have now sounded, namely this concept of gloom , disappointment , and petrified insensibility . Doesn’t it turn out that depression can also be a state of a spiritual disease, an incorrect spiritual step made by a person and, as a result, a false spiritual state to which a human person has come?
– Specialist psychopathologists who have the courage to openly call themselves believers always recognize that each phenomenon in the world has its own logo, design. In the same way, for every psychopathological phenomenon, for every emotion, for every illness, there is a certain understanding on the spiritual level. Some damage at the moral level, damage to the religious sphere, i.e. violation of communion with God to the extent that it was possible for a given person.
And, of course, depression will manifest both despondency and a sense of worthlessness, sometimes a rebellion against higher powers: “Why am I allowed this?”
Like any disease, the Lord can soften a person with depression, and can strengthen him spiritually, because even depressed patients who became wise psychiatrists of the 20th century noticed and even entered into the aphorism: “depression ennobles a person. With depression, as with correctly tolerated suffering, a person becomes kinder and wiser. ”
The famous psychotherapist Victor Frankl said: “the only meaning of suffering is to become different.” And with depression, a person has the opportunity to become spiritually richer, because those things to which he still did not pay attention: the same sun, the same arrival of spring, is perceived more acutely with it. Conversely, if experiencing depression is wrong, we begin to murmur against God.
Correctly transferred depression, like any suffering, leads to a greater potentiality of gratitude to the Creator for what is happening to us. Therefore, depression (in contrast to the opposite state – manic, excited, euphoric) can serve the spiritual growth of a person, if it is lived and experienced correctly ..
Sometimes depression simply leads to the release of time, because a person cannot work and he has the opportunity, as they say sometimes, to “think about the soul”. And for this depression you can say thanks. This is a kind of blessing for depression. Well, let’s recall the Gospel: “My strength is made perfect in weakness” (2 Cor 12: 9). And depression is precisely that very spiritual weakness in which simply miracles of self-sacrifice can be revealed.
In depression, a person sometimes finds himself kicked out of the mechanical routine of a repeating world, he mentally comes into contact with a very special experience of being, and this contact can lead to spiritual healing. Spiritually, we are all sick to one degree or another. If a person says: “I am in excellent spiritual form”, then we will give him an undoubted and disappointing diagnosis.
And depression relieves pride . And in general, it’s good to be familiar with depression firsthand, and I didn’t say it — I’m just rephrasing pr. Silwan of Athos : “Keep your mind in hell, and do not despair.” Or the letters of the Valaam elder: “The surest way to prevent mortal sin is to constantly think about death.”
And when, if not depressed, thoughts come of inevitable death, of the end of being. In a spiritual sense, a truly believing person should see the absolute “non-niceness” of his spiritual structure and take confession seriously. So in the case of depression, a person must be aware of his emotional damage. So in depression there is a very deep and positive spiritual meaning.
But there is a destructive potential – as in any disease. So the meaning of prescribing depression, like any other, not only bodily disease, but also spiritual one, is that it is also a way of communication, an opportunity to come to a person either in a white coat or in a cassock, and say: “brother, I feel bad, can you do something for me? ” And when one person does something for another – then the amount of love multiplies in the world.
– If something happened to the Christian – is it necessary to look for an Orthodox psychotherapist or is a specialist who knows his job suitable? We usually do not look for an Orthodox otolaryngologist or cardiologist …
– Here I will designate this principle: the more severe the depression, the less important is the ideological identification of a specialist. In other words, in severe depression, when a person does not see the light of white, he cannot get out of bed, trembles with fear, it does not matter what kind of creed psychiatrist will help him.
The less depression occurs at a lighter and at the same time spiritually meaningful level – at the level of difficulty in receiving joy, at the level of despondency, anxiety – the more the role of those values in the format of which the psychotherapist assists is growing. Because for an Orthodox-minded person, Freudian interpretations regarding some incestuous inclinations will simply be misunderstood for a start, and then simply rejected.
Or, as the Russian philosopher Vladimir Solovyov said in conversations about the meaning of love, sometimes there are present gentlemen psychologists, people come to them who suffer from shyness, shyness, indecision, and they recommend selling love as a means, thereby increasing income to their venereologist colleagues.
That is, at high levels, it is better to trust a specialist who shares the same moral scale with you.
We treat the immortal soul with pills, or how to overcome depression?
– The soul is a concept from the realm of faith. How is it possible to treat the soul with something completely earthly – pills or conversations?
“I think we still need to repeat more often that the soul and emotions are not exactly the same thing.”
The psychotherapist does not set as his goal the salvation of the soul of the client who addresses him – he is engaged in the dispensation of the soul in the visible world.
In general, the concept of “soul” for a start is better to replace the word “psyche”. Then the soul in the generally accepted religious sense, we denote the “upper floor” of the psyche.
But the “lower floor” of the psyche or emotions, we denote the level at which the actual depressive psychopathology.
How do medications work? We think and become conscious of the cerebral cortex. More precisely – neurons, cells of the cerebral cortex. More precisely – axons and dendrites – these are processes of these cells, the connections between them, which are in contact at the points of contact (synapses). And there, at the expense of neurotransmitters such as serotonin, the “process of thinking” occurs, if you will.
At this level, the brain’s work process takes place – both satisfaction, awareness, and information. In the same place, with the violation of these processes, the formation of depression also occurs. And due to well and correctly selected neurotransmitters, i.e. substances affecting the fluid exchange between the processes of nerve cells, these processes normalize. This is how antidepressants work, helping to establish the physiologically favorable existence of the entire mental and emotional structure of a person.
– Where did the idea to treat depression with chemicals come from?
– A lot in our science of psychiatry and psychotherapy was created in some bizarre ways. How, for example, were the first antidepressants discovered and synthesized?
It happened only in the 50s of the XX century. In Germany, in a tuberculosis clinic, it was noticed that patients using a certain drug suddenly become unusually cheerful and lively. They began to study, and then use the properties of this drug, began to synthesize on the basis of it a similar, but without anti-tuberculosis effect.
It turned out the first antidepressant, still working. Of course, it has already become morally obsolete, but there are cases when you can appoint it and get an effect. This is a drug that was created from practice.
Another way to create drugs is from theory. When we talked about the chrono-biological concept of the onset of depression, on the basis of melatonin, that is, the hormone associated with sun tanning, such an antidepressant drug was created.
– Is it possible to single out those cases when depression is nevertheless an organic disease, and the patient needs, first of all, medical treatment?
– Yes. Endogenous depressions are, relatively speaking, organic, they are caused by biochemical changes in the body, which can be understood not only at the verbal level, but also when using some tests (sometimes the so-called “dexamethasone test” is used).
In the treatment of such diseases, it is required to use antidepressant drugs, and it is reasonable and differentiated, depending on the variant of the disease: with apathetic depression – antidepressants with a stimulating effect, with anxiety – with a calming, sedative effect.
Here is the case of last week. A 32 year old man, a programmer, came to me with such complaints:
– The condition, doctor, began a week ago, they gave me a task, and the task is simple, trifling, I coped with them already, but the night before I did not sleep. I was pierced by the thought, “What if I can’t handle it?”, I came, sat down, turned on the computer and … walked away from it. I was paralyzed. I tried to come up again. Then half a day I walked around and pretended that I was asking someone for something, but I felt that I, sorry, got hooked, I just can’t do it, the consideration refuses. It seems to me that I forgot the multiplication table, it seems to me that comparing 2 variables is higher than my understanding. I tried to take sick leave, imitated a cold, but I feel that something is wrong.