November - December 2017

Written by Steven Burns
From his column To Your Health

The young couple sat at a table in a hotel conference room. The event leader opened the gathering saying, “Today, we’re going to do a personality inventory.” He then proceeded to distribute booklets with a series of questions. Everyone completed the forms and submitted them. After an hour or so, the results were available, and they served as a source of discussion for the rest of the session.

Following the meeting, the group leader pulled aside the couple, asking to meet with them privately. “Your results,” he told the wife, “show a likelihood that you are suffering from significant depression. I think you should see someone, a counselor or psychologist, so that you can address this.” He was kind and gentle, but the couple was distressed, broken.

By way of background, the couple was having a tough time. The husband was two years into graduate school and was gone constantly—physically and emotionally. The wife was working full-time at a daycare center for minimum wage, trying to make ends meet and care for two young children. Macaroni and cheese was a frequent dinner.

With the help of a psychologist, the mother recovered and the marriage was strengthened. The therapy technique used—Cognitive Behavioral Therapy (CBT)—has become a mainstay of psychological treatment. It was hard work, and she undertook it seriously, with excellent results. Life was still hard, but the hopelessness faded.

Clinical or major depression is an illness. It is not the same as getting the blues after something bad happens, such as failing to get a pay raise at work, or hearing that a friend has had a car accident. These are normal reactions. The terms that best define the feelings of clinical depression are hopeless and helpless. In fact, the two questions recommended by Medicare to screen for it are:

  1. How many times in the last two weeks have you felt down, depressed, or hopeless?
  2. How many times in the last two weeks have you had little interest in doing things?
The terms that best define the feelings of clinical depression are hopeless and helpless.

A positive score (>0) requires additional discussion and testing to determine if clinical depression exists.

In 2015, 16.1 million adults in the United States had at least one episode of clinical depression. That’s 6.7% of all adults, about 1 of every 15 people. Worldwide, according to the World Health Organization, the number is 350 million. Now, we’re not talking about people who are sad, or have a “down day” once in a while. In fact, clinical depression is an illness with a mortality rate: in 2015, 13 of every 100,000 persons in the U.S. died by suicide. That adds up to over 40,000 people per year, making it the tenth leading cause of death.

In my practice, I have often heard depressed patients say they were told by Christian friends or pastors that they would be fine if they just believed hard enough, or prayed enough, or relied enough on God. But in the case of our young couple, the woman’s faith never wavered. She firmly believed in God and His love for her.

The refusal to consider emotional illnesses is a legacy of the Early Church. St. Thomas Aquinas considered the soul to be separate from the body. As such, he believed the soul could not be sick; therefore, melancholy or depression was a sin against God. The Council of Trent in the 1500s codified that philosophy, saying that all mental illness was a result of sin.

In reality, however, this idea is not biblical. It is borrowed from Greek philosophy. In other words, it is not even Christian!

Most modern believers would reject such teachings, but when it comes to clinical depression, some even act as if it is the fault of the person who suffers from it. All the sufferer needs to do is “buck up, trust God, and get over it.” However, we now know that, like other illnesses, depression has genetic and biochemical roots. This means it can be treated, with both behavioral methods and medications.

When it comes to the spiritual side of clinical depression, we believe God can heal us—physically, spiritually, and emotionally (James 5:14). Sometimes he does so through prayer and fasting; sometimes through counseling and medication.

So, when you read the Medicare screening questions above, was your score greater than zero? If so, you should talk to someone. Your primary care physician would be a good start, although counselors and psychologists can be excellent at treating the illness without the use of meds—and most depression can be treated without medication. Just don’t ignore it. Like any other illness, left untreated clinical depression can cause great harm to you and to those around you. Call someone today.

Dr. Steven Burns is board-certified in family medicine and has been in practice for more than 30 years.

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