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Depression, Faith and Spirituality

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“Ultimately my upbringing with religion did really help me get through my depression because even when I struggled a lot, I always got out of bed, I always went to school, I always went to work, I never hid from life and I think that a lot of that was what I was taught through my faith.” Elizabeth was a sensitive child -- moody, quick to cry and often “down”. By the time she got to high school she describes feeling like that piece in the jigsaw puzzle that wants to fit “but just can’t no matter how hard you try.” She was diagnosed with depression and an eating disorder. She also had trouble with drugs and alcohol, and a problematic group of peers. Long-standing sensitivities combined with growing self-doubt and the lack of good coping skills made her late teen years “a big fireball of depression”. Her parents, both social workers, supported her as much as possible. She saw a psychiatrist who diagnosed her with a significant depressive disorder and anxiety and prescribed anti-depressants. But Elizabeth says the medication did nothing or made her “in some ways feel worse”. Her all-time low point was when she took a bottle of pills at age 17. Today in the U.S., depression is an epidemic among young adults. Suicide is the 2nd leading cause of death for people aged 15-24; those diagnosed with depression are five times more likely to attempt suicide than adults. Mood disorders, including depression, are the third most common cause of hospitalization in the U.S. Sadly, 80% of young adults who need mental health services won’t get them. Fortunately for Elizabeth, she is not among the statistics. Immediately after taking the pills she told her mother what she had done and was rushed to the ER. She says the hospital experience was frightening and “horribly embarrassing” but it led to a new medication that put her on a steady path to healing. She says the new medicine helped “calm down the noise” in her head and let her “focus on working with a therapist, working on behavior, working on coping skills, and problem solving.” She stopped taking the medication after a few years, but continues with behavioral therapy. It’s time we – friends, families and caregivers -- look for better ways to proactively support, rather than judge, young people who are suffering alone. One way is to share stories, like Elizabeth’s. Patient experiences can improve care -- whether for cancer, chronic disease or mental health. But because no two patients are exactly alike, stories can also be misleading when used to stuff patients into a one-size-fits-all anecdote. Which is why an international movement is underway to provide a scientifically sound way to share patients’ experiences. For the first time in the U.S., methodology that scientifically shares patient experiences, developed by Oxford University, is available. The first online module targets the epidemic of depression. Health Experiences USA shares dozens of first person stories from young adults who bravely bust through bias to help friends and family, caregivers and sufferers, understand the disease and seek treatment to better manage day-to-day. Among the 38 storytellers is Elizabeth. Now age 28, she wants young adults to know that “if you put in time and effort and energy and you really, really address and confront who you are and what depression is all about, it gets easier.” Reaching out for support was crucial for her, and she hopes others can find ways to stop feeling trapped in “that really tight lonely bubble” and connect with others who can understand and help. Religion has also been helpful along her path. Experiences with religion and spirituality vary, and interestingly, the links between faith and depression did not appear to be influenced by whether people were connected to conventional religious practices or more eclectic spiritual ones. For some of the young people interviewed, drawing on faith provided a reservoir of strength during their struggles with depression. But that wasn’t true for everyone. Some depict religion as worsening the impact of depression by impinging on emerging identity or delaying access to treatment. Others found that the search for their own beliefs after leaving their parents’ faith was difficult, and heightened the absence of purpose they already felt in connection with depression. For others, religion and spirituality provided strength to go on, even when depression sapped their will. Some looked to their spiritual beliefs to sustain hope when the future seemed bleak. Even if not religious, others found they were unconditionally accepted in communities of faith in unique ways. “I think it made me work hard and I think that ultimately it gave me courage to face some of the things that I was going through,” Elizabeth recounts of her faith, “and it gave me the strength to feel like I could do it.“ To hear more from young adults sharing their unique stories about depression: www.healthtalk.org About the authors: Rachel Grob, M.A., Ph.D. heads national initiatives at the Center for Patient Partnerships at the University of Wisconsin, which seeks to improve the patient experience to make healthcare more effective. Nancy Pandhi, M.D., MPH, Ph.D., faculty at the University of Wisconsin’s Department of Family Medicine and Community Health, is a clinician whose research explores ways to engage patients to help rethink and redesign patient care.