Selected annotated bibliography on depression and suicide.St. John of the Cross. Dark Night of the Soul. New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , Image Books, p 1959.
Saint John Saint John, city, Canada
Saint John, city (1991 pop. 74,969), S N.B., Canada, at the mouth of the St. John River on the Bay of Fundy. A major year-round port, it has an excellent harbor, large dry docks, and terminal facilities and maintains extensive of the Cross (1542-1591), a Catholic mystic, was a major figure in the Catholic Reformation A Spanish mystic and Carmelite friar, he worked closely with Saint Teresa of Avila Noun 1. Saint Teresa of Avila - Spanish mystic and religious reformer; author of religious classics and a Christian saint (1515-1582)
Teresa of Avila , another well-known mystic in the reformation of the Carmelite order Noun 1. Carmelite order - a Roman Catholic mendicant order founded in the 12th century
Order of Our Lady of Mount Carmel
monastic order, order - a group of person living under a religious rule; "the order of Saint Benedict" . The Dark Night of the Soul, the best known of his written works, is actually the continuation of a longer work on the journey of the soul toward a greater union with and purification by God. The dark night represents the hardships and difficulties the soul meets as it seeks detachment from the world and reaches for the final light of union with the Creator. The book takes on special significance for the understanding of depression and spirituality in that the "dark night of the soul" has become a metaphor for a spiritual melancholy and emotional struggle that many have assumed must accompany any true spiritual growth. In reality, the book focuses upon a more narrow stage of spiritual growth for mystics in which St. John emphasizes that the mystic, by herself, cannot attain true spiritual cleansing and therefore must passively submit to God, a submission which leads through a period when the soul experiences no pleasure in the things of God or in creation, no sense of being in touch with God, and therefore steeped in melancholy.
Blazer DG. The Age of Melancholy: Major Depression and Its Social Origins. New York, Routledge, 2005.
In this book, the author ponders why--if the basic biology of the brain has not changed fundamentally during the last half-century--humankind has become depressed on an epidemic scale. He focuses upon the social origins of depression, origins that tend to be ignored in current investigations. In one chapter, "Things Fall Apart: Society and Depression in the 21st Century," he describes characteristics of modern society that may blunt spirituality and therefore fuel spiritual melancholy, characteristics of the postmodern critique. These characteristics include loss of hope; loss of story (the loss of one's sense that his life is integrated); loss of language (words lose their meaning); loss of self (loss of a core sense of identity); loss of unity (the challenge of a diverse society); loss of trust (we reflect upon society with suspicion); loss of orientation (liberation from tradition often accompanied by confusion and disorientation disorientation /dis·or·i·en·ta·tion/ (-or?e-en-ta´shun) the loss of proper bearings, or a state of mental confusion as to time, place, or identity. ); loss of meaning (all explanations are brought under suspicion); and nihilism nihilism (nī`əlĭzəm), theory of revolution popular among Russian extremists until the fall of the czarist government (1917); the theory was given its name by Ivan Turgenev in his novel Fathers and Sons (1861). (believing in nothing, having no allegiances and no purposes).
Blazer DG. Freud versus God: How Psychiatry Lost Its Soul and Christianity Lost Its Mind. Downers Grove Downers Grove, village (1990 pop. 46,858), Du Page co., NE Ill.; settled 1832, inc. 1873. Downers Grove has undergone population growth and commercial development that include the construction of new office complexes. , IL, Inter Varsity Press, 1998.
In this book, the author challenges the comfortable accommodation that has occurred between psychiatry and even the most conservative faith traditions. Psychiatry and Christianity have never experienced better superficial relations and this is no more clearly observed than in the diagnosis and treatment of depression. Thirty years ago, people from a religious background would have been much more resistant to antidepressant antidepressant, any of a wide range of drugs used to treat psychic depression. They are given to elevate mood, counter suicidal thoughts, and increase the effectiveness of psychotherapy. medications than today. Though not challenging the therapeutic benefit of our modern treatments of depression, the author suggests that a healthy tension between psychiatry and faith traditions should stimulate advances in our understanding of the deepest emotional pains. Why does this not occur? The existential pain and subjective experience of psychiatric illness are of little interest to modern psychiatrists; meanwhile, the philosophical and theological implications of disorders of the brain and modern psychiatric therapies are of little interest to religious leaders. As a result, psychiatry has lost its soul, and religion (in this specific case, Christianity) has lost its mind.
Burton R. The Anatomy of Melancholy Anatomy of Melancholy
lists causes, symptoms, and characteristics of melancholy. [Br. Lit.: Anatomy of Melancholy]
See : Melancholy , 1st ed. New York, Tudor, 1948.
Few will wish to slog through this massive volume, yet familiarity with Burton's The Anatomy of Melancholy (1621) is important to those wishing to understand spirituality and depression. For Robert Burton Robert Burton may refer to:
humor effecting temperament of gloominess. [Medieval Physiology: Hall, 130]
See : Melancholy ) as recognized by the ancients, though he waxed eloquently exploiting many literary genres to describe his experience with the malady malady /mal·a·dy/ (-ah-de) disease.
A disease, disorder, or ailment.
a disease or illness. . Yet Burton was not one-dimensional: he developed a detailed description of a multi-causal depression. At the top of his hierarchy of causes, he leaves sufficient (though not necessary) room for both God and the devil to work their ways with the moods of men. He also described a specific variety of melancholy which he labeled religious melancholy, a depression that could emerge from an excess of "superstition," leading to excessive solitariness, fasting, and a "diseased imagination." Religious melancholy could also derive from a defect of belief in God and love of God. In the former case, the heart is grieved, the conscious is pierced, and the mind is overwhelmed with terrors; in the latter case, the melancholy was the justly deserved result of the anger of God.
Rubin JH. Religious Melancholy and the Protestant Experience in America. New York, Oxford University Press, 1994
Rubin follows on Burton's exploration of religious melancholy with a focus upon the Protestant experience in America, especially among the colonial Puritans. Those who were most fervent in their devotion to the Christian life, those who longed most for a close relationship with God, were at times obsessed ob·sess
v. ob·sessed, ob·sess·ing, ob·sess·es
To preoccupy the mind of excessively.
v.intr. by guilt, terror, and despair, feeling that they had been forsaken for·sake
tr.v. for·sook , for·sak·en , for·sak·ing, for·sakes
1. To give up (something formerly held dear); renounce: forsook liquor.
2. by God. This distinctive religious experience was characterized by a grieving over the loss of God's love and a fruitless and often dangerous striving toward conversion--for example, some would fast until they died. During the 19th and 20th centuries, however, a religion of healthy-mindedness emerged, and the melancholy of some Puritans passed out of existence. Depression among evangelical Christians This is a list of people who are notable due to their influence on the popularity or development of evangelical Christianity or for their professed Evangelicalism.
Affected or marked by low spirits; dejected. See Synonyms at depressed.
Adj. and therefore depressed souls.
LaHaye T. How to Win Over Depression. Grand Rapids Grand Rapids, city (1990 pop. 189,126), seat of Kent co., SW central Mich., on the Grand River; inc. 1850. The second largest city in the state, it is a distribution, wholesale, and industrial center for an area that yields fruit, dairy products, farm produce, , Zondervan, 1974
LaHaye is the coauthor of the Left Behind series which has been among the best-sellers over the past few years. He is a conservative evangelical Christian and probably reflects the views of many (but perhaps not most) evangelical Christians. Given that evangelical Christians represent millions of Americans and these people will frequent the offices of all practitioners, especially in the southern US. Practitioners should be aware of their views, though most of us would not agree with them. In this book, written over 30 years ago, LaHaye posits that depression is something "in the mind" that can be overcome through will power and trust in God through the use of steps similar to those posed by more secular cognitive therapies. Examples of these steps beyond prayer and accepting Jesus are "renew your mind daily," "practice creative imagery daily through prayer," "always be positive," and "forgive those who sin against you."
Lutz C. Depression and the translation of emotional worlds. In: Kleinman A, Good B, eds. Culture and Depression: Studies in the Anthropology and Cross-Cultural Psychiatry Cross-cultural psychiatry is a branch of psychiatry concerned with the cultural and ethnic context of mental disorder and psychiatric services. It emerged as a coherent field from several strands of work, including surveys of the prevalence and form of disorders in different of Affect and Disorder. Berkeley, University of California Press "UC Press" redirects here, but this is also an abbreviation for University of Chicago Press
University of California Press, also known as UC Press, is a publishing house associated with the University of California that engages in academic publishing. , 1985
Lutz suggests that emotions are socially determined. This is an extreme view but one that has relevance to depression and spirituality. The social context surrounding the person provides criteria for judging one's own emotions and those of others. Every society attempts to explain what constitutes behavioral deviance, and the proper responses to it, whether that be therapy or punishment. For example, the appropriate and inappropriate expressions of anger are determined by society. Certain behaviors (such as overt expression of anger) may be unconditionally accepted in some societies yet proscribed PROSCRIBED, civil law. Among the Romans, a man was said to be proscribed when a reward was offered for his head; but the term was more usually applied to those who were sentenced to some punishment which carried with it the consequences of civil death. Code, 9; 49. in others. These societal influences may be so profound that the society literally influences the actual feeling of the individual. In a society with significant religious inhibitions, a person may not "feel" anger when anger would appear to be a natural response. Those feelings may be turned inward, and the person may instead feel depression (an accepted feeling in the society).
Karp DA. Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness. New York, Oxford University Press, 1996.
Karp is a professor of sociology at Boston College Boston College, main campus at Chestnut Hill, Mass.; coeducational; Jesuit; est. and opened 1863. Actually a university, the school's Chestnut Hill campus comprises colleges of arts and sciences and business administration, the graduate school, and schools of nursing and a sufferer of periodic severe depression. He captures the human face of mood disorders The mood or affective disorders are mental disorders that primarily affect mood and interfere with the activities of daily living. Usually it includes major depressive disorder (MDD) and bipolar disorder (also called Manic Depressive Psychosis). , and, though not specifically written with the spiritual in mind, the book informs the reader of the feelings that emerge during the midst of a depressive episode which can leave the victim questioning the very meaning of her life. Combining his personal experience with a series of interviews with fellow suffers, he describes what depression "feels like," what it means to receive an "official" diagnosis, and what depressed persons think of the myriad of mental health experts--doctors, nurses, social workers, therapists--employed to help them. He especially focuses on the ongoing struggle to make sense of biochemical explanations and metaphors of depression as a disease. He is particularly poignant in his description of how society contributes to the widespread alienation and emotional exhaustion Emotional exhaustion is a chronic state of physical and emotional depletion that results from excessive job demands and continuous hassles. it describes feeling of being emotionally overextended and exhausted by one's work. of depression as the medical profession attempts to "medicalize med·i·ca·lize
To characterize a behavior or condition as a disorder requiring medical treatment. " the experience.
Smith J. Where the Roots Reach for Water: A Personal & Natural History of Melancholia. New York, North Point Press, 1997.
Smith was a psychiatric case manager in Montana when he first experienced a serious and protracted pro·tract
tr.v. pro·tract·ed, pro·tract·ing, pro·tracts
1. To draw out or lengthen in time; prolong: disputants who needlessly protracted the negotiations.
2. depression. He sought medications and therapy, but none were effective; his medical therapy was a failure, and he never fully recovered from the depressed mood. His depression lead him on a journey during which he learns much about his deepest inner feelings as he copes with melancholy. Along this journey he encountered the writings of many mystics, including Teresa of Avila Noun 1. Teresa of Avila - Spanish mystic and religious reformer; author of religious classics and a Christian saint (1515-1582)
Saint Teresa of Avila , Catherine of Sienna sienna: see ocher. , Meister Eckhart Noun 1. Meister Eckhart - German Roman Catholic theologian and mystic (1260-1327)
Eckhart, Johannes Eckhart , and Evelyn Underhill. All suggested to him that during the midst of severe depression, the consciousness of God vanishes, but when one quits theologizing depression and experiences its depths, then one can achieve a new state of equilibrium. Smith's book is quite different from virtually any other description of the personal and spiritual challenges that are brought by depression. Perhaps his final sentences best summarizes his journey: "And my thanks to our Almighty Creator. For everything, even melancholia."
Kramer PD. Listening to Prozac: A Psychiatrist Explores the Antidepressant Drugs Antidepressant Drugs Definition
Antidepressant drugs are medicines that relieve symptoms of depressive disorders.
Depressive disorders may either be unipolar (depression alone) or bipolar (depression alternating with periods of and the Remaking of the Self. New York, Viking Penguin, 1994.
Though Kramer says little about spirituality as it relates to depression, this groundbreaking book is essential reading for anyone wishing to understand the interaction between mood, medicines, and meaning. Kramer notes that we are on the verge On the Verge (or The Geography of Yearning) is a play written by Eric Overmyer. It makes extensive use of esoteric language and pop culture references from the late nineteenth century to 1955. of possessing medications that take us "beyond therapy." He focuses on the selective serotonin reuptake inhibitors Selective Serotonin Reuptake Inhibitors Definition
Selective serotonin reuptake inhibitors are medicines that relieve symptoms of depression.
Purpose (SSRI SSRI selective serotonin reuptake inhibitor.
Selective serotonin reuptake inhibitor; a class of drugs that inhibit the reuptake of serotonin in the central nervous system, used to treat depression and other ), specifically the one to take us into the new era, Prozac. Some people who take Prozac (and other newer medications) express the feeling that the medications can help them feel "better than ever"--in other words, the medications not only relieve the emotional suffering of depression, but they also can give people the feeling that they actually have experienced a change in their identities. For example, a person who was shy all her life is now much more outgoing. Although the SSRIs actually do not lead to such dramatic consequences in the vast majority of cases, the mere possibility of "designer personalities" has profound implications for those interested in spirituality and depression.
Durkheim E. Suicide: A Study in Sociology. New York, The Free Press, 1951.
Though an old study, the work of Durkheim has as much relevance today as it did over 100 years ago. Durkheim reasoned that since different groups in society have different suicide rates, characteristics of social organization may contribute to preventing suicide in some organization and may even prompt it in others. He classified suicide in three groupings: altruistic (in a tightly bound society, such as that of Japan, a member of that society will sacrifice her life for group goals); egoistic e·go·ist
1. One devoted to one's own interests and advancement; an egocentric person.
2. An egotist.
3. An adherent of egoism. (in a weakly attached society, the impulse toward suicide would not be thwarted for the person could not fall back upon relations in that society--Durkheim viewed Protestantism as egoistic whereas Catholicism was more integrated); and anomic anomic /ano·mic/ (ah-no´mik) lacking a name.
Socially unstable, alienated, and disorganized.
A socially unstable, alienated person. (a society that lacks clear-cut norms to govern aspirations and conduct a person will lose the security that group control and regulation can provide--Durkheim would have characterized much of American society as anomic). Durkheim supported his theories by noting that Protestants experienced higher suicide frequency than Catholics, and the unmarried, higher frequencies than the married.
Koenig H, McCullough M, Larson D. Handbook of Religion and Heatlh. New York, Oxford University Press, 2001, pp 118-143.
Though becoming somewhat dated, this text continues to provide the most comprehensive review of the literature that explores the relationship of religion and health. The purpose of the book is to review for the reader the evidence base supporting this relationship. Chapter 7 reviews the association of depression with religious affiliation, religious involvement, organizational and nonorganizational religious activity, religious salience sa·li·ence also sa·li·en·cy
n. pl. sa·li·en·ces also sa·li·en·cies
1. The quality or condition of being salient.
2. A pronounced feature or part; a highlight.
Noun 1. and motivation, and religious coping religious coping,
n means of dealing with stress (which may be a consequence of illness) that are religious. These include prayer, congregational support, pastoral care, and religious faith. . The authors conclude the chapter with a review of adjunctive and accommodative religious psychotherapies. In like manner, Chapter 8 reviews the association of suicide with religious affiliation, religious involvement, and attitudes toward suicide. Readers may be surprised with the expanse of the literature, a literature that is far from conclusive and at times contradictory. That said, the scientific study of religion and depression is moving from its infancy toward maturity; this book stands at an important developmental phase.
Meador K, Koenig H, Turnbull J, et al. Religious affiliation and major depression. Hosp Community Psychiatry com·mu·ni·ty psychiatry
Psychiatry focusing on detection, prevention, early treatment, and rehabilitation of emotional and behavioral disorders as they develop in a community. 1992;43:1204-1208
The investigators in this study examined the relationship between religious affiliation and major depression among 2,850 adults in the community. Religious affiliations were categorized into six groups: mainline Protestant (27%), conservative Protestant (59%), Pentecostal (4.2%), Catholic (2.4%), other religions (2.6%), and no affiliation (4.4%). The six-month prevalence of major depression among Pentecostals was 5.4%, compared with 1.7% for the entire sample. Even after psychosocial factors such as gender, age, race, socioeconomic status socioeconomic status,
n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. , negative life events, and social support were controlled for, the likelihood of major depression among Pentecostals was three times greater than among persons with other affiliations. Carefully designed studies are needed to understand the complex interactions of religion and mental health.
Ellison C. Race, religious involvement and depressive symptomatology symptomatology /symp·to·ma·tol·o·gy/ (simp?to-mah-tol´ah-je)
1. the branch of medicine dealing with symptoms.
2. the combined symptoms of a disease.
n. in a southeastern U.S. community. Soc Sci Med 1995;40:1561-1572.
Aspects of religious involvement may have beneficial implications for preventing or reducing depression, and religion may be an especially valuable resource for racial minorities in the United States. These issues are explored empirically using data from a large (n = 2956) community sample drawn in the southeastern US. Findings include the following: 1) frequency of church attendance is inversely associated with depressive symptoms among whites, but not among blacks; 2) absence of denominational affiliation is positively associated with depressive symptoms among blacks, but not among whites; 3) frequency of private devotional activities (eg, prayer) is positively associated with depressive symptoms among both racial groups.
Bosworth H, Park K-S K-S Kolmogorov-Smirnov (statistical test) , McQuoid D, et al. The impact of religious practice and religious coping on geriatric depression. Int J Geriatr Psychiatry 2003;18:905-914.
Both religiousness and social support have been shown to influence depression outcome, yet some researchers have theorized that religiousness largely reflects social support. Elderly patients (n = 114) undergoing treatment were examined using a standardized algorithm. Patients completed measures of public and private religious practice to measure religious coping, and subjective and instrument social support measures. A geriatric psychiatrist completed the Montgomery-Asberg Depression Rating Scale at baseline and six months. Both positive and negative religious coping were related to depression scores in treated individuals, and positive coping was related to depression six months later, independent of social support measures, demographic, and clinical measures (eg, use of electro-convulsive therapy, number of depressed episodes). Public religious practice, but not private religious practice, was independently related to depression scores at the time of completion of the religiousness measures. Religious coping was related to social support, but was independently related to depression outcome. The authors conclude that clinicians caring for older depressives should consider inquiring about spirituality and religious coping as well as social support as a way of improving depressive outcomes.
Cloninger CR. Feeling Good: The Science of Well Being. New York, Oxford University Press, 2004.
Though most physicians concentrate on the "disorder" of depression, a branch of psychology has emerged--positive psychology. In this book, Cloninger, a psychiatrist with deep roots in biologic psychiatry, integrates a lifetime of work to explore the science of well-being. His is a massive attempt, from a nonreductive perspective, to integrate extant knowledge across the biopsychosocial model to include the spiritual. He describes a way to coherent living that satisfies these strong basic needs through growth in the uniquely human gift of self-awareness. Though not everyone may agree with Cloninger's approach, anyone who seriously wishes to explore the interface of brain science with spirituality in trying to understand depression (and feeling good, which is not necessarily the polar opposite) would do well to read and absorb Cloninger's exposition.
Dan Blazer, MD, PhD