A quick scan of the Canadian Mental Health Association website tells me that in a normal year, one in five Canadians will experience some sort of mental health problem or mental illness. At least 8 or 9 percent will suffer major depression at some point in their lives, 2 percent live with chronic depression, 1 percent are bipolar. If we were to zoom in then on an average Sunday morning at my little neighbourhood Anglican church, it would follow that about thirty-five people will suffer some kind of mental illness this year, fourteen will suffer major depression at some point, three or four are chronic depressives, and one or two are bipolar.
No doubt the COVID-19 pandemic has pushed all those numbers higher. But even before the pandemic, the actual numbers at my church would have been above average. Not because Anglicanism is especially bad for mental health, but because the little congregation I am a part of attracts a disproportionate number of sensitive, creative, and intelligent women and men, precisely the kind of people who tend to suffer more mental health trouble than most. It’s a good place to be when you’re low, especially the Sunday evening service, when the lights are dimmed, attendance is sparse, and the service includes long periods of silence. Plus, the chances of hearing a cheery, don’t-worry-be-happy kind of sermon are next to nil. If you are depressed, it’s a good place to sit for an hour at the end of a Sunday.
It is a stifling, claustrophobic, lonely thing to be depressed. But that isolating experience of depression belies the fact that there are patterns and clusters of symptoms that give the family physician a shorthand to help identify and diagnose your condition. Yes or no, are you experiencing any of the following? Feelings of hopelessness, increased irritability, loss of enjoyment in otherwise satisfying activities, significant changes in sleep patterns, changes in appetite, racing or obsessive thoughts, thoughts of self-loathing, thoughts of self-harm, suicidal ideation. Have these symptoms persisted for more than two weeks? Tick five or more boxes and your doctor can diagnose your condition as mild, moderate, or major before prescribing some pharmaceuticals, recommending a therapist, or referring you to a psychiatrist.
The checklist is useful shorthand for, say, the overworked rural doctor who has five minutes with the fifty-two-year-old recently divorced farmer who has spent decades cultivating the skill of not talking about his feelings. But even an exhaustive list of symptoms couldn’t get you or the doctor inside what depression feels like. Andrew Solomon’s The Noonday Demon: An Atlas of Depression puts the experience into words better than anything else I’ve read. The book recounts Solomon’s personal history of severe, crippling depression in harrowing detail, but it also dives deep into different ways of understanding the condition: the history of melancholy and depression, traditional and alternative treatments, neuroscience and brain chemistry, depression and gender, suicide, addiction, philosophy, theology, and politics.
“The opposite of depression is not happiness,” writes Solomon. The opposite of depression is “vitality.”
Mild depression is a gradual and sometimes permanent thing that undermines people the way rust weakens iron. It is too much grief at too slight a cause, pain that takes over from the other emotions and crowds them out. It hurts our heart and lungs, making the contraction of involuntary muscles harder than it needs to be. . . . Large depression is the stuff of breakdowns. . . . The first thing that goes is happiness. But soon other emotions follow happiness into oblivion: sadness as you had known it, the sadness that seemed to have led you here; your sense of humor; your belief in and capacity for love. Your mind is leached until you seem dim-witted even to yourself. You smell sour even to yourself. You lose the ability to trust anyone, to be touched, to grieve. Eventually, you are simply absent from yourself.
Literary accounts of depression like Solomon’s are simultaneously hard to read and comforting. Hard to read because of the deep, visceral torment of depression, and the better the writer, the more harrowing the account; and comforting because they break that stifling loneliness: someone else knows what this feels like. Lauren Winner’s beautiful, gut-wrenching book Still is a spiritual memoir of something like depression, a soul-searching reflection in the fallout of a divorce. Mary Karr’s devastating Lit isn’t exactly about depression, but the lethal drinking she describes is a go-to coping strategy for plenty of depressives. Three decades ago William Styron published a haunting memoir of depression and suicidal ideation called Darkness Visible. Here’s the first line: “In Paris on a chilly evening late in October of 1985 I first became fully aware that the struggle with the disorder of my mind—a struggle which had engaged me for several months—might have a fatal outcome.” When I was in university, my mom recommended I read John Bentley Mays’s In the Jaws of the Black Dogs, which opens with this:
This book is a life with the black dogs of depression. I have written it in a clearing bounded by thickets roamed by the killing dogs, sometimes wondering, in the writing, whether I would complete it before they returned on silent paws to snatch the text and take me away. For the depressed can never be sure we can finish anything we begin, or indeed certain of anything except the black dogs’ eventual return, and their terrible circling at the clearing’s edge.
The Australian poet Les Murray wrote a slim little depression memoir called Killing the Black Dog that begins,
On the last day of 1985 I went home to live in Bunyah, the farming valley I had left some twenty-nine years earlier. My wife and our younger children followed two days later. . . . I was going home to care for my father in his old age and to live in the place from which I’d always felt displaced. What I didn’t know was that I was heading home in order to go mad.
I’m partial to the simple term “depression”—a low, swampy spot in a field you’d better skirt around with the tractor. I also like the term “depressed”—pushed down, like the brake pedal in your car. But when I’m stuck and pressed down in my own depressive spell, the images of a consuming dark, or packs of hungry, slavering canines—all the visceral, terrifying metaphors authors use to try to express the experience of depression—speak more deeply to my experience.
I come from a long line of depressives and bipolars on my maternal side. My mom is a moderate depressive, and her oldest sister suffered from crippling bipolar disorder for more than thirty years. I have numerous cousins with wobbly mental health, one who’s been unable to work for more than two decades because of depression and bipolar disorder. Two young cousins committed suicide in the past decade, one a severe depressive, the other bipolar.
I’m a chronic depressive with bipolar tendencies. I had my first real depressive episode when I was eighteen and since then seem to have a couple bad spells every year. I’m high-functioning, so even at my worst I can still get out of bed and go to work. I still shower and shave, eat with my family, mow the lawn, shop for groceries. I can only think of a handful of meetings I’ve cancelled because of depression. It doesn’t look that bad, and by many measures I suppose it really isn’t. That’s one of the painful things about depression: it really is all in your head. If you accidentally bust your femur you’ll be wearing a cast for six weeks, and even total strangers can tell what’s wrong. If you need heart surgery, it’s not the kind of thing where you can put on a brave face and power through. The doctor prescribes bypass surgery, and you’re looking at ten days in the hospital and six months’ recovery, plus a big trophy scar down the middle of your chest. But if it’s depression, how do you know you’re not just being mopey, pathetic, and self-absorbed? Everyone else goes about their days without much fuss, and you can name a dozen people who’ve lived through a whole lot of circumstances more catastrophic than yours. What’s your problem? Solomon recounts a conversation with an editor who questioned whether he’d ever really been depressed. “I don’t buy into this whole depression business,” he tells Solomon. “C’mon. What the hell do you have to be depressed about?” Solomon writes, “I protested that people who have never been depressed don’t tend to pretend about it, but he was not to be persuaded. No matter what you say about your depression, [some] people don’t really believe you unless you seem acutely depressed as they look at and talk to you.”
Three years ago I had a really bad spell that started mid-October, was in full swing by November, and didn’t lift until the end of January, twice as long as what I’m used to, and especially dark. I mentioned to a friend that I’d had a rough few months, and he asked, “What does that feel like?” I told him it was three long, dark months of trying as hard as I could to not want to kill myself.
I didn’t mean to be glib; I was trying to be succinct. When my oldest daughter was born I made a vow to her and to God that I would not kill myself. I made a vow to stay, even when I felt like things might be better if I was no longer around, and that the lives of those I love might be easier if they didn’t have to deal with me and my recurring, abysmally dark moods. But the self-destructive thoughts persist. January three years ago, I was working alone in the kitchen after supper, washing dishes. I took the big chef’s knife from the drying rack and wiped it dry with a dish towel, and on the four short steps between the sink and the knife block, I had to say out loud to myself: “No. No. No. No.” By the time I got to the fourth “no” I was sobbing. I wasn’t saying no to the temptation to actually slice an artery, but no to the tempting, haunting thought that killing myself was somehow a good idea, no to the dark thought hinting that those around me would be better off if I were dead. Fourteen years into my promise to God and to my daughter, and I still had to renew my vow: No, No, No, No.
Here’s another symptom of depression, at least for me: doubt. I don’t have much natural capacity for genuine faith to begin with, but when depression hits, it smothers the little bit that’s there. When I’m sunk low, Christian language can feel entirely hollow and dead. Those lofty words of the liturgy, the poetry in the hymns, the thoughtful, meditative sermon: there is no spiritual succor in any of it. I don’t expect an ecstatic encounter with the Almighty every time I show up at church, but the elevated language of worship exaggerates the depths of what’s inside my head.
For the depressive, the good thing about liturgy is that it doesn’t matter much how you feel because worship, like Scripture, isn’t really about you. When depression has me so pressed down I can barely muster a plea for help, the recited prayers promise that the love of God in Christ is present anyway. The liturgy doesn’t make the snarling black dogs lie down and rest, but depression doesn’t get the last word. I bring myself to church, hoping that the love of God will meet me, and when I can’t figure out how to make room for Jesus in my heart, I can still process to the front and kneel at the altar, and receive the Eucharist. Regardless of what’s inside my head, the bread and wine still fit inside my mouth.
In John’s Gospel, Jesus and his disciples meet a blind man, and the disciples ask, “Who sinned, this man or his parents?” Jesus responds, “Neither this man nor his parents,” which seems like a relief at first, but then he keeps going: “this happened so that the works of God might be displayed in him.”
Don’t go quoting this passage to depressives. They might wish they had sinned, because at least then they’d know why they were suffering. Better that than listening to you tell them their suffering is for God’s glory. To quote this passage to someone who’s depressed is stupid, reckless, and wrong. Jesus’s word here is for his disciples, not for the blind man. The blind man needs healing, not a lecture in theodicy. Likewise, if you’re caring for someone who’s depressed, Jesus’s words might be for you, the one who wants to know how to care for the one who’s suffering. This depressed man or woman—your friend, sister, cousin, father, or daughter—is not to blame for the suffering. The point isn’t that God makes bad things happen but that he can take anything and use it for his glory.
When you’re depressed, you need help: talk therapy, maybe pills, cognitive behaviour therapy. Go find the physicians, therapists, psychiatrists, psychologists, and nurses, and quit dowsing for answers in Scripture. One of my friends, a Quaker and a poet, told me he mostly watches television when he’s depressed. “I can’t even read genre fiction,” he said. “I try to read anything, and my eyes just slide off the page.” It’s the job of the rest of us to read Scripture on behalf of, and to pray for, those who are in the depths of depression. It isn’t our job to try to figure out the cause of someone else’s suffering. And if you are the one living your days in the teeth of the black dogs, it’s not your job to try to make sense of your suffering either. You need someone to love you, someone to simply show up. That sounds simple enough, but like most simple things, it is the hardest thing to do. Depressed people with even an ounce of self-awareness know that they’re not easy to be with. It’s hard to simply be present with anyone in their suffering, and serious depression is a serious kind of suffering. Yet simple, authentic presence can be everything. For the depressive, lost in the dark, empty, vicious places inside your own head, the simple loving presence of another is life-giving. Jesus’s promise that “where two or three are gathered in my name, there am I with them” can be the life-saving reality when the black dogs are circling, a simple reminder that you are not alone.
It wasn’t until the nineteenth century that the term “mental depression” even came into use. But since the fourth century, Christian tradition has diagnosed a set of behaviours, attitudes, and dispositions that overlap with it in many ways. One of the most long-lasting metaphors used to talk about depression is the noonday demon. “Most demons rely on the cover of night,” writes Solomon. “To see them clearly is to defeat them. [But the noonday demon] stands in the full glare of the sun, unchallenged by recognition. You can know all the why and the wherefore and suffer just as much as if you were shrouded by ignorance.”
The noonday demon refers to what ancient Christian monastics called “acedia.” Before we had the seven deadly sins, monastics counted eight bad thoughts, including acedia, which they considered worst of all. The Greek term simply means the absence of care, but the experience of acedia is complex: a stubborn sadness that could lead a monk into a state of great distress; detached, uncaring, resentful, and distracted weariness; torpor; an aversion of the appetite for its own good; an aversion to God himself. The desert fathers and mothers knew the dangers of bad thoughts, and the monastic life included ongoing, deliberate examination of one’s thoughts. Countless passages from the writings of the fourth-century Christian monastics resemble aspects of modern psychology, especially cognitive behaviour therapy. In a passage that sounds like it could have been written yesterday, the fourth-century monk Evagrius of Pontus said that the noonday demon “makes it seem that the sun barely moves, if at all, and that the day is fifty hours long. . . . He instills in the heart of the monk a hatred for the place, a hatred for his very life itself, a hatred for manual labour,” followed by a hatred for prayer. “He leads him to reflect that charity has departed from among the brethren, that there is no one to give encouragement. Should there be someone at this period who happens to offend him in some way or other, this too the demon uses to contribute further to his hatred.”
Acedia is the kind of restlessness and resentment that grows in the heart of the monastic whose life is one of commitment, discipline, repetition, prayer, and focus, and it was long considered something only a monk or a nun would have to contend with. In the slow transition from the eight bad thoughts to the seven deadly sins, acedia was basically lumped with the sin of sloth, which has come to be associated with simple laziness. The term largely fell out of use until the middle of the twentieth century, when it began to re-emerge as a descriptor for Western culture’s spiritual listlessness and apathy, life in the land of plenty, with empty souls.
Every Sunday I confess that I have sinned against God, “in thought, word, and deed, by what I have done, and what I have left undone.” Morning prayer bids us profess: “There is no health in us,” and evening prayer calls us “miserable offenders.” But is it even possible to talk meaningfully about depression and sin at the same time? Isn’t “sin” a religious hangover, an archaism, psychologically damaging, definitely unfashionable? “Sin” conjures bad memories—or caricatures—of Sunday sermons from Bible-thumping fundamentalists, prophesying sulfur and hellfire for those who indulge in the desires for things like sex and booze. The prolific, outspoken blogger Chrissy Stroop, who calls herself an “exvangelical,” thinks the language of “sin” is nothing more than a tool that abusive and powerful religious leaders use to gaslight followers. Plenty of mental health experts would argue it’s harmful and foolish to talk of sin in the age of science. Why complicate things by introducing religious language and metaphysics?
But there’s no getting around it. The core problems of acedia and depression are rooted in a fundamentally metaphysical question: “What is man that thou art mindful of him?” We are the curious, questioning, suffering, searching species. Christianity offers a meaningful, coherent vocabulary for who we are, where we’re from, and what’s gone wrong. Actually wrong, not just unpleasant, distasteful, troubling, or problematic. “Sin” is the only word potent enough to account for what’s really wrong with the world, including me. Not that it’s fun: meaningless, hedonistic pleasure, for example, sounds a whole lot more fun than sin and salvation. But the problem with picking a word or a concept you think sounds better is that you don’t actually know what you need because you don’t actually know yourself nearly as well as you imagine. The self-help drivel that encourages you to “be the expert on you” leaves you free to choose the religious options that feel just right, skip the unsavoury bits, and jettison words like “sin” if they make you uncomfortable. Pick-a-path religion leads to a hackneyed, self-indulgent self-portrait, a lukewarm mush of likes and dislikes so limp and tepid it’s hardly real belief at all.
Sin matters because life matters, and that bedrock of meaning depends on the real presence of God. Absent the Almighty, and the whole enterprise is strung together in flimsy, arbitrary ways. Culture’s disparate and disputed metaphors for what constitutes a human being are carrying us away from meaningful, effective treatments for maladies like acedia because we have no real sense of what it actually means to be human.
Consumer culture thrives on the restless, tired, bored apathy of acedia. In spite of many anxious warnings about the impending doom of our overconsumption, modern technological consumer culture chugs happily along unabated. Wall Street and Bay Street don’t want you to think about your soul because the health of the economy depends on your not thinking about your soul. Even the popular, lukewarm spiritual practice of mindfulness has proved lucrative, another way to gloss over the deeper soul condition and help folks keep it together emotionally without seriously disrupting business as usual. Acedia is great for the economy.
With the twin false promises that you can have the life you want and that you deserve to be happy, consumer culture offers an endless array of stuff to buy that will help you feel good. And the truth is, it works. Buying stuff feels good. I’m not much drawn to fashion, gadgets, or shiny objects, but for me three hours in the bookstore is better than drugs, and Lord knows I get a way stronger dopamine hit buying books that I do actually reading them. There’s always something to buy to numb the boredom of real life, something to quell the thrumming, aching restlessness of existence. “Consumer therapy” gives you the sensation of doing well without the hard work of spiritual discipline, and when that dopamine high wears off—which it always does—you can go back and buy something again, because the malls are open till nine, the bookstore open till ten, and Amazon is open forever.
Where the economic metaphors rule, the human is not a soul but a consumer. Mental health treatment boils down to questions of cost. The psychiatrist only has so much time, so she’s got to quickly diagnose whether you’re going to be a lifer or a straightforward “buff and turf”: Sign the script for the SSRI and lithium, fill out the paperwork, and on to the next patient. Repeat. Obviously there are caring, thoughtful, wise men and women in the mental-health-care field. Some of them go to my church. I am deeply grateful for them, just as I am deeply grateful for the mental health system and a benefit plan that pays for the little egg-shaped yellow pill I take every morning to help keep my head on straight. We badly need mental health professionals. But we also need soul health professionals because there’s more to you and me than what the doctors can measure and chart.
“Sin” says that yes, you actually do make things worse for yourself, and you’ve got some responsibility for your condition. It is unprofessional, dangerous, and immoral to tell a clinically depressed patient that their problem is a spiritual matter, so throw away those pills, confess your sins, and pray to Jesus for deliverance and healing. At the same time, it’s misleading, foolish, and unloving to offer someone advice about psychiatry, antidepressants, and mood stabilizers and not once bring up questions about the state of their soul. Sin is sin, and switching around the labels doesn’t change what’s in the can.
Christian theology says that human beings are lumps of clay shaped and animated by the breath of God himself, and that we have been made for communion with that very God. It also says there’s something wrong with you that cannot simply be reduced to chemical imbalance. Sin is a useful and meaningful term because it says that there is something that we’ve deviated from, a moral “oughtness” to what we are as humans, a misalignment between what is and what should be. Anyone who’s suffered with depression knows something is wrong, and that experience of suffering is a sign of the gap between is and ought. Without the religious language of sin and acedia to help deepen our understanding of ourselves, suffering is meaningless, random shit, bad luck, and bad timing. The language of sin allows you to start by saying a clear, decisive no: this is not how things are meant to be. I’ve had well-meaning friends suggest that it might be religious language that makes me miserable, that I might feel better if I stopped going to church. But I’m already miserable. I don’t go to church to feel good. I go to church because there I find language and ritual potent enough to make sense of what I’m already suffering. That religious language also includes “soul,” which says that every single human being is a miracle of God’s grace and an object of his love, and each of us is invited and encouraged into a posture where each can speak of the God of the universe as my God. There’s sin that goes all the way down and all the way back, and I keep coming back to church to confess that I am a miserable offender; that there is no health in me. Every year I get an ashy cross smeared on my forehead and hear the sombre words of our priests: “Remember, son of Adam: from dust thou hast come; to dust thou shalt return.” The church tells the truth about the gravity of my condition. But I also come to church every Sunday to lift my face and watch the priest say these words: “Almighty God have mercy upon you, pardon and deliver you from all your sins, preserve and strengthen you in all goodness, and bring you to everlasting life, through Jesus Christ our Lord”—and then bless the whole lot of us with the sign of the cross.