Welcome to the next installment of our conversation about clinical depression amongst nine BCC permas. Parts I and II can be found here and here. If you haven’t already read the series overview, please do so before proceeding. If you’re experiencing symptoms of clinical depression, contact a health care professional without delay.
All-Or-Nothing Religious Thinking Can Lead To Depression
What is the connection between depression and religion? It has long been observed that religious faith can help heal emotional pain. Even the most secular therapist will encourage her clients to explore their spirituality as part of recovery. Yet at the same time, religion and depression often seem to overlap in an insidious way. Religion can calm a troubled mind, yet the religious mind can be troubled. How do we make sense of this seeming contradiction?
As we seek an answer, let’s first look at one of the most effective treatments for depression, Cognitive-Behavioral Therapy (CBT) 1. CBT is based on the premise that our thoughts, feelings, and actionsare interconnected. A person who is severely depressed will also usually have distorted thoughts such as “I’m a failure,” or “Nobody would care if I were dead.” Painful emotions and distorted thoughts lead to unhealthy actions such as isolation and substance abuse, which reinforce the whole problem. Round-and-round we go, in the downward spiral of depression.
CBT acknowledges that we do not have conscious control over our feelings. We do, however, have some control over the other two areas. We can try to minimize depression-reinforcing behaviors. Most importantly, we can challenge distorted thinking. Replacing distorted thoughts with the truth is the core of CBT. “I’m a failure” becomes “I’ve had a setback but I’ve bounced back before.”
There are certain common thought distortions experienced by individuals who are depressed. A primary distortion is ‘all-or-nothing thinking.’ It is also described as ‘black-and-white’ or ‘either/or’ thinking. A good student who gets one D and tells himself “I am stupid” is engaged in all-or-nothing thinking. Prom date rejections lead many to think “I am ugly.” All-or-nothing thinking forms the basis of perfectionism, and cannot tolerate ambiguity or uncertainty. The problem is, life on earth is full of ambiguity and uncertainty.
Understanding the problem of all-or-nothing thinking helps answer our original question. Religious faith can acknowledge that we live in a world of uncertainty and provide comfort therein, or it can insist that reality is black-and-white and keep us trapped in all-or-nothing thinking. The latter is a path to depression for many. Evangelicals who divide humanity into the saved and unsaved are engaged in this thought distortion. Closer to home, at times Latter-day Saints engage in the similar thinking: “The Church is either completely true or the biggest fraud in history!” When I hear Mormons make this kind of statement I wonder what lies ahead for them. Those who cling to all-or-nothing religious beliefs often fall the hardest later on. At times, they fall into clinical depression.
How do you see the connection between religion and depression? Have you engaged in all-or-nothing thinking about your faith, and if so how has it affected you?
Butler AC, Chapman JE, Forman EM, Beck AT (January 2006). “The empirical status of cognitive-behavioral therapy: a review of meta-analyses”. Clin Psychol Rev 26 (1): 17–31
Beatrice: In the past I’ve thought about religion in black-and-white/all-or-nothing terms like Mike described, and it was depressing intellectually, but I wouldn’t say it contributed to my clinical depression. My worst faith crises occurred after I had moved past this all-or-nothing mindset re church. I don’t spend much time fretting over whether or not the church is true–whether it’s all true or whether it’s only partially true. What’s true theologically is going to be true regardless of what I think or feel about it, so I confess I don’t think that much about it. At this stage of my life I’m concerned mostly with doing good and not doing bad, and what concerns me and depresses me is when I don’t live up to moral expectations and the fact that I don’t have a close relationship with God, that I can’t access divine guidance and comfort the way other people do. I do feel adrift spiritually, and that is depressing.
Mistress Quickly: I haven’t struggled so much with all-or-nothing thinking in terms of the LDS church’s authenticity. (I loved Tracy M’s “Pillars of My Faith” essay on this topic.) But it’s definitely an issue for me in other ways. For many years I interpreted the gospel in a way that led to destructive expectations of myself and others. I struggled with various types of perfectionism (as do many women I know) and had little tolerance for the failure, weakness, and other difficult vehicles of growth that are an inevitable part of life. Treating my depression has enabled me to break free of a mindset that really hurt my family life and my spiritual development. I know my depression is ramping up when I fall into certain thought patterns about how a “good” person lives. Whether the thoughts cause the depression or the depression causes the thoughts, I can’t say for sure–I think it works both ways. But I do know that cognitive therapy does nothing for me if I’m significantly depressed. I need to be in a pretty good place mentally and emotionally to clearly identify, evaluate, and change my thought patterns. Likewise, spiritual “therapy” such as prayer, fasting, scripture study, temple attendance, etc. typically does nothing for me when depression is in full bloom.
Beatrice: Sometime while I was pregnant with my second child and suffering a particularly bad depression, I was praying in my daughter’s room because my daughter was sick with something I didn’t even know what it was and she kept screaming during the night (my husband was out of the country at the time), and at the time I just wanted some confirmation that God was there and he was mindful of me, as the saying goes. But no, nothing. Not a thing. And I remember thinking, “Unlike me, the imperfect, lacking-perfect-knowledge parent, who wants to comfort her screaming daughter but just doesn’t know how–God is ignoring me.” And at that point I stopped crying and stopped petitioning and I just said, “You know, one of these days I’m going to be well again. I’m not going to feel this way anymore. I’m going to be normal and do all of the things I used to do, but I will never forget that at this moment, when I was begging for your help, you left me alone.”
And I never have forgotten it. I like to think that I’ve matured since then, and I’ve had moments of insight and I’ve “forgiven” God, that depression is just my thorn in the flesh or whatever, blah blah–but that experience is burned into my memory. I don’t turn to God for comfort when I need it because I simply can’t believe I’ll get any. It’s pride, sure, but it’s all I have, so there. I don’t really do petitionary prayer on my best days, but on my worst days I would no sooner pray to Heavenly Father for comfort and/or guidance than I would consult tea leaves or apply banana peels to my plantar warts. It feels that silly to me.
Mistress Quickly: That might sound really harsh to some LDS, given how much we emphasize the power of prayer in times of adversity. But again, depression can be a completely different animal than any other type of adversity, because it screws with your ability to access God. And you know God could break through that wall if he really wanted to, so you’re left with the conclusion that he didn’t care to.
It’s a huge shock to realize that the portal to the divine you’ve always counted on is closed. I don’t think you ever get over that, entirely.
Portia: Beatrice’s excruciating description of feeling abandoned or ignored by God brings up something I think is important, and that happens right at the intersection of brain disorder and spiritual crisis. It seems to me that we have become more comfortable in Mormon culture about talking about depression, precisely because it has been medicalized, and we can explain it in comfortingly technical terms like “serotonin re-uptake” and “dopamine receptors.” What we still can’t do is talk about the spiritual aspects of it–it’s ok to stand up in testimony meeting and say “the Lord has helped me recover from postpartum depression through priesthood blessings and medical care,” but it simply isn’t ok to say “I feel abandoned by God. When you talk about your close relationship with Him, I wonder why I can’t feel what you do, and it makes me feel terrible.”
We countenance talking about grief, depression, and anger only when they’re safely in the past tense, or when we can explain them away as a physical, brain-based phenomenon. It’s understandable, of course, because it is painful and unsettling to see someone suffering and have prayer or priesthood blessings seem not to work–”mourning with those that mourn” can be (perhaps must be) a genuine challenge to the faith and testimony of the comforter, as well as the comforted. What does it mean to bear one another’s burdens, when one of our brother’s or sister’s burdens is despair, or the absence of hope and faith?
Mistress Quickly: I think it means a lot more than we’ll feel comfortable giving. I don’t know about you all, but I construct all kinds of paradigms in my mind to help me feel safe, and I feel threatened when someone’s experience doesn’t fit. I will do all kinds of mental gymnastics to avoid having to question the paradigm. I’d much rather blame a person or situation than face the possibility that the way I think things work is not how they actually work.
I think we have so many of these paradigms in our church culture–equations and charts and diagrams that are supposed to explain how God or life works–that there’s very little room for anything that isn’t neat and tidy, like despair. We’re quick to come up with ways in which the suffering person is responsible for her own mess, because we don’t want to believe that such things could happen to us without fault.
This year I’ve formed relationships with a group of people whose experiences have pulled me out of my comfort zone, people for whom my usual answers don’t work. Their reality challenges mine. I’m starting to realize that one of the greatest gifts we can give another human being is to be willing to reconsider our version of reality for their sake, to make uncomfortable shifts inside ourselves in order to make room for them. Especially, to give them the benefit of the doubt and not assume they’re struggling because they’re losers in one way or another.
Viola: I’ve had some problems with black and white thinking in terms of perfectionism and massive amounts of guilt but the biggest religious problem from my depression is the relationship with God. Through some of my own construct and some from Mormonism, I believed deeply in a very personal and intimate God. Very involved, aware. Giving me blessings and lessons and arranging things just for me. I believed he was that kind of God to everyone and would only occasionally run into problems with that when I’d think about the ‘blessing disparity’ in the world but mostly that didn’t enter into my thinking. (I’m self-focused like that.)
In my first depressive episode, like Beatrice, I felt completely rejected and felt in fact that God was not personal, mostly uninvolved and when he was involved he was capricious. This was the devastating part to me and I had to rework everything I believed about God, Jesus, the Atonement, my relationship to them. I felt like I had a new vision worked together okay but when all the complicated things went wrong in my ward, I found that there was nothing left keeping me. The personal relationship with God and Christ was now impersonal (it was the only way I knew how to deal with what I had seen, felt, experienced) mixed with the bad practical experience (my ward) was too much and I stopped going.
Mistress Quickly: This reworking you describe is at the heart of my experience as well. It’s still in process, and will be for a long time, I suspect. It’s hard, and frightening, and lonely, and most of all, disorienting. It’s like suddenly realizing that 2 + 2 equals 5, and having to redo every mathematical equation in your repertoire. But everyone else doing math keeps insisting that 2 + 2 = 4, and you can’t give 4 as the answer anymore without shredding your integrity. And every time you bring up the number 5, everyone around you looks at you like you’re crazy, or an infidel. And a lot of the time you wonder if maybe you are.
Ophelia: And it takes a tremendous amount of personal strength hold onto what you know, if the face of everyone else shouting 4’s at you. And in a sick twist, it’s that personal strength that is so lacking when fighting a depressive period, and the spiral continues down.
Falstaff: I hope I can write this without it being taken the wrong way, but at times like this I’ve never found God or prayer particularly useful. He vanishes with my good feelings. (I once rewrote the “Footprints in the Sand” story to end, “My son, I never left you. I was on your back.”) In fact, it becomes a source of frustration because he ought to be there by everything I’d been taught and believed. But in the darkest moments of my life I am abandoned. I know this is not true for many people. But those times I have really suffered I’ve also been forsaken. Notice I don’t say, “I feel like I was forsaken.” I am forsaken. People try and convince me that I only felt that way and God was footsteps-in-the-sand-ing me. If someone is not there, they are not there. I’m sounding bitter but I I’ve tried to come to grips with this my whole life. God will help me find a lost wrench but to get help when things are really tanking seems to be beyond his interest. I would not write this but I’m trying to lay it all on the table. In short, my prayers have come a bit like conversations with someone in a chat room. They can give me insight now and then, but they aren’t going to help me otherwise and should I ever need them, really badly, they’ll be logged off. I feel bad writing this. I feel like it can’t be true and I’m just not looking over my life in the right way. But there it is.
Mistress Quickly: Recently I read Valley of Sorrow for the first time. It was a step in the right direction as far as bringing LDS culture into this millennium regarding perspectives on mental health, but it’s only one drop in a very large bucket… Anyway, one line that stood out to me was something close to this: “Sometimes the pure love of God is the only thing that sustains those suffering with mental illness.” Which made me respond with something close to this: “Pffft.”
There are other quotes in the book that acknowledge how abandoned mental illness can make you feel, including one about “trodding the winepress alone” that I appreciated, yet the underlying message is still “you’re not alone; God never abandons you.”
It’s another aspect of the trap of depression: the time you need spiritual communion the most is the time you receive it the least. Whether it’s a matter of being unable to discern the spirit, or a matter of the spirit withdrawing, or a combination of the two, it’s awful.
Ophelia: There are days I think God is the worst Father there ever was. If I ignored the pleas of my children, if I left them in abject silence, if I was distant and mysterious, yet expected them to be obedient and love me before all else- how on earth could I be considered a loving parent? There are days when I am so mad at God I want to spit and curse Him. Then I feel guilty for even writing that sentence. Then I wonder if maybe the atheists are right and there is no God. I’m still terrified that God is not there- or like Viola said, that he’s distant and capricious. And that terrifies me more. But then I remember some of the more powerful experiences I’ve had and I know better. Then I wonder if I’m just emotionally mannipulating myself and there really is nothing after all. And round and round it goes.
I can’t believe I just told someone that.
Falstaff: What’s so surprising to me is how so many of you have had this experience. I was reluctant to share it even here, where I feel safer than I ever have before, in expressing my feelings honestly. Our discourse in the church does not touch or acknowledge this experience and I wonder if we stood and told these stories in a testimony meeting how many people would stand up weeping and say, ‘yea, verily!’ Thank you all so much for sharing.
Rosencrantz: I found myself in a position where I realized that when it came to the church and the gospel, I only believed about 5% of what I had believed previously. I had to make a decision to either leave, or to rebuild my testimony pretty much from the ground up. Obviously I stayed, but my testimony is much smaller than it was before, although I do think it is now more authentic and stronger.
Mistress Quickly: That’s exactly where I am right now. I’m definitely not leaving. But I’m letting go of a lot. You know at the end of Return of the King, when Barad-Dûr collapses, and the ground under the armies’ feet falls away, except for a small patch where the men are standing? That’s what it feels like. It scares the crap out of me, to tell you the truth.
Falstaff: I’m just glad that I have others to hold hands with on that little patch. I feel just a little more secure.
Ophelia: Maybe this IS perfect faith- are we not all hoping for things unseen and unproved? It’s the Hope that’s the important part. The part of being willing to believe. At least that’s what I’m holding to. I am not blessed with *the gift* of faith. So I have to make that leap- and remembering that faith is laid out scripturally as a gift is important. Lacking in faith is not a character flaw- it is something that requires different work from us.
Viola: I felt exactly, exactly what Beatrice did about God during my first breakdown. I felt so deserted. Prayers were meaningless, in fact I think I gave up praying during that time. The only constructive religious thing that came out of that was to realize how poisonous I had let my own guilt become. So I decided to let it go, in the very same way that you’re taught to get a bad thought out of your head by singing a hymn or something. I would feel guilty about not reading my scriptures or not liking my bishop or for just generally being a terrible person and then I’d sing a hymn and distract myself from the guilt. Now I’m a far less guilty person and I like that.
Mistress Quickly: I lived many years as a guilt sponge. I vividly recall sobbing to a friend on the phone one afternoon because I couldn’t get my kids to eat whole wheat bread. Shortly thereafter I had this experience where I envisioned myself in a small-ish boat which was rapidly sinking due to all the cargo. I realized if I didn’t let go of some things I would die. Literally. I was pretty sure God was deeply disappointed in me for a thousand and one reasons (beginning with the white bread) but I felt strangely certain that he didn’t want me to die. I decided I would chuck some of the cargo overboard, temporarily, just as a survival technique. I figured that if it was legitimate guilt it would wait for me, that God at least was merciful enough to wait until I was strong enough to face it. So I postponed a whole bunch of guilt. I don’t know how I did it. It must’ve been grace, because I was utterly incapable of “letting things go” before that point. Maybe it was just a fight-or-flight instinct that kicked in when I hit major danger. In any case, I have let go of a LOT of things–some that I should probably pick up again sometime, many that I now realize were pointless.
I am a big, big believer in doing what works. It wasn’t working for me to care about x, y, and z even though they were worthy things to care about. It doesn’t really matter how important it is to care about certain things if caring about them puts your life in danger. God doesn’t want me to self-destruct. That one point I am straight on.
Beatrice: Mistress Quickly, I like your boat analogy. Unloading cargo was the only way I survived the month of September. I’m doing better now, largely because I am still postponing guilt. I do wonder how long I can get away with postponing it before I start to hate myself again, though.
Viola: I say if you’ve postponed guilt now, it’s really best to postpone it indefinitely.
Ophelia: Guilt is deadly. It will sink you and kill your spirit faster than a thousand poison-dart-frog arrows. That might be easy for me to say, as it doesn’t happen to be one of the boulders on my back. But I have seen what its crushing, debilitating weight has done to loved ones. It’s a bad, bad thing.
Rosencrantz: My first round of depression settled on me when I was bishop of the ward. It was a really weird feeling to spend 4 or 5 hours in the bishop’s office trying to help people with their problems — sin, marriage up in smoke, crazy teenagers, you name it — and at the end of the evening to realize that I was undoubtedly in worse shape than any of the people who had sought my help. I felt like a major hypocrite, trying to offer hope to others when I felt none myself.
We had a GA visitor for stake conference and he wanted to interview the HC and bishops. I decided to just be brutally honest with him and hope that they would release me. When I told him what I was struggling with, that I thought I was failing in my calling, and that I was seeing a non-LDS professional therapist, I started to cry. He surprised me by getting up from behind the desk. He came and sat in the chair next to me and put his arm around my shoulder, and cried with me. It was about the nicest thing anybody has ever done for me, and totally unexpected.
Anyhow, he told me not to worry unduly about my depression. He told me he personally knew some GAs on anti-depressants, and that the pain and hopelessness I was feeling sometimes would make me a better servant because I would have more empathy and compassion for the flock.
And he was right. My experience with depression has helped me appreciate our LDS teaching about this life being a time of testing and growth. Obviously the testing part is a lot harder than I ever wanted or expected it to be, but at least the way we teach about the second estate give me a framework which helps me make sense of my life.
Part IV of this series, Successes and Challenges of Treatment, will be posted Thursday. Today we invite readers to respond to Mike’s questions as well as the other points brought up in the permas’ conversation.
Next in the series: Part IV: Everything Else for Now