The Psychological Roots

“I’VE done every test, and nothing shows up,” the kindly doctor told Elizabeth. “I believe you are severely depressed and for good reason.”

Elizabeth, who felt that her problem was a physical illness, began to wonder if the doctor was correct. She reflected on her daily struggle for the past few years with her unruly, and often uncontrollable, six-year-old son, who was later diagnosed as having an attention-deficit disorder. “The day-in, day-out stress and anxiety that never let up took an enormous toll on my emotions,” confided Elizabeth. “I had reached the point where I felt hopeless and suicidal.”

Many depressed persons, like Elizabeth, have faced an exceptional amount of emotional strain. In fact, a landmark study by British researchers George Brown and Tirril Harris found that depressed women had a rate of “major difficulties,” such as bad housing or a strained family relationship, that was over three times greater than that of nondepressed women. These difficulties had caused “considerable and often unremitting distress” for at least two years. Severe life experiences, such as the death of a close relative or friend, a severe illness or accident, shockingly bad news, or the loss of a job, also were four times more common among the depressed women!

Yet, Brown and Harris found that adversity alone does not cause the depression. Much depended on the mental response and emotional vulnerability of the individual.

“Everything Seemed Hopeless”

For instance, Sarah, a hardworking wife and the mother of three young children, wrenched her back in a job-related accident. Her doctor said that she would have to curtail much of her physical activity because of a ruptured disk. “I thought my whole world had come to an end. I had always been an active, athletic person who played sports with my kids. I pondered this loss and felt things would never get better. Soon I lost all joy of living. Everything seemed hopeless,” confessed Sarah.

Her reaction to the accident led to thoughts of hopelessness concerning her life as a whole, and this bred the depression. As Brown and Harris, in their book Social Origins of Depression, state: “It [the provoking incident, such as Sarah’s accident] may lead to thoughts about the hopelessness of one’s life in general. It is such generalization of hopelessness that we believe forms the central core of a depressive disorder.”

But what makes many people feel unable to repair the damage of a painful loss, causing them to fall into major depression? Why was Sarah, for example, vulnerable to such a negative train of thought?

‘I’m Unworthy’

“I’ve always lacked confidence in myself,” explained Sarah. “My self-esteem was very low, and I felt unworthy of any attention.” The painful feelings associated with one’s lacking self-worth are often the critical factor. “Because of the pain of the heart there is a stricken spirit,” states Proverbs 15:13. The Bible recognizes that a depressed spirit can be the result, not of external pressures alone, but of inward misgivings. What can cause low self-esteem?

Some of our thought patterns are shaped by our upbringing. “As a child, I was never praised by my parents,” confided Sarah. “I cannot ever remember receiving a compliment until after I was married. Consequently, I sought approval from others. I have this terrible fear of people’s disapproval.”

Sarah’s intense need of approval is a common element with many who become seriously depressed. Research has revealed that such persons tend to build their self-esteem on the love and approval received from others, rather than on their own achievements. They may estimate their own worth by the extent that they are likable or significant to someone else. “Loss of such support,” reports one team of researchers, “will lead to a fall in self-esteem and this contributes significantly to the onset of depression.”

Perfectionism

An exaggerated concern about gaining the approval of others often expresses itself in an unusual way. Sarah explains: “I strove to do everything just right so that I could get the approval that I didn’t get as a child. On my secular job, I did everything just so. I had to have the ‘perfect’ family. I had this image that I had to live up to.” When she had her accident, however, all seemed hopeless. She adds: “I believed I was keeping the family going and feared that if I couldn’t function, they would fail and then people would say, ‘She is a bad mother and wife.’”

Sarah’s thinking led to major depression. Research about the personalities of depressed persons reveals that her case is not unique. Margaret, who also suffered from severe depression, admitted: “I worried about what others thought of me. I was a perfectionistic, clock-watching, organized worrier.” Setting unrealistically high goals or being overly conscientious, and yet failing to live up to expectations, is at the root of many depressions. Ecclesiastes 7:16 warns: “Do not become righteous overmuch, nor show yourself excessively wise. Why should you cause desolation to yourself?” Trying to show yourself nearly “perfect” to others can lead to emotional and physical desolation. The frustrations can also lead to a destructive type of self-blame.

“I Can’t Do Anything Right”

Self-blame can be a positive reaction. For instance, a person may be robbed because of walking alone in a dangerous neighborhood. He may blame himself for putting himself into such a situation, resolving to change and thereby avoid a similar problem later. But a person could go further and blame himself for the type of person he is by saying: ‘I’m just a careless person who is unable to stay out of trouble.’ This type of self-blame faults one’s character and undermines self-esteem.

An example of such destructive self-blame occurred with 32-year-old Maria. For six months she harbored resentment toward her older sister because of a misunderstanding. One evening she lambasted her sister over the phone. Their mother, upon finding out what Maria had done, called and strongly reprimanded her.

“I got mad at my mother, but I was even more upset with myself, for I learned how much I had hurt my sister,” explained Maria. Shortly afterward she yelled at her nine-year-old son, who was misbehaving. The boy, who became very upset, later said to her: “Mommy, you sounded like you wanted to kill me!”

Maria was crushed. She reported: “I felt that I was a terrible person. I thought, ‘I can’t do anything right!’ That’s all I could think about. Then the deep depression really began.” Her self-blame proved destructive.

Does all of this mean that everyone with major depression has low self-esteem? Of course not. The causes are complex and varied. Even when the result is what the Bible calls ‘pain of heart,’ there are many emotions that cause this, including unresolved anger, resentment, guilt​—real or exaggerated—​and unsettled conflicts with others. (Proverbs 15:13) All of these can lead to a stricken spirit, or depression.

When Sarah realized that her thinking was at the root of much of her depression, at first she was crushed. “But then I felt a measure of relief,” she confided, “because I realized that if my thinking caused it, then my thinking could also fix it.” Sarah said this thought was exciting to her, explaining: “I realized that when I changed the way I was thinking about certain things, this could affect my life from here on for good.”

Sarah made the necessary changes, and her depression lifted. Maria, Margaret, and Elizabeth likewise won their fight. What changes did they make?

[Blurb on page 10]

‘When I realized that my thinking caused my depression, this gave me some relief and comfort because I believed then I could also fix it.’

Some depressed persons fail to seek skillful direction because of their fear of being viewed as mentally weak. Yet, major depression is a sign neither of mental weakness nor of spiritual failure. Research indicates that this severe disorder may exist when there is a certain chemical malfunction in the brain. Since a physical illness may cause this, if you have been severely depressed for longer than two weeks, a medical examination may be advisable. If no physical illness is found to be contributing to the problem, often the disorder can be improved by adjusting the thinking pattern along with some help from appropriate medication or nutrients.a Winning the fight against depression does not mean that you will never have a depressed mood again. Sadness is a part of life. Yet, skillfully directing your blows will help you deal with depression better.

A doctor will often prescribe antidepressants. These are drugs designed to clear up the chemical imbalance. Elizabeth, mentioned earlier, used these, and within weeks her mood began to improve. “Still, I had to cultivate a positive attitude to work along with the drugs,” she said. “With the ‘push’ from the medicine, I was determined to get well. I also maintained a daily exercise program.”

However, the use of antidepressants is not always successful. There are also troublesome side effects for some. And even if the chemical malfunction is corrected, unless one’s thinking is corrected, the depression may return. Much relief, however, can come by being willing to . . .

Open Up Your Feelings

Sarah deeply resented the one-sided load of family responsibilities that she carried, as well as the pressures of a secular job. (See page 7.) “But I just stuffed my feelings inside me,” explained Sarah. “Then one night when I felt so hopeless, I phoned my younger sister, and for the first time in my life, I began to pour out my feelings. This was a turning point, as that call brought such relief.”

So, if depressed, seek out an empathetic person in whom you can confide. This one may be a marriage mate, close friend, relative, minister, doctor, or trained counselor. One of the essentials in defeating depression, according to a study reported in the Journal of Marriage and the Family, is “having a support helper available with whom to share the tribulations of life.”

Putting your feelings into words is a healing process that prevents your mind from trying to deny the reality of the problem or loss and, hence, leaving this unresolved. But open up your real feelings. Don’t allow a sense of false pride, wanting to have an undaunted-by-adversity appearance, to inhibit you. “Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice,” states Proverbs 12:25. Yet, only by opening up can others begin to understand your “anxious care” and thus give that “good word” of encouragement.

“I just wanted sympathy when I called my sister, but I got a lot more,” recalled Sarah. “She helped me to see where my thinking was wrong. She told me that I was putting too much responsibility on myself. Though at first I didn’t want to hear this, when I began to apply her counsel, I could sense that a huge load began to be lifted.” How true are the words of Proverbs 27:9: “Oil and incense are what make the heart rejoice, also the sweetness of one’s companion due to the counsel of the soul.”

There is sweetness in having a friend or a mate who talks frankly and helps you to put things in proper perspective. This may help you to focus on just one problem at a time. So rather than becoming defensive, cherish such “skillful direction.” You may need someone who, after several conversations, can offer some short-term goals that will indicate steps you can take to change or modify your situation so as to reduce or eliminate the source of the emotional strain.b

Fighting depression often requires contending with feelings of low self-esteem. How can these be skillfully resisted?

Fighting Low Self-Esteem

For instance, Maria, as the preceding article shows, became depressed after conflicts within her family. She concluded: ‘I am a terrible person and can’t do anything right.’ This was wrong. If she had just analyzed her conclusions, she could have challenged these by reasoning: ‘I do some things right and some wrong, just like other people. I made a couple of mistakes, and I need to work on being more thoughtful, but let’s not blow this all out of proportion.’ Such reasoning would have left her self-esteem intact.

So often that overly critical inner voice that condemns us is wrong! Some typical distorted thoughts that breed depression are listed in the accompanying box. Learn to recognize such erroneous thoughts and mentally challenge their validity.

Another victim of low self-esteem was Jean, a 37-year-old single parent. “I was under strain trying to rear two boys. But when I saw other single parents get married, I thought, ‘Something must be wrong with me,’” she explained. “By dwelling on just negatives, these snowballed, and I ended up hospitalized for depression.”

“After leaving the hospital,” Jean continued, “I read in the Awake! of September 8, 1981, a list of ‘Thoughts That Can Incline One to Depression.’ Each night I read that list. Some of the wrong thoughts were, ‘My value as a person depends on what others think of me,’ ‘I should never feel hurt; I should always be happy and serene,’ ‘I should be the perfect parent.’ I tended to be a perfectionist, so as soon as I would think that way, I’d pray to Jehovah to help me stop. I learned that negative thinking leads to low self-esteem, for all you see is the trouble in your life and not the good that God has given you. By forcing myself to avoid certain incorrect thoughts, I got over my depression.” Do some of your thoughts need to be challenged or rejected?

Is It My Fault?

Although Alexander was very depressed, he managed to teach a school class. (See page 3.) When some of his pupils failed a very important reading test, he became suicidal. “He felt that he had failed,” reported Esther, his wife. “I told him it was not his fault. You can’t have 100-percent success.” Yet, his overwhelming guilt closed his mind and led him to suicide. Often, exaggerated guilt is caused by assuming an unrealistic responsibility for the behavior of other people.

Even in the case of a child, a parent can strongly influence his life but not absolutely control it. If something does not go as well as you had planned, ask yourself: Did I face unforeseen occurrences beyond my control? (Ecclesiastes 9:11) Did I do all I reasonably could within the limits of my physical, mental, and emotional resources? Were my expectations just too high? Do I need to learn to be more reasonable and modest?​—Philippians 4:5.

But what if you do make a serious mistake, and it is your fault? Will continuing to beat yourself mentally change the mistake? Is not God willing to forgive you, even “in a large way,” if you are genuinely repentant? (Isaiah 55:7) If God will “not for all time keep finding fault,” should you sentence yourself to a lifetime of mental suffering over such wrongdoing? (Psalm 103:8-14) Not constant sadness but taking positive steps to ‘right the wrong’ is what will please Jehovah God and also ease your depression.​—2 Corinthians 7:8-11.

‘Forget the Things Behind’

Some of our emotional problems may be rooted in the past, especially if we were victims of unjust treatment. Be willing to forgive and forget. ‘Forgetting is not easy!’ you may be thinking. True, but it is better than destroying the rest of your life by dwelling on what cannot be undone.

“Forgetting the things behind and stretching forward to the things ahead,” wrote the apostle Paul, “I am pursuing down toward the goal for the prize.” (Philippians 3:13, 14) Paul did not dwell on the wrong course he had pursued in Judaism, including even approving of murder. (Acts 8:1) No, he concentrated his energies on qualifying for the future prize of eternal life. Maria also learned not to dwell on the past. At one time she blamed her mother for the way she had reared her. Her mother had stressed excellence and physical beauty; hence, Maria was a perfectionist and tended to be jealous of her attractive sister.

“This underlying jealousy was the root of the conflicts, but I blamed my family for the way I acted. Then I came to the point where I thought, ‘Really, what difference does it make whose fault it was?’ Maybe I have some bad traits because of the way Mother raised me, but the point is to do something about it! Don’t continue to act that way.” This realization helped Maria make the needed mental adjustments to win her fight against depression.​—Proverbs 14:30.

Your Real Value

All factors considered, successfully fighting depression requires having a balanced view of your own worth. “I would say to every one of you,” wrote the apostle Paul, “not to estimate himself above his real value, but to make a sober rating of himself.” (Romans 12:3, Charles B. Williams) False pride, ignoring our limitations, and perfectionism are all an overestimate of ourselves. These tendencies must be resisted. Yet, avoid going to the other extreme.

Jesus Christ stressed the individual worth of each of his disciples by saying: “Five sparrows sell for two coins of small value, do they not? Yet not one of them goes forgotten before God. But even the hairs of your heads are all numbered. Have no fear; you are worth more than many sparrows.” (Luke 12:6, 7) We are of such worth to God that he takes note of even the minutest detail about us. He knows things about us that we do not know ourselves because he deeply cares about each of us.​—1 Peter 5:7.

Recognizing the personal interest God had in her helped Sarah to improve her feelings of self-worth. “I always felt awe for the Creator, but then I came to realize that he cared about me as a person. No matter what my children do, no matter what my husband does, regardless of how my mom and dad raised me, I realized I had a personal friendship with Jehovah. Then my self-esteem really began to grow.”

Since God considers his servants precious, our worth does not rest on approval by another human. Of course, rejection is unpleasant. But when we use another’s approval or disapproval as the yardstick by which to measure our own worth, we are making ourselves vulnerable to depression. King David, a man after God’s own heart, was on one occasion called a “good-for-nothing man,” literally, a “man of worthlessness.” Yet, David realized that the name-caller had a problem, and he did not view the remark as a final judgment of his own worth. In fact, as people often do, Shimei later apologized. Even if someone justly criticizes you, recognize it as directed against a specific thing you did, not your worth as a person.​—2 Samuel 16:7; 19:18, 19.

Sarah’s personal study of the Bible and Bible-based literature and attending the meetings of Jehovah’s Witnesses helped her lay the foundation for a relationship with God. “But my changed attitude about prayer was the biggest help,” recalled Sarah. “I used to think that we only prayed to God about big things and should not bother him with insignificant problems. Now I feel I can talk to him about anything. If I’m nervous about making a decision, I ask him to help me be calm and reasonable. I draw even closer as I see him responding to my prayers and helping me get through each day and each trying circumstance.”​—1 John 5:14; Philippians 4:7.

Indeed, the assurance that God has a personal interest in you, understands your limitations, and will give you the strength to tackle each day is the key in the fight against depression. Yet, at times, regardless of what you do, the depression lingers.

‘Hour-by-Hour’ Endurance

“I have tried everything, including nutritional supplements and antidepressants,” bemoans Eileen, a 47-year-old mother who has struggled with major depression for years. “I have learned to adjust wrong thinking, and this has helped me to be a more reasonable person. But the depression remains.”

The fact that depression persists does not mean that you are not fighting it skillfully. Doctors do not know all the answers to treating the disorder. In some situations the depression is a side effect of some medicines taken to treat a serious illness. Thus, the use of such medicines is a trade-off because of the benefit they may be in treating some other medical problem.

Of course, pouring out your feelings to another understanding person helps. Yet, no other human can really know the depth of your agony. However, God knows and will help. “Jehovah has provided strength to keep trying,” revealed Eileen. “He has not let me give up, and he has given me hope.”

With God’s help, emotional support from others, and your own efforts, you will not be overwhelmed so that you give up. In time you can adjust to the depression, just as you would to any chronic illness. Endurance is not easy, but it is possible! Jean, whose severe depression persisted, said: “We didn’t even take it day by day. It was more like hour by hour.” With both Eileen and Jean, the hope promised in the Bible kept them going.