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November 30, 2006

The great (non) depression

http://www.jewishjournal.com/health/article/the_great_non_depression_20061201

I overdid it yesterday. Perhaps I misjudged the line between exhaustion and sloth.

Or perhaps my recuperation from the cancer treatment requires a slower return to fitness than yesterday's exertion.

But this morning's desire to stay in bed needs to be honored, unlike yesterday's, which called forth a kick in the pants.

Some might suspect depression, but I disagree. I am finding, in my confinement, too many sources of pleasure, despite the situation. I am delighting in friends, home, books, writing, Jon Stewart, Stephen Colbert, NPR, PBS....

Besides I am pharmacologically covered for depression.

Depression is a word that has been cheapened. We forget that it is a diagnosis for a bona fide disease. It becomes a catch phrase for the weighty feelings we experience as we come to terms with life's challenges and honor the process of change. Those who cannot tolerate taking the time and effort that normal healing requires are quick to label depression and try to prescribe it away.

Shortly after receiving a cancer diagnosis, Janet came to my office. She sat down on the couch opposite me and sank into the pillows, settling shapelessly and breathing shallowly. Finally she let out a sigh.

"I feel depressed," she said. "I feel heavy. I can't move. I'm paralyzed. I cry all the time. I have no desire to go on with my treatment."

As she spoke, a trickle of tears ran down her cheek. Janet was mourning her health.

Grief is not depression. It is not a disease. The sense of heaviness and weight that we feel when we face challenges is our organism's insistence that it is time to stop, give honor to what is lost, and surrender to the healing process. One of the symptoms is often an overwhelming fatigue triggering the fear that we don't have the energy to face what is demanded.

This feeling sets in when there has been a death and the fires of grief have been banked and the mourner begins to sift through the ashes. In other losses, it descends when the fact of the illness, divorce or other change begins to sink in. Each labored breath exposes what has been left behind and reveals a glimpse of the obstacles ahead. While at times, we may still feel wrapped in gauze and unable to move, this so-called depression indicates that the time of numbness is over. Feeling begins to return. Sadness is palpable. We begin to comprehend the changes that have taken place and their consequences in our lives. Difficult feelings lie in the wake of this understanding. But have heart, this heaviness is a sign of life.

In this state we have no vitality. The pulse of our life force is barely detectable. So we wait. And we can't move. The time of the broken heart is necessary to heal. There are genuine tragedies, sadnesses and injustices that cannot be denied or rationalized away when we take the measure of our lives and the changes that they have wrought. We must dwell in this valley of tears as if we are seeds, lying fallow in the earth, absorbing the moisture necessary to bring forth the sprouts of spring and the harvests that follow.

Taking time to feel, we honor the need for change. We learn about patience, surrender, acceptance and, ultimately, letting go. It can be a quiet and inarticulate time in which until we are able, literally, to come to terms with our loss.

I take issue with the word "depression." Depression is a clinical state. It is a psychological diagnosis of something with an organic base. Although elements of the symptoms of depression and of grief have much in common, the two are not the same. Depression describes an illness. Grief is a healthy, appropriate, though often excruciating, response to loss. Loss is not just letting go, which would be difficult enough. It requires us to reconstruct our entire world. We must come to see the universe in a completely different way.

Rather than "depression," I prefer the Hebrew word "kavod." "Kavod" means "honor" as in the biblical commandment to "honor thy father and mother." It also is translated as "weight" or "heaviness." These latter translations are what people who suffer often experience.

This paralytic feeling is their organism asserting the opposite of what the culture demands. While they are urged to get over their loss quickly and get on with their lives, their bodies and souls are saying, "Stop. Feel the gravity...the weight, of this situation. Honor what is past and what is being born within you. Honor your need to broaden your understanding and come to terms with your new status and new world. Stop."

By labeling this experience with a holy Hebrew word, perhaps we can be kinder to ourselves and less afraid. Perhaps this will encourage us to take the time we need for healing, learning its lessons and allowing it to transform our lives. We contemplate our situation and thus give it kavod -- honor. We feel the weight; the heaviness of what loss itself is about. In the process, we transform it. As we wait, contemplating our lives and the nature of life itself, we begin to heal.

I'm staying in bed this morning.

Anne Brener is an L.A.-based psychotherapist. She is the author of "Mourning & Mitzvah: Walking the Mourner's Path" (Jewish Lights, 1993 and 2001), a fourth-year rabbinical student at Hebrew Union College-Jewish Institute of Religion and a faculty member of the Academy for Jewish Religion.

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