Thesis: Spirituality and Depression What Is Spirituality?

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Spirituality and Depression

What is Spirituality?

The absence of an adequate definition of spirituality is perhaps one reason why researchers have difficulty identifying the role of spirituality in the treatment of depression. What is spirituality? Every culture, every school of thought, even every individual can differ on this point. For the purposes of this paper, we will work with a variety of perspectives concerning "spirituality" -- but at the same time we may assert a kind of working definition that will help guide our review of the literature which follows. According to Bernard Fellay (2011), a bishop of the Roman Catholic Church, spirituality may be defined as "a sense of God."

However, as the modern age is distinctly more secular with regard to science than the medieval age in which Church and science were united in the effort to reconcile faith and reason known now as scholasticism, spirituality outside the Church often refers to a kind of humanistic endeavor: as Jan Fawcett (2006) states, spirituality is seeing the 'big picture'…it is looking for a spark of divinity within myself, but also in every person I meet…it is about empathy, fairness to others, loving kindness, feeling a part of the great connectedness of human life -- of all life everywhere, of all the amazing and beautiful joys that the 'Force' or whatever has endowed us with consciousness and the capacity of appreciation of this continuing miracle (p. 137).

Fawcett's definition is encouraging, for it illuminates to some extent the definition provided by Fellay. If Fawcett's sounds like an expansion of the Golden Rule, we may be inclined to believe that "spirituality" as it is understood today, in a humanistic sense, is a philosophical holdover from the religion of the age of faith. While the Christian Triune God of Western civilization has been replaced by a vague, disoriented deism, there remains the sense that mankind may benefit from an evaluation of his spiritual aspect.

The impact that spirituality may have on the treatment of depression is, therefore, not to be ignored. Fawcett argues: "Being able to convey an appreciation for the miracle of consciousness, implicitly or explicitly, to patients who find conscious life meaningless or a source of continuing pain, is the core of giving a sense of hope that life is worth the struggle" (p. 137). Fulton Sheen (1954) likewise asserts that "life is worth living" when he asks the question: "Is life worth living, or is it dull and monotonous? Life is monotonous if it is meaningless; it is not monotonous if it has a purpose" (p. 15). However, the purpose of life, Sheen implies, is spiritual in essence.

What is depression/Major depression disorder?

Many patients, however, suffer from a disorder now termed as depression. Depression may take a variety of forms -- but it is most frequently characterized by a state in which the mind and body suffer from a loss of drive and initiative. The DSM-IV classification of depression is that of an Axis I disorder (categorized, therefore, as clinical). According to I. Sarason (2005), who gives a more clinical explanation, a major depressive episode is marked by either depressed mood or a loss of interest or pleasure in almost all activities, as well as at least four additional symptoms from the following group: marked weight loss or gain when not dieting; constant sleeping problems; agitated or greatly slowed-down behavior; fatigue; inability to think clearly; feelings of worthlessness; and frequent thoughts about death or suicide. These symptoms must last at least 2 weeks and represent a change from the person's usual functioning (p. 339-40).

Yet, one problem with DSM-IV classifications is that many researchers find them restrictive: according to Johns Hopkins Medicine (n.d.), DSM-IV categorizations "have not shown to be helpful in predicting outcomes of the disorder," and researchers hope to better pinpoint causes of schizophrenia by classifying "types based on the preponderance of 'positive' vs. 'negative' symptoms, progression in terms of severity, and the co-occurrence of other mental disorders."

Depression, therefore, may fall under any one of the five axes in the DSM-IV multi-axial system. Axis IV, for example, which is concerned with psychosocial disorders, could very easily serve as a category in which depression might be analyzed: "Psychoanalytic theorists have suggested that clinical episodes of depression happen because the events that set off the depression revive dimly conscious, threatening views of the self and others that are based on childhood experience" (Sarason, p. 349). What is more likely the case is that depression is not limited to any one classification -- but extends through many of them.

Conventional Treatment for Depression/Medication and Therapy

According to George Papakostas et al. (2007), "Recent studies suggest that the treatment of major depressive disorder (MDD) with newer antidepressant drugs that simultaneously enhance norepinephrine and serotonin neurotransmission might result in higher response and remission rates than the selective serotonin reuptake inhibitors (SSRIs)" -- a fact which indicates what the modern conventional method of treatment for depression is: the application of antidepressants. Mood stabilizers, support groups, day programs, and alternative medication are also options available in the treatment of depression, but conventional medication and therapy relies upon prescription drugs.

The Mayo Clinic (2010) lists a variety of antidepressants in the treatment of depression: selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, norepinephrine and dopamine reuptake inhibitors, atypical antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors. Psychotherapy and electroconvulsive therapy are also available: in the former, "cognitive behavioral therapy is one of the most commonly used therapies…[which] helps you identify negative beliefs and behaviors and replace them with healthy, positive ones. It is based on the idea that your own thoughts -- not other people or situations -- determine how you feel or behave" (Treatments and drugs, 2010).

Here is where the role of spirituality in the treatment of depression can be said to find a foothold: as Richard Weaver (1984) suggests, ideas have consequences and it is the loss of transcendentals (aka "spirituality") that may account for the plethora of mental disorders seen today: "It is inevitable that the decay of sentiment should be accompanied by a deterioration of human relationships" (p. 30). Weaver, likewise, has nothing but suspicion for the sociological research of the 20th century by men like John B. Watson, whose tendency to view disorder as a mechanical kink produced a program of scientific inquiry that continues to this day. As Weaver says, "To one brought up in a society spiritually fused -- what I shall call the metaphysical community…the art of manipulating personalities obviously presumes a disrespect for personality. Only in a splintered community, where the spirit is starved to the point of atrophy, could such an imposture flourish" (p. 31). The role of spirituality, therefore, may be of primary importance. Let us look at the history and evidence of other cultures that have used spirituality in the treatment of depression and other mental disorders.

Cultural Differences/Considerations

Jennifer Farrah and Mary Ann McColl (2008) state that "prayer is a 'spiritual practice which establishes communication with a higher being' and is 'the simple act of turning our mind and our heart to the sacred.' It is an act central to the practice of most major world religions, including Christianity, Judaism, Islam, Buddhism, Sikhism, and Hinduism" (p. 6). They also observe that "praying for the sick is one of the oldest religious practices in the world" (p. 6). Because all of the major civilizations of the past have found some form of relief in the exercise of spirituality, we look at the ways in which those civilizations did so and the reasons that backed these exercises.

Theocharis Kyziridis (2005) notes that the symptoms associated with mental disorders, as they are now classified, "can be traced in written documents to the old Pharaonic Egypt, as far back as the second millennium before Christ" (p. 42). Symptoms associated with schizophrenia, for example, "are described in detail in the Book of Hearts, which is part of the Eber papyrus. Heart and mind seem to have been synonymous in ancient Egypt" (Kyziridis, p. 42), and ancient Egyptians associated mental disturbance with the physic.

In Asia, the Hindus, whose literature dates back to over a millennium before Christ, imply that poor mental health "resulted from a balance between 5 elements (Buthas) and 3 humors (Dosas) and that an imbalance between these various elements might result in madness" (Kyziridis, p. 42). The Chinese, likewise, ascribed the symptoms to a disturbance of spiritual elements: "Demonic or supernatural possession was often implicated as the cause of psychotic behaviors" (Kyziridis, p. 42).

Chinese medicinal treatments for depression were varied and ranged from massage to acupuncture to herbal ingestion: Tui Na was a massage technique used for the those who suffered from mental and physical problems; acupuncture -- a technique that is as old as written history itself -- is the application of needles inserted into the skin at precise points of the body to desensitize the patient; natural foods and herbs were also viewed as necessary in the proper… [END OF PREVIEW]

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