Silent Souls Healing

An in-depth response to Jane Clayson Johnson’s best-selling book on depression.

Written jointly with Carrie M. Wrigley and Mark Duke. Photo by Jackson David on Unsplash

Since its publication in 2018, many Latter-day Saints facing emotional distress have sought help, understanding, and comfort in Jane Clayson’s best-selling book, “Silent Souls Weeping” (SSW).  

Alongside our own appreciation for many key messages in the book, we write as mental health professionals and fellow Latter-day Saints to offer additional insights and raise a few questions based on our experience over the years in supporting those facing depression and related mental health conditions.  

Jane is the first to note that she is not a mental health professional, and that her intent in writing the book is not to suggest a treatment strategy.  We hope to build on the good she accomplished in this book, voicing our support for ideas we find especially helpful and highlighting a few additional questions to further clarify the healing process. 

OUR FAVORITE INSIGHTS IN THE BOOK

There’s a lot to love about Jane’s book. Here are some points that we consider especially helpful:   

1. Profound empathy for the painful experience of depression:  Given how difficult it can be for others to understand the pain of those facing depression, SSW offers powerful glimpses into what it feels like to suffer from this condition—with poignant excerpts from suffering people quoted throughout the book, demonstrating the acute inner distress that accompanies depression:

• “Made me feel like I couldn’t handle anything.  Everything seemed overwhelming.” 

• “I was faking it. Every day. Every task... Merely going through the motions of life.” 

• “All I could do was the bare minimum of what was expected of me as a wife and mother.”  

After commenting on how applicable words like “strangling, drowning, choking, sinking, and suffocating” are for the experience of depression, Jane observed that “physical symptoms are mild, when compared to its effects on the mind and spirit.”

The book also focuses needed attention on “toxic perfectionism,” as reflected by one woman who described “slowly killing myself with criticism” and becoming “convinced I wasn’t good enough: not a good enough mother, not a good enough wife, not a good enough friend, not good enough at anything.” 

2. Insight on the difficulty feeling the Spirit. SSW insightfully addresses a common question that comes up for many people of faith facing serious emotional struggles.  As one woman put it, the Holy Spirit had been “present in my life and carried me through many previous trials.” How then could this sacred influence now be seemingly “completely absent”? 

What an aching question, in such a time of need!  This woman’s query continued:  “Wasn’t constant access to the Spirit part of the gift given after baptism, at confirmation?” 

Throughout the book, Jane’s explanations on that important point are compelling.  As she describes one suffering individual:  “No signals were penetrating, and she could not feel the presence of the Spirit…her mind was generating too much static.” She cites another interviewee, Patrese, saying, “The Spirit speaks to our minds and hearts… If our minds are a garbled mess…we’re not able to recognize that still, small voice.  It just gets drowned out by the crisis that’s happening.”    

We believe there is more to the story of distance from the Spirit—including one significant factor unaddressed in SSW, which we touch on below.  But what Jane does emphasize on this point is helpful and powerful.  

3. Remembering amidst the cloud.  Even in moments of not being able to feel the Spirit of God, SSW underscores the valuable practice of remembering times when you previously did have this experience.  This was powerfully illustrated in the story of Ann, who had yearned and pleaded to feel the Spirit again amidst her emotional wrestle. After a significant breakthrough, she recalled various times in her life when she had felt spiritual connection—expressing to God, with remarkable faith: “I have probably felt the Spirit more than any woman alive, and since that’s the case, if I never feel it again, that’s okay. I can rely on the way I felt then.”  She was later happily surprised at how often past experiences would come to mind—all of which became a “turning point for me.”  

Jane goes on to note how uniquely helpful remembering is for those facing depression “who have become convinced they are worthless and estranged from the Spirit.”  She encouragingly writes, “Even when we are experiencing little spiritual light in the present moment…our remembrance of Him and His remembrance of us are at the heart of our ongoing relationship, and it is not a relationship that He abandons.” 

4. Reassurance from someone else in the storm. In Patrese’s story, even amidst a nightmarish period of isolation in the hospital when she couldn’t feel much of anything,  her husband was able to verbalize vivid peace he felt in visiting her:  “Although she couldn’t feel anything but despair, her husband testified that the Spirit was indeed there, that Heavenly Father was still pouring down His love for her.  It was tangible to him.”  Despite her own lack of feeling, this thought from her husband “provided hope” for her, throughout the recovery process. 

Jane went on to highlight “someone else’s spoken testimony of God’s love, or a priesthood blessing pronouncing His concern aloud” as especially helpful to those experiencing “despair at their inability to feel divine love.” As one woman put it, “there are times that you cannot feel the Spirit of God, so you need to hear it from someone else’s voice.” This woman also encouraged others to consider receiving a priesthood blessing in times of need, explaining, “I think there are things that you need to hear that you can’t feel right now.”  

The value of things you “can’t feel...but can [still] see or hear” is significant, as another interviewee pointed out—with another observing, “There’s a big difference between the Spirit not being present, and me not being able to feel His presence. Sometimes, we don’t distinguish that.” 

5. How the pain of depression can disrupt normal community support. However helpful it may be to hear some reassurance from others, SSW also makes it clear how many barriers exist to this needed connection occurring—starting with the pain of being around others who aren’t feeling the same weight and burden.  As one interviewee noted, “I’m not comfortable going somewhere where everyone is happy and friendly, when I am feeling horrible about myself or my life.” 

Such an acute contrast can also prompt feelings of condemnation for others, who may seem hypocritical because that observed happiness may feel so impossible to even imagine.  Sufferers may also pick up on questions and latent judgments others may have about why they aren’t able to "make" themselves feel better or happier.

All of this translates into some predictable, even understandable isolation, precisely in the moment when outside reassurance could be most helpful. As Jane summarized: “The worst part of depression is the profound isolation it engenders, not just from the Spirit but from family, friends, and community.” As another person says in the book, “When you’re in it, you feel very lonely; you think nobody else in the whole world would know how awful you feel and how bad your life has become.”  

6. A call to improve the quality of our ministry. All of this raises the critical question that Jane underscores—essentially, how would Christ minister to someone dealing with depression?  After acknowledging how Saints excel at supporting those facing the heartache of grief and physical health challenges, Jane expresses hope that we can likewise learn how to give "the same compassion, love, understanding, and help for those who suffer ailments of the mind… like Jesus, discerning the unspoken need, and offering our shoulders to help lighten the burdens others carry, regardless of their cause.” 

Jane captures in interview accounts the tenderness of spouses and others caring for depressed family members, saying of one such person,  “It was only her husband’s love and support that sustained her.” 

Just being heard is powerful—as Jane illustrates through research demonstrating how the act of sharing one’s experiences elicits physiological changes in the body—thus helping them move more in a healing direction.    

7. The healing power of connection. Despite unique difficulties in getting there, the healing power of relationships is evident throughout the book. One person who had crawled under a table in the student union and held her knees was approached by another student who said, “Can I talk to you?”  As this woman described it, “She brought me into a classroom and... she just had this love and compassion,” like “this little guardian angel of sorts.”

As noted earlier, though, receiving this help is not so simple when enshrouded by depression. In Sue’s story featured in the book, “instead of surrendering” to the feeling of despair, she “uses it as a cue to remind herself that she needs to seek encouragement from an outside source.”

Sharing encouragement with others can also lift us—something Sue called a “huge thing I need to do,” “one of the most important things” in her recovery and a “prime ingredient in the treatment of depression.” Against the backdrop of depression’s intrinsic self-absorption, she reflects, “When we are serving others, we turn outward, away from ourselves, and to the Lord.” 

Yet doing so is not simple—and can be very difficult while facing depression, as Jane points out—which calls for gentleness and patience, rather than simplistic encouragement such as “you’ll feel better when you serve!” 

8. Positive discoveries, amidst the sense of powerlessness.  Limitations in one’s freedom to feel and act lie at the heart of depression’s burden.  And yet, SSW highlights the extent to which sometimes these severe limitations can prompt insights and discoveries that prove transformative over time. 

For instance, precisely due to her inability to do what she used to, one woman describes appreciating more deeply some experiences that she may have otherwise missed—including the joy of just being with her children: “Every single day the kids were in and out of my bed.  Each one of them would come and spend twenty minutes with me or more.  I would sit and talk to them—each of them individually—because that’s all I could do.”  

Jane also remarks how striking it is that so many painful stories “also bear witness to the miraculous power of the Savior’s atonement.” As she puts it: “Even when depression becomes so oppressive that the Spirit appears to have been utterly usurped…you can still see glimpses of God’s love.”  She adds movingly, “The possibility of healing and grace is always there.”  

Who can read any or all of this above, and not rejoice in the hope it provides and the power it points towards?  Each of these positive themes are a great blessing for those who read this text—and will undoubtedly bear good fruit in the lives of readers—both immediately, and over the long-term.  

EXPLORING OTHER PARTS OF THE PICTURE

It’s possible, however, for something to provide a great deal of truth—and still be missing other crucial parts of the picture. And in this case, we believe it is important to identify additional perspectives that need to be considered when addressing the spiritual, emotional and physical aspects of depression. We do this for precisely the same reason that Jane writes—in hopes of supporting and encouraging those weighed down by this painful condition.   

Since interview data is such a vital element in Jane’s inquiry, it’s important to note one specific issue in analyzing interview data that plays a role in the scope of what the book addresses, and leaves untouched.       

Interviewing as a “window into reality”?      

Most interviewing projects examine interesting differences and similarities in what happened in people’s stories—an important starting point for any good qualitative investigation. But in dealing with sensitive mental health issues, one more thing is needed:  to analyze not only the reported experiences people have and share—but also to explore the many rich differences in how they make sense of, narrate and interpret those experiences.  

Why would that even matter? For two significant reasons:

1) Much of what’s most crucial, interesting, and confusing in mental health happens in the realm of how people interpret their experiences. That’s why we assert that if we’re not paying enough attention to that dynamic, we can easily miss valuable insight that can prove vital in helping people understand what they’re facing and provide clarity on the range of possible options in response. 

2) In addition, if we overlook patterns at the level of interpretation, we risk inadvertently reinforcing common beliefs and status quo norms that can actually impede, rather than promote recovery.  

A lot depends, then, on whether an inquiry goes deep enough to explore any of those interpretive distinctions. In what follows, we draw attention to five such distinctions largely unaddressed in Silent Souls Weeping—each connected to key interpretive questions that, in our judgment, feel crucial to any conversation about deepening healing for those facing depression. 

These include:

1. Is my body messed up for good?

2. Is it possible to get better from this? 
3. Does what I do (or don’t do) matter for my healing? 
4. Is stigma the major barrier in healing?

5. Is medical treatment always necessary to get feeling better?

In this, we aim to contribute to a conversation about mental health that encourages more people to move along the path to deeper, more sustainable healing from depression. From our experience and review of the available research literature, it’s clear that some approaches to depression are simply more helpful than others in the healing process - especially when evaluated over the long-term. 

And not all interpretations of what’s gone wrong with depression - and what to do about it - help promote hope and healing.  If we’re not paying enough attention to these contrasts in approach and perspective, once again, we miss an opportunity to provide those facing these painful conditions with crucial guidance in how to navigate them.  

All this being said, we affirm the core aspiration of Silent Souls Weeping and feel united with Jane in her devotion to promoting healing in those who suffer. We hope these additional insights can help readers identify resources that can bring further comfort, relief, and power to overcome this increasingly common and painful affliction.  

FIVE QUESTIONS MERITING GREATER ATTENTION IN THE BOOK 

1. Is my body messed up for good? Competing views of the brain. 

Few topics seem more scientifically settled than brain science. That may be why references to the brain have often been so reassuring to those who have endured skepticism for what they are facing - allowing them to say, “No, this really is a thing. I’m not just making this up.”  

One interviewee is quoted in the book advocating for “brain health” as an alternative to “mental health,” as a way to push back on any such skepticism or stigma. References to underlying contributors from a malfunctioning and “chemically imbalanced brain” also show up multiple times throughout the book.

What doesn’t show up, however, is an acknowledgement of the encouraging sea change that has taken place in brain research over the past decade.  Although we’ve always known the brain changes in developing children, science continues to highlight the degree to which it changes in adults too—with ongoing development taking place from birth to old age. 

Neuroplasticity— the changeability of the brain—is now known to be a life-long phenomenon.  Why, then, are so few people facing mental health problems aware of this?  

Maybe because we aren’t talking about it enough! We once reviewed the main 400 page text for NAMI’s family class and found only a single reference to brain changeability - compared with many mentions of brain defects.  SSW also doesn’t say anything about neuroplasticity.  As noted, what does come up—over and over—are references to the brain that reinforce the idea that depression is an enduring disease or illness—even a “chronic” or life-long one.

This is the opposite of what the more hopeful, updated brain research now suggests. 

2. Is it possible to get better from this?  Competing views of the possibility of healing and recovery.  

This brings us to a second key question deserving greater exploration than takes place in mainstream mental health discussions, including Silent Souls Weeping:  Is it possible to find lasting healing to depression?  

While this doesn’t seem to be the intention of the author, one could easily walk away from reading SSW with the impression that the answer to this question is mostly no. For example, one interviewee, Laurie, is quoted as saying:  “I treat my depression as if it’s a chronic illness, which of course it is… something you have to pay attention to every day.” She asserts definitely: “I will have this struggle with me my whole life.” 

After noting that a difficulty feeling the Spirit is “not reality and certainly not a permanent condition,” Jane also clarifies that stories of people seeking healing shouldn’t be over interpreted as “offer[ing] a cure for depression.” Comparing depression to Paul’s “thorn in the flesh,” she emphasizes, “it is never removed completely.”  

For some, of course, this may be a true statement—with such admissions validating for those who have struggled to find deeper, more lasting healing from depression. Many people don’t realize, though, that it’s only the last couple of decades depression has come to be seen as a chronic illness - with previous eras of mental health professionals understanding the condition to be time-limited, episodic, and most often tied to difficult circumstances.    

Hope in this possibility is, at times, met with a cautionary message in SSW, like the sister who asked a heartfelt question, “Isn’t it true that the Lord will take away my depression if I can just be good enough and prayerful enough and feel the Spirit enough.” Despite some ways this good sister’s expectations can clearly set up some disappointment, her question is mentioned in SSW not as an expression of faith in God—or of hope in his power to do great things—but largely of naivete. 

This is not to say there is no hope provided in SSW for any such deeper healing. For instance, Jane makes clear that people can still find sweetness in life, saying, “A diagnosis of depression does not mean that life is over or that there will never be joy again.” And while quoted as suggesting that it’s simply not possible for some to find healing (“depression is a trial, and some of us simply have to endure this one”), one medical doctor does acknowledge the possibility of some finding just that. 

But despite these occasional mentions, a narrative of life-long struggle for those facing these painful conditions dominates the text.  And we argue that this narrative itself has tangible consequences.  No story reflects that more poignantly than Lizzie’s “long, torturous” journey that began with a phone-call home to her father, “something is wrong.” Readers hear an account of doctors searching, experimenting and finally finding an appropriate diagnosis of “bipolar disorder.”  

Despite these doctors’ best efforts, the pain worsens and Lizzie’s hopelessness spirals with the sobering prognosis she’s given by doctors - leading to her tragically ending her life.  What this analysis understates is the role of the narrative of life-long disability and the impact that had on this precious, despairing young woman. This is evident when Lizzie was first told about her new condition:  “Lizzie was devastated to receive her diagnosis.  She believed her future had changed dramatically.”

This prognosis is presented in SSW as a reality that Lizzie had to eventually accept, despite her own deeper, desperate hopes otherwise: “At first Lizzie hoped she would somehow return to normal, that the promise of her future was still attainable and not...an ‘endless road’ with ‘no way out.’  But as the next few years passed, Lizzie became increasingly aware that her life had what she called a new baseline.  Mental illness was something she would have to live with, and the unpredictability of it tormented her.”

As Jane went on to summarize: “She could not escape the fact that she would never get better.  This used to really throw her for a loop because her practitioners, although they were sympathetic, told her, ‘Unless there is some new miracle cure, we cannot cure you, Lizzie, but we can manage your symptoms.’ She worried it would get much worse.”

“It did” Jane continued - eventually noting, tragically, “The thought of living her whole lifetime with this disease...trying new medications and enduring the debilitating side effects...eventually overwhelmed her.” 

All of this, once again, is presented as an objective, tragic folding - with only little acknowledgment of the hopelessness the professional narrative itself can often invoke. Without critical scrutiny, Jane herself notes that some national experts on this condition have suggested that bipolar, by nature, involves a future where “there is no way out and an endless road ahead.” She adds, “When someone is in this state, suicide can seem a bad choice but the only one.” 

It perhaps shouldn’t surprise us that the thought of living a whole lifetime with this disease is overwhelming for many - especially when presented as a “fact” that they will “never get better.”  Drawing attention to the consequence of this very narrative is our purpose in this section.  

By contrast, we  have seen repeatedly over the years people healing from both unipolar and bipolar depression—and not just from “mild” cases of it.  Even deep and serious depressive conditions do not have to be permanent, if sufferers are supported in moving along a path that cultivates gradual healing, rather than simply accepting and anticipating a course of never-ending struggle.  

A wide variety of approaches exist that can lead those facing depression towards deeper, more lasting healing. While some mention of these different approaches is acknowledged in the text, including spiritual, psychological and physical supports, readers need to be aware that the full scope of resources available for healing are underrepresented—perhaps due to the book’s distinctive focus on the most common and conventional pathway of treatment.  

3. Does what I do (or don’t do) even matter for my healing?  Competing views of agency. 

Most experts agree there is a view of agency and emotions that deserves critique–one that says “Come on, just look at the sunlight!  Just buck up, and choose to feel happy.”  This is neither fair nor helpful to those facing depression, anxiety, eating disorders, etc.—which is something Jane underscores in an important way. 

As a cautionary example, one young woman is quoted as saying, “I’ve been praying so much for God to take this away, and I’ve been trying to read extra scriptures every night to make this go away, and I’ve been trying to do extra Personal Progress goals.” 

We agree the idea of “just doing more” to make depression go away is unhelpful—as reflected in one interviewee speaking of the confusion that arose from interacting with others who told her, “Go to the temple, or just serve more, or are you praying enough”—leaving her feeling that they weren’t taking her problem seriously.

Unsurprisingly, these earnest and well-intentioned efforts don’t always turn out the way people expect—and often create additional disappointment, as reflected in the teenager cited as saying: “Nothing is working, Mom.  How come God isn’t helping me like He’s supposed to?” 

This raises an important conversation about undue attention centered on our own individual efforts at the expense of learning to rely on the support of others around us and God’s love as well. While acknowledging the value of both, SSW also seems to caution people against expecting too much from prayer and worship when it comes to healing. Advice to “pray harder, study the scriptures more deeply, and repent more sincerely” are raised not as wise guidance - but, instead, as cautionary tales.  A psychiatrist is quoted as lamenting those who suggest to those facing depression “to pray more…or that they just need more faith.” 

As a way to perhaps discourage the idea that depression is closely tied to people’s chosen actions, SSW also repeats more than once a sharp contrast between biological and spiritual:  “How many could we reach if we regarded depression as the illness it is, and not as a spiritual malady?” / “Depression is a disease, not a spiritual deficit.”

In all these ways, the book reinforces a larger message that can subtly minimize the role of what someone does (or doesn’t do) in relation to either alleviating or causing depression. For instance, one man facing depression is paraphrased as knowing “from experience that its onset was not tied to any specific thing that he was doing.” 

While it’s true depression can often just appear to come out of the blue—in seemingly random ways—it’s not true that it’s not related to anything we’re doing. There are all sorts of contributors to the painful condition confirmed in medical and psychological research. If you load up on sugar or junk food, you are more likely to feel depressed.  If you are aggressive to other people, you are more likely to be depressed.  If you don’t get much sunlight or needed nutrition, you are more likely to feel depressed.  If you don’t move around your body enough, you are more likely to feel depressed. If you keep turning to compulsive-addictive patterns, you are more likely to feel depressed. 

Additionally, those who have experienced trauma, abuse, and or other toxic environments can be particularly vulnerable. A skilled mental health provider takes all these elements into account including the role of a client’s agency and spirituality in helping a person find a deeper level of healing from depression.

In fairness, the text does at times acknowledge the value of self-care and the potential impact of personal choices in that regard.  One woman is quoted, for instance, as saying “When I am depressed” and “have a hard time feeling the Spirit…I try to be diligent about doing what it takes for me not to let depression do that to me.”

Compared with other examples that downplay the extent to which personal choices can spark deeper healing, references like this one are rare. But to be clear, the choices we make in a variety of areas of life have substantial power to influence our own moods and emotional state over time.  We can learn what works for us, and what works against us—what behaviors feed depression, versus what behaviors foster emotional wellness.  

The wise use of our agency to choose healing behaviors is a vital key that we have seen, over and over again, as crucial components in the healing process over time.  We wish the encouraging influence of these activities had received more attention in the book.    

4. Is stigma the major barrier in healing? Contrasting views on feelings of resistance and discomfort. 

One of the most dominant messages of Silent Souls Weeping is that stigma and shame are the major barrier in healing from depression - and a primary reason behind the expansion of suffering:  “How many are absent from the pews in sacrament meetings because of stigma—external or internally imposed, real or imagined?”

Anything that might make people feel personally responsible in some way is cast as problematic—with SSW emphasizing the need for people to lift the “heavy burden of shame” so that those who are depressed can “lose their fear of being blamed for their condition.” 

Of course, no one should be “blamed” or “shamed” in their suffering.  No one believes that is helpful - and we all know how damaging both can be. Out of all these well-intentioned attempts to eradicate such feelings, however, the larger mental health conversation often denies the extent to which our day by day actions do, in fact, often contribute to our mood and emotional well-being overall (as confirmed by many hundreds of studies about depression risk-factors we have reviewed).    

That’s one problem with strenuous stigma-busting. A second problem is what it conveys to people who may have honest, legitimate questions about prevailing approaches to treatment.  

SSW tells the story of Laurie, for instance, and how a sense of resistance prevented her initially from embracing both her initial diagnosis and recommended treatment. “Finally...she talked to a doctor again—and this time, took the medication that he prescribed.  She was amazed a few weeks later: she started to feel better!  She marveled that she’d go long without seeking help. What had she been thinking!” 

It would be easy to take away this message:  If anything stands in your way or prevents you from “getting help,” that’s a problem and a barrier to fight. In many respects, of course, we agree:  If people are fearful or resistant to getting any help, that’s a problem.  But sometimes we’ve observed honest concerns or questions people have about antidepressants, in particular, being quickly labeled as “stigma” that must be overcome—wholly sidelining meaningful questions that deserve space to be explored.    

Rather than casting feelings of treatment resistance automatically as a barrier to be overcome, we believe it’s important to explore the questions behind this resistance. To do otherwise and fight stigma on every turn prevents an open public discourse that allows informed consent.  (It’s important to not overlook that stigma-busting campaigns were originally started by pharmaceutical companies as a way to market antidepressants, in particular). 

Rather than focus additional energy trying to reduce any sense of resistance to treatment, we find it more helpful to encourage a broader conversation that allows people to explore competing support options and which makes space for questions about these same treatments.  

5. Is medical treatment always necessary to get feeling better?  Contrasting views regarding antidepressants. 

After acknowledging other contributors to healing, Jane says at one point, “Equally important—and very often necessary—is finding external support in a sympathetic medical doctor.  Sometimes, in fact, when the Spirit seems the furthest away and hope is most dim, the greatest act of faith you can make is to seek out a psychiatrist or other physician who can work with you to find a medication best suited to your situation” (italics our own). 

There is distinctive emphasis throughout SSW on medical treatment for those facing depression.  Simultaneous with the taking of antidepressants, another interviewee spoke of being “able to move forward and keep climbing…the darkness lifted and so did the numbness.  Increasingly I felt like myself again.”  Against the backdrop of this kind of a redemptive narrative, medical treatment is proposed not as one possible support, but as an essential requirement on the healing journey for many.  For instance, one counselor is cited as saying, “Sometimes the best way to get traction is through medication.  In fact, a lot of times it’s the only way to get traction.”  Jane paraphrases another leader’s suggestion that depression, “like other chronic diseases, requires a specific regimen of care and medication to keep at bay.”

Turning to medication has become, in many cases, an automatic response when things get especially dark - which now leads many parents, spouses and leaders to usher someone into a process to “confide in [your] doctor” and have “doctors work[ing] to find the right treatment.”  

That being said, it’s also true that the view of medical treatment propounded in SSW is, in some respects, more nuanced than other education efforts in the past. For instance, medication is not presented as the exclusive answer—with one woman quoted as saying “medication is only part of my treatment. I also know that how I manage my diet and exercise and sleep makes a huge difference.” Another woman says, “Medication helped, but so did natural methods of healing and—perhaps most importantly, she says—grace.” 

There is also an acknowledgment of treatment limitations, as Jane herself notes, “Medication provides the traction…but it is rarely enough on its own”—advocating for a “regimen of complementary tools and behaviors” to “really break through and reopen the circuits that allow the Spirit to flow more freely and restore our reception.” Another individual says, “You can’t just take a medicine. They work and they do help…but you may not reach your potential if you don’t also learn how to redirect your thoughts and form better ways of going about life by drawing upon the power of the Son.”

And one woman is quoted as having heard professionals keep saying, “Give us two weeks and we’ll have you properly medicated.” Yet she admits, “Three years later, I was still just hanging on by my fingernails.  It took three to five years for that depression to lift.” 

It’s this longer-term picture of antidepressant treatment that has received inadequate attention in our broader mental health conversations. While the FDA has approved antidepressants for short-term use, increasing numbers of people use them over many years—partly because they are difficult to get off of—and partly because of the popular narrative of depression as a life-long struggle rooted in a permanently deficient brain. (It’s also the case that overstated marketing  has taken place with antidepressants in a way that closely mirrors what took place with opioids in America).  

Given all that, many people have also been persuaded that their emotional well-being depends on life-long treatment management.  Indeed, the idea someone might not need medication is portrayed in some cases as naïve.  Laurie spoke of her earlier resistance, for instance, as lamentable ignorance: “I felt like I shouldn’t need medication.  I was convinced I should be able to...do it myself.”

Whatever legitimate relief and support people may find in short-term usage of antidepressants, the scientific picture of long-term  pharmaceutical treatment is clear. In every single long-term study we’ve gathered, those on antidepressants long-term face unique and enduring challenges.  

In the short-term, there are other issues likewise not fully addressed.  For instance, many of the physical symptoms attributed in SSW to depression (headaches, fatigue, intestinal distress) are also widely known side effects of antidepressant medications.  And while some experience an ability to access more normal feelings on the medications (especially early on), others report feeling of apathy, and difficulty feeling what they used to (especially later on)—including in their ability to feel the Holy Spirit.  This is the other part of the picture in understanding those struggling to feel the Spirit not acknowledged in the text. 

In sum, SSW hews closely to the prevailing narrative that promotes the possible benefits of pharmaceutical treatment, while saying very little about the downsides. 

SO MUCH MORE HOPE IS AVAILABLE 

These 5 questions are challenging ones—and each are highly sensitive, personal matters. And we respect that thoughtful, good-hearted people can and do reach different conclusions on each.  

And to reiterate, as LDS mental health professionals, we applaud the work Jane carried out to gather the voices of so many who struggle, to describe their pain, and validate their struggle.  We regard this work as a powerful continuation of a crucial—and we hope, ongoing—conversation on this important issue—one that took great courage for Jane and those involved to open the door on this painful condition, and the issues it raises.   

We caution once more, that as Jane herself points out early on—this book, while descriptive, is not written as a treatment manual promising an outline to guide healing. And we have felt it vital to continue to open this door even further, and address some critical issues that are unaddressed in the book. 

There is inadequate space to say more about why we feel so much more hope exists or the many resources available to help people find deeper, more lasting healing. But there is so much out there!  

Along with the validation provided in SSW for the reality of depression, we hope the full range of these options can become more apparent to the many who could benefit from them. 

So many other parts of Jane’s message are timely and crucial. Deepening empathy, encouraging connection and improving ministry are goals we can all support and celebrate. However, any messaging that repeatedly encourages people to embrace a disease model and the necessity of biological treatment ultimately feels on many levels counterproductive to longer-term healing.  

Just as one participant is citing as saying “I’ve learned that we need to be more open-minded…to medicine,” we invite the reader to stay open to other perspectives on conventional treatments and the many other healing pathways available.  

The consequences could not be more significant.  As one woman put it, “Every hour…I’d go into my bedroom in an empty house, kneel down, and say, ‘I know you’re there, God.  I honestly believe you are there, but will you please do something for me?  Help me out of this, I’m drowning.’” 

With Jane, we yearn to be part of the reassuring answer to this woman and the others feeling this kind of desperation. And we share her desire to “offer hope and encouragement” to those many “precious souls stranded in the wilderness of affliction needing our rescue.”

All of that we share.  

Our differences are in where we encourage others to seek hope—and in what to place their trust in relief and rescue.  

However painful this experience truly is, it need not be permanent.  Enormous amounts of research and years of experience helping people tell us the same thing:  Deeper, more lasting healing from this painful condition is possible.  Yes, it requires patience in exploring the many kinds of adjustments that can make a difference in our lives. But “sweet is the work” of building a healthier brain, a more vibrant mood, and a happier life.  

“Silent Souls” can heal.  

Don’t give up on that. And let’s not give up on each other, as allies in this aching, urgent work to reach those seeking greater hope and deeper healing.   

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Jacob Hess, Ph.D. offers online consulting to individuals and families seeking deeper, more sustainable healing from depression and anxiety. He is currently re-launching a podcast for The Council for Sustainable Healing and preparing to lead online depression recovery retreats in the fall.  Jacob helped co-create Mindweather 101 and the app Lift - and co-authored The Power of Stillness: Mindful Living for Latter-day Saints.

Carrie M. Wrigley, LCSW, has been a counselor for over 30 years, and a public health educator for over 20 years, teaching strategies for Christ-Centered Healing from Depression at BYU Education Week, on YouTube, and at conferences throughout the country.   She is the author of Your Happiness Toolkit: 16 Strategies for Overcoming Depression, and Building a Joyful, Fulfilling Life.

Mark Duke, LCSW, recently retired after 38 years working for LDS Family Services, including clinical counseling, administrative services, and extensive work with the professional community. He has worked both internationally and in the U.S.