A Response to Jane Clayson Johnson’s Message on Depression
Some abbreviated reflections and concerns about a very popular book.
Originally published at Meridian Magazine with Carrie M. Wrigley and Mark Duke. A more in-depth response with citations is linked here.
In January 2018, a new Deseret Book publication on depression hit the bookshelves, responding to a need increasingly felt by many members of the Church and others. Written by Jane Clayson Johnson – a celebrated journalist, and someone who has faced depression herself – Silent Souls Weeping skillfully and compassionately reports on the internal experience of depression, with stories from Jane herself, as well as many other depression sufferers she interviewed for her book.
The book became an instant bestseller, validating the painful experience shared by so many Latter-day Saints and others struggling with this difficult condition. It opened a needed conversation about what depression feels like, what its impact is on sufferers and their families, and how important it is for others to provide compassion and support for those who struggle.
That being said, Jane herself affirms throughout the book that she is not a mental health professional, and that her book is not intended as any kind of treatment manual to guide depression sufferers through the healing process. It is, rather, a collection of interviews, drawn together by common themes and experiences, describing how depression feels from the inside, and the profound pain it can bring to those impacted by this ever-more-common affliction.
Moving Toward Deeper Healing
As three mental health professionals, with decades-long experience in helping to support individuals through the process of healing from depression and related emotional challenges, we applaud Jane’s courage, clarity and compassion in shining light and understanding into such a needed area of inquiry.
We caution – as she herself did – that this book should not be regarded as an authoritative guide on the healing process. Instead, it serves as a descriptive work, prompting recognition and relief in readers who might exclaim, “You mean, I’m not the only one who feels this way? I’m not alone? Someone else understands and shares my challenging experience?”
Being a part of a “fellowship of sufferings” can itself be meaningful and helpful. But description alone does not necessarily produce change. It describes things as they are, and as they have been. But it is beyond the scope of this work to describe – or to even envision – things as they can be.
We unitedly affirm, as three Latter-day Saint professionals, that those suffering from depression can do more than endure and cope. They can find deeper healing. They can find inspired ways to progress beyond their current pain, bringing relief to themselves – and to those who love them, and suffer alongside them.
Such healing, in our professional experience, begins when people glimpse the actual possibility of real, deep, and even lasting healing. That means recognizing that their current painful condition need not predict a permanently painful future. Depression doesn’t have to be a chronic, unchangeable condition. People can and do find greater healing – if they are supported in learning how to get there.
Such a vision is beyond the scope of this book. But it is not beyond the scope of human possibility.
Important Questions about Depression and Recovery
“Depression” is a complex and wide-ranging mental health issue. The label of “depression” has become a catch-all, used to describe everything from loneliness and temporary bouts of unhappiness to pervasive, debilitating illness. In what follows, we introduce five questions important to depression recovery, summarizing some of the most pressing issues depression sufferers may face. These questions are:
Are my body and brain messed up for good?
Is it possible to get better from this?
Does what I do (or don’t do) matter for my healing?
Is stigma a major barrier in healing?
Is medical treatment necessary to get feeling better?
We’ll use these questions to explore ideas shared in the book. We’ll then compare those with the ideas and strategies we have found most useful over the years, in promoting hope, healing, and recovery.
A more complete analysis of these questions can be found in a separate, more in-depth review we prepared, citing examples throughout Silent Souls Weeping of insights we find to be helpful, and further exploring the issues identified here. In that deeper analysis, we provide examples documenting both our appreciations and our concerns with the book, and offer additional perspectives on healing and recovery.
This current article introduces these 5 questions and summarizes approaches we have found most helpful in promoting not just awareness of, but also recovery from the ravages of depression.
Mainstream Responses to These 5 Questions:
In describing the current experiences of depression sufferers (including herself), Jane reflects the mainstream view of depression that has been highlighted repeatedly over the past several decades. This view has been featured consistently in the mass media, in other prior mental health publications, and even in other Latter-day Saint publications. It is also a first-line treatment approach for many mental health providers. So it is unsurprising that these common themes are reflected in Jane’s book as well.
In what follows, we’ll explore each of these 5 questions in turn, along with the answers to each suggested in Jane’s book and in the mainstream view that it reflects:
1. Are my body and brain messed up for good?
This view assumes that depression is a chronic physical condition, and that once someone has it, they will likely have it for the rest of their life. It is also assumed that because depression often involves physical symptoms, including fatigue, loss of appetite, etc., that it reflects a “chemical imbalance” that negatively affects both body and brain function – and that this dysfunction, once experienced, will continue throughout a person’s life, and will likely be passed on further through that person’s genes and family relationships.
2. Is it possible to get better from this?
In the mainstream view, reflected in the book, the answer is no – this affliction is most likely permanent. However, the symptoms of it can be moderated somewhat, through ongoing medical management. It may be possible to get somewhat better – to not feel the pain as deeply, or to have the symptoms disrupt life quite as much. But that’s as much as can really be hoped for, in this view.
3. Does what I do (or don’t do) matter for my healing?
According to this view, one’s actions are not defining influences on one’s emotional or physical condition. Depression is characterized as an illness that strikes unexpectedly and uncontrollably. A sufferer is portrayed as a rather helpless victim of the relentless impact of this torrential disorder – often independent of what they do or don’t do.
4. Is stigma a major barrier in healing?
The stigma and shame associated with mental health challenges is presented, in this perspective, as one of the most significant obstacles sufferers face in their hoped-for recovery – especially if it stands in the way of embracing the prevailing treatment approach. Lack of understanding by others – along with self-blame some feel for having to rely on medication – are seen as major factors keeping sufferers from reaching out for help. Sufferers are seen as being trapped within the stigma that others inflict upon them, unable to progress because of others’ unkind judgments and responses.
5. Is medical treatment necessary to get feeling better?
According to this view, reflected in the book, asking your doctor for relief through medication is often an essential component of recovery. This is discussed as a crucial element in fixing the “chemical imbalance” afflicting the broken brain. Gaining the courage to finally be willing to go on medication is thus seen as an important victory – a needed step in the treatment process.
Impact of This Mainstream View
The combination of views described above have become so mainstream over the past 2-3 decades that many assume it all to be accepted and scientifically-verified fact. That perspective is taken for granted and reflected throughout the book – that depression is a permanent brain disease that can only be relieved with medical treatment, together with ongoing caring and kindness from others.
The impact of such ideas is not always helpful – as the book itself reports. In one particularly heartbreaking interview, Jane learned of a depressed young woman whose depressive situation worsened into suicidal depression when she was told that she had what would likely be a lifetime struggle. In the face of this discouraging information, as well as intensive treatments, that individual’s original despair escalated into abject hopelessness, tragically leading to full suicidality.
Over and over in our professional work, we have likewise seen that individuals struggling with depressed mood can become even more despondent when they are convinced that depression is a permanent affliction that can only be managed by reliance on someone or something outside themselves. This disempowering idea often generates increased hopelessness and a sense of dependence. Indeed, these ideas often infer that healing is not really an option – that “controlling the illness” is as good as it gets – and that those mood-altering products are required to achieve this level of relief.
There Are Better, Happier Answers to These Questions
In contrast, our professional experience has demonstrated to us, over and over again, that there are better, happier options – along with more empowering, hopeful answers to the 5 questions introduced earlier:
1. Is my body messed up for good?
No, absolutely not! Our bodies are equipped with the inborn, lifetime capacity to regenerate new cells, to change and adapt, and to activate healing from within. Likewise, recent research has revealed that the brain is capable of neuroplasticity – of creating healthy new brain cells, and learning healthy new patterns that support health and vibrancy. This has been shown to be present regardless of age, as the brain is capable of generating healthy new cells from birth to old age. The key is to learn what sets that healing process in motion, and to follow it. Fortunately, many effective resources are available now to help facilitate that learning and positive growth.
2. Is it possible to get better from this?
Yes! Greater healing from depression is absolutely possible – with deeper, more sustainable recovery available to anyone willing to keep learning more about the process of healing, and then continue to gradually implement the changes in thinking and behavior that are associated with it. (Keep in mind that “healing” does not always mean “immediate, complete relief.” Far more often, healing is a gradual, incremental process, carried out by degrees, over the process of time).
The speed and thoroughness of healing is affected by the severity of factors impacting the depression, how long they have been present, and the depth of the symptoms. This is just as true of emotional wounds as it is true of physical ones. In our experience, deeper, more severe wounds take longer to heal, and involve more elements in the healing process. For example, a depressive condition preceded by long-term sexual abuse or other significant harm will likely take longer to heal than a depressive mood triggered by more temporary disappointment. But across different levels of severity we have witnessed people generating powerful improvements in mood, as they make adjustments in behaviors and attitudes that lead toward ever-increasing wellness, hope, and recovery.
We heal by degrees – building strength upon strength, insight upon insight. It doesn’t happen all at once. But from what we have seen in our work – and in the scientific research – this is a path available to anyone who moves in that direction. As we have witnessed in so many cases, this is a course that can lead, layer by layer, to joyful transformation and healing.
Just as a gaping physical wound can heal by degrees over time as we provide proper cleaning and care – so also our emotional wounds can be healed as we learn to provide proper care to activate that healing process.
3. Does what I do (or don’t do) matter for my healing?
Yes, absolutely! Our choices and actions, day by day, either strengthen our wellness and vibrancy over time, or contribute to our ongoing depression and distress. The key is to recognize that whatever our current emotional state might be, we have the ability to make healthy choices and change our thoughts and behaviors, in a more positive, wellness-promoting direction.
Research has repeatedly shown that there are many tools and resources that can help in this healing process. Some of our favorite strategies include: cognitive therapy, mindfulness, journaling, behavioral replacement, brain-healing nutrition, physical exercise, and communication training. Individuals can customize this mix of strategies to fit their current needs and energy level, drawing on their existing strengths and resources. Over the process of time, they can intentionally build (or rebuild) a life that brings satisfaction, healing, and joy.
4. Is stigma a major barrier in healing?
While stigma can be a powerful barrier, it is not an insurmountable one. Negative judgments or misunderstandings from others, while lamentable, need not stop our progress or impede our recovery. Overfocus on stigma can obscure meaningful concerns or questions about treatment options. And, of course, negative judgments and labels we apply to ourselves can also exist as a barrier to recovery. We do best when we learn to control what we can control, and not give undue attention to what we cannot control – including the opinions or judgments of others. As we press forward day by day on a healing path and choose behaviors and attitudes that help us grow, stigma becomes increasingly irrelevant and no longer a barrier to our progress.
5. Is medical treatment necessary to get feeling better?
Medical treatment is only one of dozens of available treatments for depression, and its potential use should be approached cautiously. It always invites side effects, and is not necessary for everyone. Nor is it necessary or wise to rely upon it long-term in most cases – especially if individuals are supported in learning and applying the necessary strategies to deepen healing and sustain their own wellbeing. People can and do heal from depression, as they learn to address the underlying factors that otherwise contribute to the development and maintenance of the disorder over time.
CONCLUSION
In summary, we recognize that gathering the voices of so many who struggle, describing their pain, and validating their struggle, is needed and valuable work. We regard this book as a powerful contribution to a crucial – and we hope, ongoing – conversation on this important issue. But while the book does a superb job describing this painful condition, it falls short of leading people out of it.
Understanding a problem is a helpful beginning. Solving a problem is a different matter altogether. Validating the pain of depression is a needed service, provided well by this book. Deeper healing for the condition of depression is absolutely possible – but is beyond the range of this book.
So to those looking for answers for themselves or their loved ones who struggle, we say: Enjoy the book for the insights it contains. But then, keep looking – and know that there are many powerful and well-established paths for hope, healing, and recovery.
Medication is not the only treatment. “Chemical imbalance” is not the only explanation. Lifetime struggle is not the only prognosis. There are better paths, and more productive courses to follow – to not just endure, but to actually overcome and move past this painful condition.
Depression need not be permanent. Real, deep-down healing is possible. It requires some learning, work, and change. But “sweet is the work” of building a healthier brain, a more vibrant mood, and a happier life.
“Silent Souls” can do more than just “weep.” They can heal.
We encourage you not to settle for anything less. And…let’s keep the conversation going.
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.