My Friend is Depressed: Now What?

August 13, 2014
Van Gogh "Sorrowing Old Man" 1890

Van Gogh “Sorrowing Old Man” 1890

What can Jewish tradition teach us about helping people who are depressed?

REACH OUT – Make contact, either by phone or in person. There is a beautiful story in tractate Berakhot 5a-b of the Talmud about three rabbis. The first rabbi, Chiyya bar Abba, fell ill. Rabbi Yochanan went to see him, and asked him if he welcomed his suffering. Rabbi Chiyya said no. Then Rabbi Yochanan reached out his hand, took the sick rabbi’s hand, and raised him up.

Rabbi Yochanan fell sick. Rabbi Hanina, his teacher, went to see him. He asked the same question, and got the same answer. Then he took Rabbi Yochanan’s hand and raised him up. The text itself asks then, why couldn’t Rabbi Yochanan heal himself? It answers itself, saying, “The prisoner cannot free himself.”

Finally, Rabbi Eleazar fell ill. Rabbi Yochanan went to see him. He finds the rabbi lying in a dark room and crying. Rabbi Yochanan asks some questions about Rabbi Eleazar’s sadness. When Rabbi Eleazar says, “i am weeping because you are going to die someday.” Rabbi Yochanan says, “Yes, that’s very sad” and then they both cry for a while. Then Rabbi Yochanan says, “Do you welcome your suffering?” and Rabbi Eleazar says no, and Rabbi Yochanan takes his hand and helps Rabbi Eleazar up.

What can we learn from this? First of all, it is good to visit people who are sick, whether they are physically or mentally ill. We don’t know exactly what was wrong with Rabbi Chiyya bar Abba, but Rabbi Yochanan visited him, expressed his care, and helped him get better.

Second, we learn that people can’t heal themselves. Never tell a person with depression to “snap out of it.” Instead, ask how they are feeling, listen, and if you can “give them a hand,” literally or metaphorically, do so. Few of us can heal miraculously like Rabbis Yochanan and Hanina, but friendly contact can help.

The case of Rabbi Eleazar is particularly interesting. In his case, it’s clear that the illness is depression. So one thing we learn is that the ancient rabbis saw overwhelming sadness and “lying in a dark room” as a genuine illness. Secondly, Rabbi Yochanan treated Rabbi Eleazar’s sadness with respect. He didn’t say, “That’s silly, everyone dies sometime!” He agreed that it was sad, empathized with his student, and then helped him up.

OFFER COMFORT – In 1 Kings 19, the prophet Elijah hears that Queen Jezebel wants to kill him. Initially, he runs for his life, but after a day’s journey into the wilderness, he sinks down to the ground under a tree and says, “I just want to die.” Then he falls asleep. After he sleeps for a while, an angel comes to him and sets down food and water, saying only, “Get up and eat.” Elijah does so, then lies back down to sleep some more. The angel comes again, bringing more food and water, and says, “Get up and eat; the journey has been too much for you.” Elijah eats and drinks and feels stronger – he is able to travel ahead to Mt. Horeb, where he has an encounter with God.

The angel brings food and water to Elijah. He offers sympathy (“the journey has been too much for you”) but no advice or analysis. He doesn’t scold or tell Elijah to snap out of it. And he is not impatient when Elijah says nothing, just eats the food and goes back to sleep.

The angel is an example of one way to help a depressed friend. Don’t ask “what can I do?” because that requires thought and decision making. Simply bringing by a bit of comfort food, and delivering it without demanding much social interaction can be very helpful. A brief bit of human (or angel!) connection can be helpful. If you decide to bring food, bring it in a disposable dish. That isn’t very “green,” I know, but washing dishes takes energy. It also doesn’t have to be a whole meal. It can be a slice of cake or a bowl of soup to heat in the microwave.

The same is true for some small errand or chore. Don’t do housework (that may feel like criticism) but visit briefly and bring in the newspaper or the mail that has collected on the doorstep. All of these things say, “I care about you.”

The important thing is to keep it simple.

Finally, we have an example of the wrong thing to do for a depressed person:

DO NOT GIVE ADVICE - The Book of Job offers some powerful examples of “how not to help.” Job suffers one misfortune after another, and when his friends come to see him, they focus on their belief that he must have done something to bring his misfortune upon himself. He needs to repent his sins and get right with God! (Job 4-27)

When our friends are distressed, we are distressed. The desire to fix things can be almost unbearable, especially if we think we know a remedy. We want to point out the obvious and give advice. We ache to tell our friend to get some exercise, to eat right, to see a better therapist, to snap out of it!

Just as it was for Job’s “comforters,” this impulse is worse than useless. Many depressed individuals are already mired in a swamp of “shoulds” and “oughts,” and the depression has paralyzed them. Giving even the most well-meaning advice can make them feel worse. If they want help finding a therapist or getting some exercise, that’s different – but pushing unwanted “solutions” will be unproductive.

GET HELP: If someone in your community is depressed, tell your rabbi! He or she wants to know and will know how to contact the person.

Finally – this is very important! - If a person talks about suicide, take it seriously. Call a suicide hotline or their doctor. Never assume that talk about suicide is “kidding” or attention seeking. If there was anything at all to the talk, it’s important that they get help immediately. Even if later they say they didn’t mean it, you can’t take that chance. The principle of pikuach nefesh – the preservation of life – demands that we take such talk at face value and react.

Being a good friend to a person with depression is a mitzvah. It is tempting to stay away from people who are in pain – pain is unpleasant, after all. But reaching out, checking in, offering food or simple help – those things can make a huge difference. Be a mensch!


Depression and Judaism

August 6, 2014
Black Dog #1: Jojo

Black Dog #1: Jojo

I have two black dogs. One makes me laugh, and one makes me cry.

This is Jojo. Sometimes we refer to her as Jojo the Clown, because she makes my entire family laugh. She has a dance that she does when she sees new people or favorite people, aka “the Jojo dance,” which consists of her front paws doing a waltz and her back paws doing the Charleston. Someday I need to stop laughing long enough to make a video.

Jojo is a rescue dog. She languished at her foster home, waiting for new people. The old people had gotten sick and had to give her up. After months of being passed over (something that often happens to black dogs) she became depressed. For comfort, she stole food from the other dogs, and her normally 9 pound body ballooned to 15. When Linda and I met her, she was a sad little depressed dog. She lay there, looking sad until I picked her up. Then she peed all over me.

I immediately identified with Jojo; we both had “black dogs.” That was what Winston Churchill called depression: his black dog. I have that kind of black dog, too, and from time to time it sticks to my heels like glue. Lately, I have been visited by Black Dog #2. (Jojo is Black Dog #1 – of course she is #1 – she makes me laugh.)

When Jojo got a home, and the right meds, she returned to the self she was meant to be. And I find her encouraging during my spells with Black Dog #2. If Jojo could learn to dance again, so can I.

Part of recovery is following doctor’s orders and taking my meds. And part of it is immersing myself in the home of my heart: Judaism. Judaism teaches me in my morning prayers, “The soul … within me is pure.” I’m not bad, even if I feel bad. Moreover, I can do good: I can do mitzvot. I can study texts, I can pray, I can give tzedakah, I can teach my students, and I can relieve suffering (in small ways). Like Jojo, I can rejoice in having a home, even if “rejoicing” consists of eating good things and staying in touch with loved ones until I feel like more strenuous rejoicing.

Judaism teaches me that when God finished Creation, God saw that it was “tov me’od,” – it is very good. All of it. Including a certain depressed rabbi.

I am writing about this because I know that some of my readers, some whom I don’t even know, also suffer from depression. You aren’t alone, just as I am not alone. There are lots of us. And with the right help, and doing mitzvot (eating right, following doctor’s orders, getting outside ourselves to do mitzvot for others) it will be OK.

It is the tough weeks when I am most grateful for being a Jew. I have a storehouse of wisdom saved up for me by the Jews of the past: the Torah, the Tanakh (Bible), the Mishnah and the Gemara, and wise words written by centuries of wise Jews. Even when I can’t get it together to study them, I can see them there on my shelves: centuries of faith, seeking to do good.

We’re all going to be OK.


Living on the Mitzvah Plan

February 21, 2014
To climb out of a tough place, it helps to have a plan.

To climb out of a tough place, it helps to have a plan.

Depression is an old companion of mine. It doesn’t run my life, but it shows up periodically and moves into the guest room of my mind, helping itself to my energy and attention.  In almost 59 years of living, I’ve acquired a lot of strategies for dealing with it (therapy, medication, exercise, meditation, etc) but one of the most powerful is something I call the Mitzvah Plan.

The basic idea is this: with 613 mitzvot to choose from, there are always mitzvot waiting to be done, from washing first thing in the morning to saying the bedtime Shema at night. Using the Mitzvah Plan, whenever I begin to be bothered with the thought patterns of depression, I look for the first available mitzvah and do it. Then I look for the next one, and I do that. I keep doing mitzvot until I feel better. I don’t have to think about it, I don’t have to enjoy it, I just need to do a mitzvah.

I came up with this back in rabbinical school, during a particularly bad stretch of depression, when the words we say at morning prayer jumped out at me:

These are the precepts whose fruits a person enjoys in this world but whose principal remains intact for him in the world to come, and these are they: . . .early attendance at the house of study morning and evening . . .Shabbat 127a

My Hebrew was still pretty bad at that point, and I translated the bolded phrase above as “sit in the house of study morning and evening.” It was a mistranslation, but a blessing nonetheless. I decided that even in the depths of depression, I could manage to sit my tuchus in the chair at school. So I chose to focus on the fact that I was doing that mitzvah, and give myself credit. One mitzvah leads to another, the sages tell us, and I found that if I kept my mind focused on looking for the next mitzvah, my mind had a harder time getting stuck in dark places. By the time I realized my mistake with the original Hebrew phrase, the Mitzvah Plan was in place and working for me.

[Mind you, I was also seeing a therapist and taking antidepressants, too. The Mitzvah Plan is not a "cure." It's a spiritual discipline I've found helpful in fighting depression. If depression is an issue for you I encourage you to ask for competent help.]

The Mitzvah Plan isn’t just for depression. Bored? Do a mitzvah. Frustrated? Do a mitzvah. Insomnia? Do a mitzvah. What, you did it and you are still bored, frustrated or awake? Do another mitzvah. And another. Keep doing mitzvot until you feel better or the world changes. Then do another mitzvah.

Sometimes it helps by taking me outside of myself to notice someone else’s troubles. Sometimes it helps by making me feel a bit better about myself. Sometimes it helps by just keeping me busy. But at least I’m not wasting my life thinking black thoughts or doing something I’ll regret later.

Where to find mitzvot? They are all around:

  • Are there thank you notes that need writing?
  • Give tzedakah. Very small amounts are still tzedakah.
  • What time of day is it? So say the prayers for that time of day.
  • Recycle something.
  • Write or call a mourner and tell them you’re thinking of them.
  • Do something kind for someone else.
  • Take care of your body: wash or exercise or brush your teeth.
  • Pay bills. (Did you know that paying workers on time is a mitzvah?)
  • Study some Torah.

I know, some of these do not sound  very “spiritual.” But in the Jewish tradition, they are mitzvot; they are acts that will make us holy if we do them with intent.

And I can say, from experience, that one mitzvah leads to another, that they can form a ladder on which to climb out of some pretty bad places. That’s life on the Mitzvah Plan.

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Unhappy Thanksgiving

November 28, 2013
Sad man holding pillow

 (Photo credit: hang_in_there)

I know what it’s like. I’ve been there: Unhappy Thanksgiving.

 

The details are private and personal, but the larger picture: the family gathering that is more painful than fun, the lonely Thanksgiving far from people you love, the holiday when there is an empty chair at the table – I’ve been to all those Thanksgivings, and they were miserable.

 

One of the blessings I count today is that this year is a good year for me: I’m surrounded by family, in a happy home, with food on the table, and the turkey is paid for. I have what I need, and more.

 

Not all years were like that. And I know, for someone reading this, this year isn’t like that. I’m truly sorry that you are having an Unhappy Thanksgiving this year. If I had a magic wand, I would heal all the hunger, and the loneliness, and the poverty, and the broken hearts – but I have no magic wand.

 

All I can tell you is that this is just one day. If the sun is shining, take a walk. If you can identify a blessing, give thanks for it. Gratitude is often the beginning of something good, weirdly enough.

 

But know that I know you are there, and I’ve been there. I wish you better years ahead.

 


Yom Kippur and Depression

September 11, 2013

National Suicide Prevention Lifeline

It happens that this year the Days of Awe align with Suicide Prevention Week.

Sometimes people think I’m exaggerating when I say that before I learned Hebrew, Yom Kippur could wreck me. The (non-Jewish) language of “sin” and “repentance” that I learned as a child sent me into a tailspin of despair.  Avinu Malkeinu [Our Father, Our King] was a fearsome image before which I cowered, a failure. A whole day of that, plus fasting, made me truly crazy.

No, I’m not exaggerating.

The years that I was in otherwise good emotional shape, I’d be OK. But I remember a couple of years when Yom Kippur coincided with a round of depression, and I shudder. Obviously I am still here, but it has sometimes been a spiritual battle.

Here are some things I have learned. I share them for the benefit of anyone who needs them this week:

PIKUACH NEFESH (pee-KOO-ach NEH-fesh) means “preservation of life.” It trumps nearly every other commandment. Do whatever you need to do to take care of your body/soul this week. If that means call someone, call someone. If that means go to the beach for your Yom Kippur “service,” do it. If that means eat, take your meds, go to a meeting, whatever, DO IT.

MEDICATION – After a long lifetime of hanging on by my very short fingernails, I finally allowed a kind doctor to write me a prescription for antidepressants.  They do not solve everything, but they have been a huge help. There is no shame to taking them, and they have saved lives. I take mine every day, and say a blessing when I do it.

THERAPY – If you can get access to therapy, it can be an enormous blessing. Find a therapist by asking people you trust for a referral. Your rabbi should be able to give you a name of someone who has helped others.  Again, there are no easy fixes, but a good therapist can help you find your way.

PRAYER - This is one of the places where traditional prayers can be powerful. My go-to prayer for navy blue days is the blessing for the soul we say in the morning prayers: Elohai neshama sheh natata bee, tehora hee – “My God, the soul you have put within me is pure.” It reminds me that the core of my soul, the core of every soul, is the Divine spark, pure and good. It reminds me that however I happen to feel, the essence of me is pure Goodness.

Why would a rabbi go online and post that she’s on medication for depression, and expects to be on it for the rest of her life? Because (1) illness, including mental illness, is nothing to be ashamed of and (2) because it is the most powerful way I can think of to say it’s OK to take care of yourself and it is OK to ask for help.

In the traditional service, there is a prayer, “Blessed are You, Adonai our God, who brings the dead to life.” While I think a future resurrection of the dead is a quaint medieval notion, I do take that prayer literally. Those who feel dead, who are in many ways as good as dead, can come back to life, and whenever that happens, it is a holy miracle.  That’s the blessing I say when I take my meds every morning, and whenever something happens that adds to the spark of the Divine within me.

This Yom Kippur, remember that what we call in English “The Gates of Repentance” are actually the Sha’arei Teshuvah. Teshuvah is much more than “repentance.” Teshuvah means  turning, changing course, and sometimes, coming home.


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