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Depression and the way of the cross

In the face of science, many people dismiss Christian teachings on clinical depression. Amelia responds with a thorough dissection of depression in light of the Orthodox patristic tradition. An excellent resource for priests who counsel pastorally or clinicians with Orthodox patients.
And [Jesus] said to them all, If any man will come after me, let him deny himself, and take up his cross daily, and follow me.
— Luke 9:23

The way of a Christian is to bear a cross. Crosses come in many forms: Poverty, losses, injustices, loneliness, betrayals, illnesses, and other hardships. Sometimes the way of the cross involves sadness.

While there is such a thing as holy sadness, which is ordained by God and intended for our spiritual benefit, it's important to understand that that's not the only type of sadness that exists. There's also sadness that comes from choices we make, as well as sadness that comes from the actions of other people, and sadness that comes from the devil. Because these variants of sadness don't come from God, they don't strengthen our faith or our relationship with Him. Much the opposite, they weaken our faith little by little, and in doing so, they separate us from Him even further.

We see so many cases of depression these days, too many of which seem to be incurable. In theory, clinical depression is supposed to be highly treatable. In practice, however, treatments are often unsuccessful in the long term. Sometimes they're not very successful in the short term, either. Depression knows no boundaries of age, gender, race, religion, or class, and neither medicine nor psychotherapy offers any sort of treatment that comes with any guarantee of success. At first glance, it might appear that God and the Christian faith are equally ineffective when it comes to offering a foolproof treatment plan, because many people that self-identify with Christianity continue to suffer from the disease. But there's a problem with this line of thought, one that we can only identify if we truly understand what the way of the cross entails.

Suffering and the way of the Holy Cross.


As Christians, we know that we're supposed to bear a cross, but what does that mean? We know it has something to do with suffering, but do all types of suffering count as bearing one's cross? Are there certain types of suffering that can stand in the way of bearing the cross? It's not often that we think about these questions, even as Christians. We more readily assume that if we're facing a difficulty, it's something that God must want us to face. We assume that any struggle in life constitutes a cross that we have to bear, a cross sent from God. But this is a hasty oversimplification, one that can prevent us from recognizing our true cross, the one that is given to us from the Lord.

Saint Isaac the Syrian writes this about the cross that each of us is called to bear:

The cross is the door to mysteries. Through this door the intellect makes entrance into the knowledge of heavenly mysteries. The knowledge of the cross is concealed in the sufferings of the cross. And the more our participation in its sufferings, the greater the perception we gain through the cross. For, as the Apostle says, 'As the sufferings of Christ abound in us, so our consolation also aboundeth by Christ.'

Through this text, we can discern why certain sufferings fail to meet the criteria of the God-given cross. The cross that comes from God brings us closer to Him. However, there are many hardships in life that actually lead us away from Him, or that make us feel as though God has abandoned us. If our suffering doesn't bring us closer to God, it has nothing to do with the cross we're called to bear. Holy suffering also grants us access to a deep, spiritual understanding of Divine truths. The more we suffer by way of the Holy Cross, which is to say the more we suffer to the glory of God, the more we're able to comprehend the unutterable and inexpressible. There are other types of suffering, however, which corrupt our faith and our understanding of anything holy; the more we suffer in those ways, the less receptive we become to any sort of revelation from God, and the more receptive we become to lies from the enemy. Suffering by the Holy Cross means sharing in the death of Christ. In doing so, we also enable ourselves to share in and be comforted by His resurrection. If we suffer for other reasons but don't share in His death, we prohibit ourselves from finding any consolation in His resurrection.

It's true that the way of the cross sometimes involves what we could call a type of sadness, but it's very different from the sadness that we typically associate with clinical depression and other mood disorders.

Holy sadness, the kind that comes from God in the form of a cross, isn't devastating. It doesn't leave us feeling sorry for ourselves or longing for our circumstances to change, because there isn't any pride at the root of holy sadness—we aren't concerned with our own desires or will. Holy sadness doesn't sweep us up in emotional rapture, nor does it hurl us into the pits of despair. Holy sadness is profound but sobering. At its core lies a deep compassion for the sorry state of the world, and a ceaseless yearning for the saving mercy of the Lord Jesus Christ—for ourselves and for all of humanity. Holy sadness brings us face-to-face with everything that's wrong with us, instilling a deep hatred for vanity and sinfulness, yet it tempers these feelings, never letting them escalate to despair or thoughts of self-destruction. Holy sadness keeps the prospect of salvation always at the center of our view, steering our souls and bodies away from every course that would lead us in another direction. It's characterized by the utmost in humility, yet the utmost in hope at the same time. It destroys our passions, steers us away from temptations, and directs our sights to the "prize of the high calling of God in Jesus Christ" (Philippians 3:14).

This kind of sadness is the only kind that has anything to do with the Christian cross. It's the kind of sadness that the righteous Job surely felt, as he endured one hardship after another. God allowed the devil to take everything from Job—his house, his entire family, his servants, his livestock, his health, and his friends. There's no way that Job endured these things without feeling some degree of sadness. Despite whatever sadness he might have felt, however, Job remained resolute in his faith. He never ceased to believe, to pray, or to live righteously, as he always had in the past, despite being surrounded by people he called "miserable comforters," who didn't make his cross any easier to bear (Job 16:2). Not only did Job not lose faith during his hardships; he even prophesied of Christ and salvation: I know that my Redeemer liveth and on the last day He shall raise from the dust this my corrupted skin, and in my flesh I shall see God. I shall see Him myself; mine eyes, and not the eyes of another, shall behold Him (Job 19:35-27). There was nothing that the devil could do, no amount of suffering he could impose that would have been powerful or destructive enough to rattle Job's faith, his love for God, or his resolve to be holy. This is the kind of sadness that God permits or provides for our spiritual growth and sanctification.

Unfortunately, this isn't the kind of sadness that characterizes a majority of the cases of clinical depression. When sadness comes from the Lord as a means of strengthening the soul, it's a burden that we're gladly and easily able to bear. When sadness comes from a source that's strictly biological (such as a brain injury, a biochemical dysfunction, or as a by-product of some other physical illness), it's also easy to bear—medication can completely eliminate it. Most instances of depression, however, don't fall under either of these categories. Most depression affects the soul just as much as it affects the body, if not more so.

Depression doesn't interlace well with Christianity—at least not with Orthodoxy—because it very frequently leads its victims toward abandonment of the Holy Cross.

Depression and the abandonment of the Holy Cross.


Numbered among countless saints and martyrs for Christ, the righteous Job experienced unfathomable suffering: The loss of loved ones, material losses and deprivation, physical pain and disfigurement, psychological and emotional distress—but his spirit was never shaken. Much to the contrary, depression is a disease that afflicts the spirit worse than it afflicts anything else. Left unchecked, it can altogether crush and destroy the spirit. Unlike holy suffering, which strengthens one's faith and one's resolve to "push through the pain" to the glory of God, depression weakens the soul and leaves it unwilling, in many cases, even to survive let alone to fight. Depression quashes the soul's desire and ability to do everything that God created it to do: To pray, to believe, to give and receive love, to hope, to rejoice, and to endure. Any affliction that's capable of leaving the soul in such a state, so contrary to its created nature, couldn't possibly be an act of God's will.

Anything sent by God is for our benefit, even if it means we have to suffer to obtain that benefit. Depression certainly entails suffering, but it's a suffering that comes without any benefit. In fact, it often causes us great harm, both physically and spiritually. Worst of all, depression often disables us to the point of not being able to bear whatever is our God-given cross.

In essence, depression is characterized by an extreme perversion of sadness. It's sadness that has extended far beyond the bounds of normal emotional expression. This type of depression involves feelings of guilt, worthlessness, meaninglessness, apathy, anxiety, restlessness, hopelessness, and despair. These aren't simply undesirable feelings; they're spiritual states that stand boldly in opposition to every single aspect of the Christian faith. Are there biological or psychosocial factors that can give rise to these spiritual states?—absolutely; but that doesn't mean the extent of the depressed person's problems are purely biological or psychosocial.

Let's look at them a little more closely.

Guilt.

The person who feels guilty (excessively or otherwise) doesn't understand the meaning of the Passion or the Resurrection. At the very core of Christian faith is the belief that the Lord has done away with guilt altogether. He gave Himself as the ultimate sacrifice for our sins. This is why we pray: O Lord, Lamb of God, Son of the Father, that takest away the sins of the world, have mercy on us (from the Great Doxology). While we have to repent for our sins, which means to regret them and strive not to repeat them, God's mercy absolves us of guilt; through our faith and repentance, He takes it away. No matter what we've done, if we repent and confess in faith, we no longer have a reason to feel guilty. By definition, then, holding onto guilt means refusing to believe in mercy, salvation, and eternal life. It implies an all-out rejection of the power of the Holy Cross, in both time and eternity. Feeling guilty isn't bearing a cross; it's a denial of the Holy Cross itself.

Worthlessness.

The person who feels worthless often mistakes his feeling for one of humility. But Christian humility has nothing in common with worthlessness. Humility only means an absence of pride before God and before others. It doesn't destroy our identity as a child of God, a servant of God. The humble person purges pride from his soul in order to make it a more suitable dwelling place for the Lord; he despises his sinfulness. But the person who feels worthless doesn't despise his sinfulness; he despises himself altogether, regardless of whether he sees himself as sinful or not. He doesn't recognize himself as bearing any resemblance to the Father in Whose image he was created. He may feel low to the ground, but not in the same way as the humble person.

The humble person sees himself as capable, and he's aware that he doesn't live up to those capabilities. The worthless person, on the other hand, doesn't feel capable of anything. In his heart, he insists that he has no ability to do good (even with God's help), no ability to embrace and fulfill the Lord's will for him. The root of this kind of stubbornness is pride, precisely the opposite of humility. Feelings of worthlessness cause the depressed person great torment because, deep down, he knows he needs to do better. He's just too fixated on the idea that he can't. He doesn't believe he has true freedom of will, and he doesn't believe that God will help him to exercise it in a holy and useful way.

Meaninglessness.

The person who no longer sees meaning in anything no longer sees God. When we see God, we should recognize a holy beauty and purpose all around us. We may be deeply saddened when we see things defiled by sin, but it's only because we're able to contrast how things actually are with how God intended them to be. The depressed person doesn't make this comparison; he only sees the ugliness, and he concludes that everything—himself, his life, and the existence of everything around him—must be an unfortunate accident. The depressed person doesn't feel that he was created for any special purpose, which is in stark contradiction to the Christian view.

We might assume that this sense of "nothing means anything" comes from an overload of pain in one's life, but the holy fathers indicate that it's just the opposite. These feelings come from having become accustomed to the taste of pleasure and then finding out, ultimately, that pleasure inevitably disappoints. The person who's truly had a rough shake in life may feel pain, but if he's truly a Christian, he clings to God and sees the holy beauty and purpose in everything. He hurts because he longs to partake of that beauty and fulfill his Divinely inspired purpose, whereas the depressed person hurts because he no longer believes that such beauty or purpose exists.

Apathy.

The person who feels apathetic no longer cares about anything. He isn't moved by anything anymore, good or bad. He feels no inspiration toward anything, He writhes in pain, but even the pain lacks meaning. His body and emotions hurt terribly, but his heart is spiritually numb. Christians are supposed to be fervent in their faith and zealous about doing good, but the depressed person has cut himself off from any such desires or inclinations. Because he doesn't feel worthy, and because he doesn't "see the point," he doesn't really care about what God expects of him. If his depression is severe enough, he doesn't care about what his family or friends or the world expect of him, either. Or perhaps he does care, but he's so worn out (from feeling worthless, for example) that he simply doesn't have the energy to do anything about it.

Saint Paul instructs us not to grow tired of living the way we're expected; God will reward us for not giving up (Galatians 6:9). Sadly, the depressed person has already given up. In anticipation of His Passion, the Lord was in agony but didn't give up. He prayed: Father, if thou be willing, remove this cup from me: nevertheless not my will, but thine, be done (Luke 22:42). The depressed person, however, is too burdened by his troubles to be able to concentrate on God's will; he only wants his cup to be taken away. Suffering that's given to us by God doesn't leave us apathetic, or without motivation or inspiration; holy suffering makes His purpose vibrantly alive within us.

Anxiety.

The depressed person often feels a certain amount of anxiety or worry. He might be concerned over the outcome of a particular situation, or he could just be troubled by thoughts of the future in general. In either case, his feelings reveal that he doesn't fully trust God. The Christian who trusts God believes that He's watching and providing, no matter how difficult or troublesome things might seem. The Bible clearly states that anxiety and worries don't help, and that Christians should trust that God is taking care of things (Matthew 6:27-30). It also tells us that worry weighs us down (Proverbs 12:25), and that instead of worrying about anything we should pray about everything (Philippians 4:6). The combination of asking God for help, thanking Him for everything He does for us, and walking in His footsteps ensures that we'll experience a sense of peace beyond all understanding (Philippians 4:6-7). Not only does the depressed person not know this peace; he doesn't even believe in its existence.

Restlessness.

There are two kinds of restlessness. In the Orthodox sense of the word, restlessness means our hearts are in a state that's not relaxed or lazy. We're called to a lifetime of hard work and vigilance, and it's not intended for us to enjoy true rest until we reach eternity. Saint Isaac the Syrian writes: The will of the Spirit is for everyone that loves Him to abide in labor. God’s Spirit does not dwell in those that are living peacefully. This isn't the kind of unrest that a depressed person experiences, however. The depressed person isn't restless intentionally or for a good reason. He's not joyfully "without rest." The depressed person is trying to rest but can't.

In the words of Saint Augustine, we pray: Thou hast made us for Thyself, O Lord, and our hearts are restless until they find their rest in Thee. Finding rest in God, though, doesn't mean kicking back and being unconcerned. It means taking on the great responsibility of carrying a cross, the burden of living as a Christian, and being comforted knowing that genuine rest will come in the next life. The depressed person has many reasons why he can't or shouldn't or doesn't feel he needs to do the work of carrying his cross, yet he always finds that none of these reasons is sufficient to provide him the very rest he seeks.

Hopelessness.

Hopelessness is the feeling of dread that comes from believing nothing will ever change. Although the Christian faith teaches us not to be unreasonably optimistic about what's to come in the present life, the very reason we follow Christ is because we have immeasurable hope in what's to come in eternity. The hopelessly depressed person does just the opposite: He's already placed all of his hope in the present life, and when life disappoints him, he abandons hope altogether, both for this life and the next. Because he doesn't see his hopes fulfilled in time, he doesn't believe anything can change for him in eternity.

Hopelessness provides half of the recipe for suicide. Seeing no prospect of improvement in the future, whether in the world or in heaven, the hopeless person sees no point in enduring. The hopeless person doesn't remember the words of our Lord and Savior Jesus Christ: But he that shall endure unto the end, the same shall be saved (Matthew 24:13).

Despair.

The other half of the recipe for suicide is despair. Along with hopelessness, despair is the most dangerous of all spiritual states. It's a darkness that knows no light. When the depressed person becomes hopeless, his depression plummets to an intensity that he can no longer bear. This is what plagued Judas when he was confronted by the reality of his betrayal. Seeing no reason to stick around on earth, and with no awareness of the soul's immortality beyond the grave, there's nothing left for the depressed person to do except kill himself. Suicide is the heaviest of all sins because it's more than just murder of the self; it's also a renunciation of God and the totality of Christian theology.

Unfortunately, the depressed person doesn't realize that his suicide will only kill the body. Because God created our souls to be immortal, suicide can't kill the soul's awareness of anything. All it does is prematurely deprive the soul of its ability to repent, to embrace faith in the salvation of Christ, and to receive eternal life. Father Victor Potapov writes: Deprived of its living vessel (the body), the soul can pass only over to a different state, and, of course, to one much worse than the one it had in its body. While suffering within the body, the soul of a man can still ease its sufferings morally, by giving them religious meaning, and physically, by helping the body with medication, for example. But when the soul has lost its body prematurely, nothing it can do can help.

* * *

In these previous examples of emotional states commonly associated with depression, any clinician should recognize that the depressed person's mind is troubled—likely, his difficulties are both cognitive and behavioral. But more importantly, any Orthodox Christian should recognize that the soul of the depressed person is also very sick and that it's in dire need of compassionate, holy, Christ-centered care. Spiritual health is characterized, at least in Eastern Orthodox terms, as the very opposite of these hallmark features of clinical depression.

While such depression is most surely a heavy burden, it shouldn't be confused with the Holy Cross, which is the burden that each of us is called to bear. The burden that the Lord asks us to carry isn't difficult. He beckons us: Take my yoke upon you, and learn of me; for I am meek and lowly in heart: and ye shall find rest unto your souls. For my yoke is easy, and my burden is light (Matthew 11:29-30). Depression is more like a set of heavy chains that a person drags around. The person becomes so fatigued from bearing all of this extra and unnecessary weight that he's too tired, both physically and spiritually, even to consider bearing whichever cross God has given him.

In every Christian's heart, there is a throne and a cross; if he refuses the cross, he remains on the throne. We want to be saved, but we insist that Christ do all the dying. No cross for us, no dethronement, no dying. We remain king within the little kingdom of man's soul and wear our tinsel crown with all the pride of Caesar; but we doom ourselves to shadows and weakness and spiritual sterility.
— Protestant Pastor Aiden W. Tozer

The reason we have to bear a cross is so we can follow Christ. If depression had anything to do with a God-given cross, it would strengthen and intensify both our ability and our desire to follow in the footsteps of the Lord. What we see with most cases of clinical depression, however, is the very opposite. Depression leaves its victims too weak and exhausted, both physically and spiritually, to be able to pick up what actually is the God-given cross. Moreover, it makes everything seem meaningless—even matters of faith and salvation.

When depression isn't effectively treated, its sufferers ultimately reach a point of feeling disconnected from everything around them, including God. In time, their Christianity becomes a collection of mere tenets, meaningless words to which they really don't feel any personal connection. What were once deeply held beliefs ultimately degrade into nothing more than ideas that don't "feel" true anymore. In time, those ideas give way to doubts. In the end, the doubts give way to all-out disbelief. Untold numbers of people who suffer from depression come to feel either that God has forsaken them or that He doesn't exist at all. This is why, in extreme cases of depression, suicide seems to be the only option that remains. In no way does this type of suffering bear any resemblance to the Holy Cross of our Lord and Savior Jesus Christ. The cross of the Lord requires suffering, but it simultaneously bestows mercy, hope, love, and life.

What manner of suffering, then, is ordained by the Holy Cross? Holy suffering means to endure pain, to fight temptations, to despise evil, to turn away from sin, to do whatever it takes, even if it means losing things, people, even physical life itself—but all for the sake of love for the Lord and glory to the All-Holy Trinity. This is what Saint Nikolai Velimirovich has to say about it:

What does it mean to take up your cross? It means the willing acceptance, at the hand of Providence, of every means of healing, bitter though it may be, that is offered. Do great catastrophes fall on you? Be obedient to God's will, as Noah was. Is sacrifice demanded of you? Give yourself into God's hands with the same faith as Abram had when he went to sacrifice his son. Is your property ruined? Do your children die suddenly? Suffer it all with patience, cleaving to God in your heart, as Job did. Do your friends forsake you, and you find yourself surrounded by enemies? Bear it all without grumbling, and with faith that God's help is at hand, as the apostles did.
— Homilies (Volume I)

If we study Saint Nikolai's words one sentence at a time, we can see that depression isn't much in line with the cross of the Lord. Suffering that comes from God is meant to strengthen us spiritually, to heal us. Depression doesn't heal us in any way; on the contrary, it weakens and harms the spirit, leaving us emotionally ravaged and spiritually destitute. When catastrophes fall, the depressed person is too upset, too driven by passions, to concern himself with God's will or what it means to be obedient to it. Depression also leaves a person feeling too physically drained to be able to carry out any acts of Christian obedience—it's difficult to do anything when one is too sad even to climb out of bed. If it seems that God is demanding a sacrifice of some sort, the depressed person sees it as yet another thing "gone wrong" in his life, more grist for his despair and self-pity. If he experiences material loss or personal bereavement, he doesn't cleave to God as Job did; he becomes angry with God, and ultimately he doubts God's very existence. If he loses his friends and gains enemies, he doesn't bear it without grumbling. In fact, he finds that his threshold for bearing anything without grumbling is very low. Unlike the apostles, the depressed person isn't faithful that God's help is at hand. The depressed person doesn't feel worthy of God's help, doesn't believe it exists, or doesn't believe it's powerful enough to help him. These kinds of feelings bear no resemblance to the Christian cross.

A soul in need of healing.


We've seen, now, that the most typical cases of clinical depression are incompatible with what it means to be a practicing Christian, at least in the Orthodox sense of the word. However, it's not a disease that mysteriously ambushes would-be Christians and makes them physically incapable of living the faith; it's a disease that results from problems in the depressed person's understanding of the Orthodox faith.

In no way is this an implication that depressed people can't ever believe in God, because many do believe—but there's more to faith than just believing in God and in an eternity that's better than the present life. According to Orthodoxy, complete faith is reflected in every aspect of our life and character: In our deeds, words, thoughts, emotions, attitudes, predispositions, and outlook. If we look at these aspects of a depressed person's life, the reflections we see looking back at us won't be ones of true faith. They may have bits and pieces of faith, but those pieces are broken, and between them are holes in desperate need of being filled with the Lord's grace and mercy.

In terms of what causes depression, the question isn't a matter of which hormone, or which neurotransmitter, or which other biochemical mechanism. Neither is it about which anatomical structure of the brain, which physiological process, or which gene. It's also not necessarily about which thought process, which behavior pattern, or which emotional makeup is responsible. To varying extents, depression has been shown to be associated with all of these aspects of bodily functioning, but the dysfunction of depression is more than a biological or cognitive impairment. It's also very much a spiritual one.

As we know from the holy fathers, the condition of the soul is inextricably related to the condition of physical and psychological health. But this relationship isn't something to which researchers will ever be able to gain access. There's simply no way to map out the workings of the soul; and even if there were, scientists would be unconcerned with it. How the soul functions, including whether any soul exists in the first place, are questions with which science wants nothing to do. These matters are the business of priests and theologians, not of physicians, psychologists, or universities.

The implication that depression is in any way related to poor spiritual health is a widely unpopular and unwelcome thought. And as unwelcome as it is in academic circles, sadly, it's even less welcome in a majority of Christian ones. It's not meant to be interpreted as a judgment against anyone, but it's the conclusion that anyone who has studied the Orthodox Patristic literature would naturally and unequivocably draw. The holy fathers don't mean the implication as a judgment, either. More than anything, their goal is to call everyone to Christ, to salvation.

But the depressed person can't draw nearer to Christ until he realizes that he's separated from Him.

If we look to the teachings of the holy fathers, we find incontrovertible evidence that depression typically begins as a problem of the soul. At its root, it's a spiritual disease. It's true that there can be medical or cognitive-behavioral symptoms associated with it, but something has to cause those symptoms. That "thing" is a spiritual problem, a condition that afflicts the soul and makes it sick. Because the soul possesses the body, rather than vice versa, when the soul is sick, the body has no choice but to become sick as well. No matter how much medical treatment the body receives, troubling symptoms will continue to emerge if an overarching sickness of the soul is left to fester.

In terms of treating depression, then, what's most needed is to heal the soul. The body may have become quite sick and be in need of healing as well, but medical intervention should be paired with spiritual intervention in order to attack the problem at its root. Medication can treat medical symptoms, and (with caution) psychotherapy can correct problems of thought and sometimes behavior, but spiritual problems must be healed by spiritual means—prayer, fasting, confession, repentance, penance, Holy Communion, the guidance of a good spiritual father, and so forth.

Because the sadness that characterizes most cases of depression isn't a holy sadness, meaning it's not a cross that God gives us for our sanctification, it's not something that anyone needs to endure—so this is good news. We don't need to learn how to make it more bearable or how to cope with it as it is. We can do away with it altogether, but first we need to have an understanding of where things went wrong.

By itself, there's no sin in being sad. God gave us a vast range of emotions and the ability to express them. Sadness is one of those many emotions. It's not until sadness intensifies to the point of being overwhelming—the point of standing in the way of bearing our Christian cross—that it becomes anything sinful. Our task, then, whether as individuals suffering with depression, as friends and family who care deeply, or as professionals enlisted to help in Christian love, is to understand at what point the sadness slipped out of control and turned into something spiritually destructive.

Sadness can come from many sources. It can come as a result of mistakes we've made, leaving us wrought with feelings of guilt and remorse. It can come as a result of other people's choices, leaving us to focus on their wrongdoing and the pain it caused us. It can come as a result of things that simply didn't work out the way we'd hoped, leaving us to grieve over what we don't have. It can come as a result of unexpected difficulties, leaving us to pity ourselves and desire pity from others.

While we may or may not have been directly responsible for the circumstances that led to our sadness, how we respond to those circumstances, which includes what we think and how we feel about them, is largely within our control. Despite our fallen nature, it's still possible to live righteously and to strive toward the image of God's perfection, in which each of us was created. We'll never attain true perfection, of course, but it's in our best interests to aim in that direction. And while living righteously won't make us entitled to a life that's free of hardships, it will help us to endure those hardships in a way that's pleasing to God.

In the face of any kind of worldly sadness, there are things we can do to deal with our emotions in a holy way so that they don't spiral out of control. If we're suffering over past sins, we can repent and ask for forgiveness, both from God and from whomever we've hurt. This will alleviate our feelings of guilt and remorse by turning them into something constructive, both on earth and in eternity. If we're suffering over regrets and past mistakes, we can ask God for the help we need to turn around and make better choices, starting right now. This, too, turns negative feelings into something constructive. If we're suffering because others have hurt us in one way or another, it's not good to dwell on their sins; it only reinforces the hurt we feel, and it gives rise to anger and other destructive emotions. Instead of blaming others, even though they may well deserve blame, it's better to forgive them. We can also strive never to hurt others in the same way we've been hurt, and to improve ourselves in some way so that the hurt is no longer at the center of our focus—both of these measures will help to absolve the initial hurt. If we're suffering because we were expecting things to turn out differently from how they have, we can ask God to help us understand and accept His will. In time, we'll find that He had something better in store for us, whether it was to protect us from one thing or to grant us opportunity through another. If we're suffering because we've been blindsided by some type of difficulty or tragedy, we can ask God to reveal Himself and comfort us. These are only a few examples of how we ought to deal with the sufferings that come our way.

When we address suffering from a place of Christian righteousness, the suffering never turns into more than we can bear. God simply doesn't allow it: He that putteth his trust in me shall possess the land, and shall inherit my holy mountain (Isaiah 57:13). When we turn away from righteousness, however, we also turn away from God. This happens when we try to deal with our sufferings in an unholy manner, or when we don't bother to deal with them at all, preferring to give up instead. It's difficult to receive help from God if we're facing in the opposite direction: When thou criest, let thy companies [of idols] deliver thee; but the wind shall carry them all away; vanity shall take them (ibid.). If we decide we're not willing to take the moral high road—to repent, to forgive, to persevere—in other words, if we show God that we're not willing to endure what He asks of us (or what life throws at us, or what we impose on ourselves), then depression is really the only result we can expect to see.

There's no way to avoid or eliminate the presence of normal sorrows from our life, but with God's help we can do things to ensure that those normal sorrows never turn into more than we can manage.

He shall feed his flock like a shepherd: he shall gather the lambs with his arm, and carry them in his bosom, and shall gently lead those that are with young … They shall not hunger nor thirst; neither shall the heat nor sun smite them: for he that hath mercy on them shall lead them, even by the springs of water shall he guide them.
— Isaiah 40:11, 49:10

As a shepherd cares for and nurtures his sheep, so God nurtures and cares for us, especially those of us who are hurting. If we desire the comfort and protection of the Good Shepherd, however, we have to see to it that we're not straying from the flock. While it's certainly no sin to feel sad, if we let that sadness escalate to the point of taking over our whole life—if we let it compromise our will, our energy, or our faith—then we are submitting to sin. The way we look at life very much affects how our life turns out: For where your treasure is, there will your heart be also. The light of the body is the eye: if therefore thine eye be single, thy whole body shall be full of light. But if thine eye be evil, thy whole body shall be full of darkness. If therefore the light that is in thee be darkness, how great is that darkness! (Matthew 6:21-23).

If we hold onto our past sins, they'll haunt us all the way into eternity. If we hold onto our mistakes and failures, we'll see ourselves as incapable, and failure will be all we're ever able to achieve. If we hold onto the offenses of others, we'll never feel the liberation that comes from forgiving them and moving on; and if we fail to forgive others, we shouldn't expect anyone else to forgive us, including God. If we hold onto disappointments and missed opportunities, we'll close ourselves off to the possibility of every new joy that could be just around the corner. If we hold onto painful memories, or if we enjoy the sick comfort that comes from reliving difficult episodes over and over again, we can never expect to move past them. Nothing good can come from reveling in sadness and pain; the only thing we could conceivably accomplish in this way is more pain.

In short, if we focus on depressing things, the only possible outcome is to feel depressed.

The antidote to depression, then, is not to focus on depressing things. This doesn't mean we should try to fool or distract ourselves from the pain; it means if we focus our efforts on other things—namely on bearing the Holy Cross that the Lord asks of us, the pain will eventually lessen into something manageable, and when it's manageable we'll be able to deal with it.

Our best medicine and first line of defense is prayer. If we struggle with depression, we certainly ought to pray for healing, but that's not the only blessing we need. More importantly, we need to pray for God's guidance as we search our souls, His mercy as we repent, His strength as we fight whatever destructive thoughts tempt us, His compassion to allow us to understand His will as much as we're able, and His help to fulfill our particular purpose for being here on this earth. If we pray for all of these things, we won't even need to pray for healing, because the healing will come automatically. This isn't to say that a life without depression will be free of hardship and suffering, but instead that a life without depression is both achievable and worth pursuing.

In our prayers, it's particularly important that we make the Sign of the Cross over ourselves. Some people never do this, and others do it in church but never at home, failing to understand the importance of it. We shouldn't look at crossing ourselves as a symbolic ritual or gesture, because it's so much more than that. When we cross ourselves during prayer, the Sign of the Cross involves our body in the prayer. If we make a prostration (bow) afterwards, we involve even more of our body in the prayer. Just as heartfelt prayer sanctifies the soul, and the name of the Lord Jesus Christ sanctifies the voice and lips, physical prayer sanctifies the body, joining it in prayer with the spirit. The body needs the benefits of prayer at all times, but the depressed body is sick and needs those benefits even more. This is one of the most powerful ways we can enlist God's help.

As much as prayer is important to the healing process, there's still more that we can do—and absolutely need to do—to help the process along its way. The following analogy will explain why.

In a patient's recovery after any kind of surgery, even if it's major, one of the most important things he can do is to get up and walk. The sooner he's able to push himself to walk, the faster he'll heal and the more problems and complications he'll prevent. Walking strengthens muscles, promotes good circulation and breathing, and improves the functioning of body systems that have slowed down as a result of the surgery. On the other hand, if he doesn't challenge himself by walking—even though it's difficult and perhaps painful, he's not going to heal as quickly or as well, and he could potentially create greater difficulties and more pain for himself. Without walking, his digestion will suffer, he'll lose muscle tone, his resistance to infections will decrease, his body will become weak, and he'll subject himself to everything from bed sores to life-threatening blood clots. The surgery may have saved his life, but his failure to push himself through the required steps of recovery could very well kill him in spite of it.

Recovery from a spiritual illness works the same way. The sooner we can push ourselves to become active, the better off we'll be. Two kinds of action are required here—physical and spiritual. Physical activity is important for the sake of the body, because depression takes an enormous toll on its physical health: Prolonged inactivity weakens it, and prolonged stress ravages and destroys it. That's why the best thing a depressed person can do is to get up and move. While any type of physical exercise is helpful to the body, the best kind is that which provides secondary benefits as well: Vacuuming, doing laundry, cutting the grass, shoveling snow, playing with children, walking the dog, or doing grocery shopping, just to name a few. These aren't physically demanding activities (although it shouldn't be a surprise if they present a daunting challenge to the depressed person), but they serve two important purposes. They get the body moving, which aids in the physical healing process, and, more importantly, they give the depressed person a sense of accomplishment, especially the one who's aware that he's been neglecting his responsibilities on account of his illness. Along with careful intervention to correct whatever faulty thoughts and ineffective behavior patterns are troubling him, and perhaps some medication to give his brain the chemical jump-start it needs, the depressed person will have taken on an active role in his recovery. Over time, baby steps will turn into larger steps, and larger steps will turn into a healthy life lived at a normal pace.

But that's still not enough. The other kind of activity that's required is spiritual. As important as physical activity is to the healing process, spiritual activity is even more important. But this doesn't mean spiritual activity in the way that many mental health workers, physicians, and practitioners of alternative medicine imply. Recognizing that spiritual activity is important, experts are starting to recommend things like meditation, hypnosis, guided imagery, "energy field" treatments such as reiki, and the like—but this kind of spirituality can only bring more harm to the depressed person. These kinds of spirituality are Godless; they work against the true needs of the soul. What the soul needs, sick or not, is the grace and mercy of the Lord Jesus Christ. What's needed, once again, is to bear one's cross. Let's conclude with the words of Saint Innocent of Alaska on what that means:

The first duty of a Christian, of a disciple and follower of Jesus Christ, is to deny oneself. To deny oneself means to give up one's bad habits, to root out of the heart all that ties us to the world; not to cherish bad desires and thoughts; to quench and suppress bad thoughts; to avoid occasions of sin; not to do or desire anything from self-love, but to do everything out of love for God. To deny oneself means, according to the Apostle Paul, to be dead to sin and the world but alive to God.

Through the prayers of Thy Most-Holy Mother and all the Saints: Lord Jesus Christ our God, teach us to bear our cross even as You did. Protect our thoughts from evil, our will from stubbornness, our days from negligence, our faith from assaults, and our spirit from languidity; and by the power of the Precious and Life-Giving Cross, have mercy on us and save us. Amen.