JUST the other day, a famous clergyman who also runs a mental health clinic at his church remarked that at least sixty per cent of the persons seeking his help suffer from mental depression. I am not surprised, for many of my acquaintances (AAs and non-AAs included) suffer from prolonged attacks of despondency and depression. Some of my AA friends frequently arrive at meetings in a state of silent rage, and often leave without showing much improvement.
Mental depression is a serious problem and often seems to defy understanding. But it can be overcome; it is a completely unnecessary evil that has no real place in a happy, normal way of life. It is as wrong to accept depression as being unavoidable as it would be to say that there is no way out of a drinking problem. Depression problems can be conquered in the same way drinking is vanquished--through a persistent and determined application of AA principles.
At this point I can sense the tortured skepticism of the individual who has tried and tried to eliminate depression, only to have the problem return again like a bad penny. I speak from experience, however, for mental depression has been one of my most besetting problems and it plagued me throughout nine successive years of sobriety in AA! In 1959, it began to lift, and in the past few years it has been practically nonexistent. Perhaps in this article I can share with others some of the thoughts I've developed on the subject out of my own experience.
One belief I have about depression and all other states of mind is that they obey a law of "cause and effect." Early in my AA experience, a speaker explained this law at an AA meeting in connection with his own drinking and thinking problems: "For every cause there is an effect and for every effect there is a cause." For the alcoholic, this means that his drinking grows out of certain causes within himself; he cannot escape responsibility for his condition by attributing it to a quirk of fate or a whim of Providence.
I believe acceptance of "cause and effect" helped me to come to terms with drinking. It seemed a cruel law, but by working with it I found complete liberation from drinking.
Then periodic attacks of depression began, and at this point "cause and effect" seemed to mock me. What were the real causes of these effects that seemed almost as soul-destroying as drinking had been? Why weren't my attempts to follow AA principles doing something about these frightful periods of self-loathing and despair? Was this a form of penance which God had laid upon me as punishment for all my years of debauchery? Was the AA program too narrow and too limited to embrace this condition as well as drinking? Had I been saved from one evil only to perish in another?
On countless occasions I sank into an almost suicidal frame of mind, and at times the pain was all but unendurable. Perhaps the greatest pain of all came from the hidden fear that there was no way out of this problem.
I wish I could say that my AA friends gave me a great deal of help and understanding during this ordeal, but the truth is that only a few did. Advice such as "cheer up" or "things will get better tomorrow" is of little benefit; I already knew that I would probably "cheer up" and "get better tomorrow," but what distressed me was the inability to get better and stay that way.
An individual also finds little assistance from those members who tend to blanket every problem under a generality such as, "You must not be following the program in its entirety or you wouldn't have this problem." Such a remark still makes me shudder. It may be true, but it leaves so much unsaid, and it doesn't help the individual find the answers he seeks so desperately.
But there are some in AA who have suffered deeply from this problem and understand it from personal experience. The dictum "seek and ye shall find" seems to apply here. Don't try to hide your problem, and from time to time you'll meet a person who can help you with it. Nor is it anything to feel guilty about, nobody has ever proved that the depressed person is failing to "follow the AA program in its entirety." Like most of us, he is probably doing the best with the AA program that he is able to do at the moment, but his illness may be pretty deep-seated. He may be climbing out of a deeper pit than those pits his fellows have occupied.
It is hardly surprising that alcoholics develop problems with depression after cessation of drinking. A dictionary definition of the depressed state is "dejected, dispirited, a lowering of the spirits, being weighed down." The depressed person is overloaded, carrying heavy burdens which bear down upon him. One way out is through drinking, but this dubious escape route leads only to the inferno of alcoholism. Once in AA, the recovering alcoholic must somehow survive bouts of depression without returning to the bottle. But he should not be alarmed when depression comes, for this malady was probably with him to a certain extent before he ever became a problem drinker. His condition is similar to that of the individual who has been indulging himself in a potent pain-killer in order to mask the agony of an abscessed tooth. If he stops using the pain-killer, his toothache is back, sharper than ever.
The real solution is to remove the causes of pain, not merely to mask them. This is easy to do in the case of an aching tooth; it is much more difficult with the deep pain of depression. A possible way of accomplishing this is to apply the AA principles directly to the problem of depression as well as to alcoholism. The need for this seeming duplication of effort is easy to understand after such a program has been started. We have to work on the specific problems that are troubling us, and if we seem to have additional problems after we have learned how to remain sober, then we should make these problems our specific targets. It is only in this way that we can find the mature, happy sobriety that so many AAs seek.
The AA Twelve Step program of recovery is sometimes reduced to four phases, for convenient discussion at meetings. These phases are: Admission, Inventory. Spiritual Realization, and Service (helping others). How can these phases be applied to mental depression?
The Admission phase is first, of course, just as it is with drinking. And it may come as a surprise that this may be a very difficult step for a person to take even after he has successfully passed the hurdle of being able to admit that he is powerless over alcohol. Persistent pride has a way of plaguing us in sobriety no less than it did in drinking, and sometimes it is extremely difficult for an AA member of long standing to admit that depression is bothering him. After all, we sometimes make such a ritual of proclaiming our serenity that this may lead a person to believe that if he is depressed there must be something that he's doing wrong. But even that thought is depressing to one who has been trying hard, so it is tempting at this point to say nothing about the problem and to hope that it will go away in time.
It's hardly likely to go away, however, unless some definite action is taken; remember, we are dealing with cause and effect. So it is important to admit the problem to ourselves and to at least one understanding and sympathetic person. (This understanding person may well be a psychiatrist, if the individual can find one whom he trusts and respects. Seeking psychiatric help is not an indictment of an individual's working of the AA program; if anything, professional counseling may be just what some of us need for complete recovery.)
In any case, it's a great relief simply to tell somebody about a matter that has been secretly troubling us. This usually has the effect of making the problem less frightening right away, just as alcohol loses its power to terrorize us when we take the big step of admitting that we are alcoholics.
The next phase is to take a personal inventory, with an eye towards searching out the defects that make us depressed. Resentment, self-pity, and jealousy are likely to be there, along with pride, excessive ambition and sex problems.
Do these character defects fuel the fires of depression? Very likely, for they seem to be present in one form or another in most depression. Yet it's possible to work unsuccessfully for years trying to eliminate such defects, and some people seem to have many of these shortcomings without also being depressed.
It is also possible, strange as it may seem, that a person can plunge himself into considerable depression and self-loathing over his failure to measure up to certain high moral standards. He may be condemning himself, in sobriety, for moral lapses that hardly rated a moment's notice during his drinking escapades. If so, he has lost perspective, for no AA member has been assigned the task of achieving sainthood in order to enjoy a modicum of happiness.
If we are wearing the hair shirt of self-condemnation because of our human imperfections, it is well to review this statement in the book Alcoholics Anonymous: "We are not saints. The point is, that we are willing to grow along spiritual lines. The principles we have set down are guides to progress. We claim spiritual progress rather than spiritual perfection."
This brings us to AA's third phase: Spiritual Realization. Here we have the ultimate answer to depression as well as all human problems. If we can receive and maintain a spiritual awakening, our mental depression must lift. Indeed, depression itself is defined as a state of being "dispirited." Therefore, to have a true spiritual awakening is to acquire the riches of the spirit that we sought vainly in the bottle.
Why is it difficult to receive such an awakening? Theologians constantly tell us that God is seeking man even more than man seeks God; if this be the case, why don't most of us live in perpetual joy once we have concluded that God exists and is interested in our welfare?
One reason for our slow progress in developing spiritual realization may be a chronic sense of guilt; we may suppose that our personal shortcomings and sins bar us from God's grace. But if this were so, no man could approach God, for we are told that all have sinned and come short of His glory. Therefore, a knowledge of personal faults is all the more reason why one should seek spiritual growth as speedily as possible.
Another barrier to spiritual progress may be the individual's fear of knowing God's will. One man voiced the fear that God might command him to leave his wife and children and go to Africa as a missionary. Another was afraid he would be made to resign his position and accept a menial job elsewhere. Many others have thought that doing God's will means being subjected to ridicule, drudgery and poverty.
All this is silly, and even a bit tragic. If we believe that God exists, that He created the heavens and the earth, and is Absolute Good at every point, then we have nothing at all to fear in accepting His will completely in everything. God comes into our lives only for good, and if His guidance eventually leads us into actions that appear difficult or impossible now, we will be prepared and strengthened for these actions when it is time for them.
We may also suffer dejection because we believe God is "testing" us or "punishing" us. But God has no need to "test" us, for He knows our capabilities instantly. As for punishment, the worst kind is that which we administer to ourselves in our own minds. As quickly as possible, we must move into a belief that we can receive God's love, protection and care, with complete abandon. Then we will be truly rich in spirit--and certainly no longer depressed.
The fourth phase of AA is to serve others, and it is also the way of our own recovery. We are fortunate that the pioneer AAs discovered the power of helping others, without it AA could not have survived, and few of us would have recovered.
It has been our experience that an individual reduces the tyranny of self-centeredness in his own life when he helps others and becomes interested in their welfare. There is an old axiom that feeling follows action. Applied to AA activity, this means that a person who acts by becoming involved in helping others will soon come to feel interested in those he is assisting. There is nothing wrong in helping others in order to help oneself; AA's entire operating premise has always been that we give because we have a need to give, not because we are especially good or highly dedicated.
In my own experience of exploring the cause and effect of depression, I believe that learning to apply spiritual principles to pride, ambition and fear has turned the tide. At the same time, however, I had to apply the brakes to self-condemnation, for there is no advantage in looking at pride and other defects and swinging from there to a condition of self-belittlement. Self-criticism is a liability if it is excessive; we must remove the defects from our lives without running the knife of self-probing any deeper than it needs to go.
How do you know if you're winning the battle against depression? The chief symptoms in my case were noticeable changes in attitude and feeling. Conditions that often caused me despair no longer had the power to hurt, and I became aware of a power to shut off a depressed state in its early stages. This improvement is a day-at-a-time activity, and we overcome depression for all time by conquering it today. We cannot wait for somebody or something in the future to remove our depression, for if we are unable to find happiness here and now, it is hardly likely we can find it anywhere.
There is no virtue in depression, nobody is helped by it, and it is destructive, not creative. It is a completely unnecessary evil that should not be allowed to coexist with the wonderful things we have in Alcoholics Anonymous. It can be beaten.
M. D. B.