What Judaism Tells you Аbout Clinical Depression?

“We Americans are insane. Eleven p.m. every night, we snuggle up, ready for bed, and what’s the last thing we do? We switch on the evening news. Thirty minutes of murder, brutality, corruption, catastrophe, moral lunacy, sports and weather. Good night. And then in the morning we are awakened by a clock radio set to some news station. And we begin the day with…murder, brutality, corruption, catastrophe, moral lunacy, sports and weather. And you want to know why you’re depressed?”

Rabbi Ed Feinstein

Depression in Torah

While the Torah does not address depression directly, it does refer to the state of being man or woman should exist in. A person should not be so troubled and despondent that they are incapable of feeling their connection to the divine. By extension, medicine that aids the body and the mind to find succor and to function is important, but not if the medicine so obliterates the pain and connection to reality that they cannot experience the wonder of the divine. In other words, some sadness is natural, but when depression is a medical condition and creates an inability to function, seeking medical help is advised.

Judaism doesn’t work like a drug that blots out pain. Judaism acknowledges the reality of sorrow in this world. The Bible itself offers poignant examples of depressed individuals. Saul, the first king of Israel, suffers excruciating fits of melancholy. He loves his protégé, David, but is also desperately jealous of him, and he fears the people around him are plotting against him. Periodically he sinks into black despair and fits of rage.

King Saul got some relief from melancholy when David played his harp. This story is interpreted as evidence that external measure – including therapy, medication, physical exercise, making art or listening to music – can help to alleviate the pain of depression.

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Elijah, the lonely prophet of the book of First Kings, is rejected by his society and feels that his work has been a failure. At the lowest point of his life he flees into the wilderness, sits down under a tree and prays for his own death. “Enough!” he cries. “Please, G-d, take my life, for I am no better than my fathers” [1 Ki.19:4].

Jonah, another misunderstood prophet, is frustrated with God and humanity alike; he, too, begs G-d to take his life and put him out of his misery. And the Book of Psalms, the most personal book in the Bible, expresses the full range of human despair at the sorrows of this world.

Historical Perspectives

Jews come from a tradition that doesn’t encourage escapism. It forces them to acknowledge the pain, injustice and strife all around, and simultaneously cultivates an intense yearning for justice, goodness and peace. Since the World around is far from being perfect, this combination inevitably produces dissatisfaction with the world. Dissatisfaction is a necessary religious trait for Jews. It’s the engine that motivates them to want to change the world and make it better.

However, while dissatisfaction with the world is essential to a Jewish life, sadness and depression are not. In fact, our tradition sees sadness as the enemy of the good life, the very antithesis of the life Judaism tries to bring about. The Torah itself commands happiness; it is a religious obligation for Jews, as stated in the book of Deuteronomy: “You shall rejoice in all the good that G-d has given you” [Dt.26:11].

In 12th century Spain, Yehudah Halevi taught: “It is not in accordance with the spirit of the Torah to worry and feel anguish throughout one’s life; one who does so transgresses God’s commandment to be content with what you have been given…” In the 19th century, Rabbi Samson Raphael Hirsch wrote that “Judaism never considered pain, sorrow, self-affliction or sadness to be valid goals. The opposite is true – one should pursue happiness, bliss, cheer, joy and delight.” And Rabbi Nachman of Bratzlav who, you’ll recall, struggled all his life with depression, is famous among Hasidim for his great teaching: “Mitzvah gedolah lihiyot b’simcha tamid – it is a great mitzvah to be ever joyful, and to overcome feelings of sorrow and melancholy” [Likkutei Etzot, Joy 30].

Jewish tradition endorses modern therapeutic techniques such as cognitive behavioral therapy, which is based on the idea that overcoming negative patterns of thought can alter the way we feel and act. Jewish ethical writing, starting in the middle ages, argues that we need not be victims of our emotions, but can discipline ourselves to acquire positive attitudes and feelings. In fact, the Baal Shem Tov, the founder of Hasidism, pointed out that if we rearrange the letters of the Hebrew word for “thought” – machshavah – we get the word “b’simcha – with joy,” teaching us that we can often combat depression by changing the way we think.

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Depression Types

A certain amount of depression in life is natural when depression refers to the sadness and anxiety associated with living. Mourning, for example, is a time when the heart and the mind can be depressed. In Judaism, rituals for observing death and mourning such as sitting shiva for the departed help assuage grief. Judaism's extended community also creates a very real support system that is vital for overcoming the psychological wear and tear of loneliness, depression and anxiety.

Depression Sources

A common source of unhappiness is unachieved goals. This can lead to low self esteem which may doom one to more failures, further erosion of self esteem, causing a downward spiral into the abyss of sorrow. One can prevent this vicious cycle by setting realistic goals from the outset. If sadness has already settled in, one can stop the snowball effect by setting short-term, easy goals that bolster ones confidence and in turn empower one to achieve longer-term, more significant goals. This will initiate an upward spiral to level ground.

Another source of sorrow is feeling that we don’t have everything we want. On this our Sages taught, "Who is truly wealthy? One, who is content with his portion." A poor man once complained to the Maggid of Mezritch about his poverty. The Maggid sent him to Rebbe Zusha of Anipoli for advice. Rebbe Zusha, who himself suffered dire poverty and poor health, questioned in all sincerity, "I don’t know why the Maggid sent you to me, I’ve got everything I need".

Also, we often get depressed about bad things that happen. Contemplating the good in the bad helps mitigate ones melancholy. King David’s son Avshalom rebelled against him, forcing him to flee: "David ascended the Mount of Olives, weeping as he went" (II Samuel 15:30). Nevertheless, David concluded that it’s better the rebel be his son because another man would have killed him. In the end, not only did he not despair, he began to sing: "A psalm of David when he fled from Avshalom his son" (Psalms 3:1).

Finally, one must realize that everything is from G-d for the ultimate good. An observer unfamiliar with surgery would consider it a most terrible act. The surgeon however understands it’s for the patients good, sometimes saving his life. Ultimately there can always be a sudden turn-around. Abraham and Sara suffered being barren for a long time until unexpectedly they were blessed with a child who fathered the entire Jewish nation.

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Judaism and Anti-depressants

Some medications that treat depression can influence a person's ability to experience emotions naturally. According to more conservative traditional views, if a person subsists on medication that inhibits their connection to G-d, then he or she should discontinue. Someone who was taking anti-depressants asked since while depressed he used to pray with tears but now the medication makes it harder for him to feel the same connection to G-d, perhaps he should stop taking the medicine. Rabbeinu Yonah (Spain, 1200-1263) addressed this issue some 800 years ago: "Although there is a beneficial aspect to sadness it prevents people from becoming overly joyous over the pleasures of this world nevertheless one should not pursue the state of sadness, since it is a physical disease. When a person is despondent, he is not able to serve his Creator properly." While it is admirable that this person initially used his depression to feel close to G-d, clearly G-d prefers that he face the new challenge of finding spirituality as a healthy person. The medicines the rabbi likely referred to involved hallucinogens, opiates and other medicines designed to disconnect mind and body and not pharmaceutical medications to treat clinical depression.

The modern position on the anti-depressants use is clear: If your doctor is reliable and he/she has prescribed anti-depressants, you should certainly take them. Modern Judaism accepts the point of view that depression is like any other illness and needs to be treated with the correct medication. A person suffering clinical depression needs competent treatment. It is wrong to tell him “Just pull yourself together,” just as it would be cruel to tell a drowning person “Just pull yourself together.” This is adding insult to injury.

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